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Hydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materials

dc.contributor.authorParker, Dana M.en
dc.contributor.authorKoch, John A.en
dc.contributor.authorGish, Charles G.en
dc.contributor.authorBrothers, Kimberly M.en
dc.contributor.authorLi, Williamen
dc.contributor.authorGilbertie, Jessicaen
dc.contributor.authorRowe, Sarah E.en
dc.contributor.authorConlon, Brian P.en
dc.contributor.authorByrapogu, Venkata K. C.en
dc.contributor.authorUrish, Kenneth L.en
dc.date.accessioned2023-06-27T17:25:19Zen
dc.date.available2023-06-27T17:25:19Zen
dc.date.issued2023-05-23en
dc.date.updated2023-06-27T13:21:38Zen
dc.description.abstractHydrogen peroxide, povidone-iodine, and chlorhexidine are antiseptics that are commonly added to irrigants to either prevent or treat infection. There are little clinical data available that demonstrate efficacy of adding antiseptics to irrigants in the treatment of periprosthetic joint infection after biofilm establishment. The objective of the study was to assess the bactericidal activity of the antiseptics on <i>S. aureus</i> planktonic and biofilm. For planktonic irrigation, <i>S. aureus</i> was exposed to different concentrations of antiseptics. <i>S. aureus</i> biofilm was developed by submerging a Kirschner wire into normalized bacteria and allowing it to grow for forty-eight hours. The Kirschner wire was then treated with irrigation solutions and plated for CFU analysis. Hydrogen peroxide, povidone-iodine, and chlorhexidine were bactericidal against planktonic bacteria with over a 3 log reduction (<i>p</i> &lt; 0.0001). Unlike cefazolin, the antiseptics were not bactericidal (less than 3 log reduction) against biofilm bacteria but did have a statistical reduction in biofilm as compared to the initial time point (<i>p</i> &lt; 0.0001). As compared to cefazolin treatment alone, the addition of hydrogen peroxide or povidone-iodine to cefazolin treatment only additionally reduced the biofilm burden by less than 1 log. The antiseptics demonstrated bactericidal properties with planktonic <i>S. aureus</i>; however, when used to irrigate <i>S. aureus</i> biofilms, these antiseptics were unable to decrease biofilm mass below a 3 log reduction, suggesting that <i>S. aureus</i> biofilm has a tolerance to antiseptics. This information should be considered when considering antibiotic tolerance in established <i>S. aureus</i> biofilm treatment.en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationParker, D.M.; Koch, J.A.; Gish, C.G.; Brothers, K.M.; Li, W.; Gilbertie, J.; Rowe, S.E.; Conlon, B.P.; Byrapogu, V.K.C.; Urish, K.L. Hydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materials. Life 2023, 13, 1230.en
dc.identifier.doihttps://doi.org/10.3390/life13061230en
dc.identifier.urihttp://hdl.handle.net/10919/115521en
dc.language.isoenen
dc.publisherMDPIen
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectantibiotic toleranceen
dc.subjectbiofilmen
dc.subjectperiprosthetic joint infectionen
dc.subjectoxidative stressen
dc.subjectsurgical infectionen
dc.titleHydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materialsen
dc.title.serialLifeen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten

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