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Updated: Aug 25, 2026
A Periprosthetic Joint Candida albicans Infection Model in Mouse
Published on: February 2, 2024
Pathogenesis of prosthesis-related infection
Jirí Gallo1, Milan Kolár, Radek Novotný
1Department of Orthopaedic Surgery, Faculty of Medicine, Palacký University, 775 15 Olomouc, Czech Republic.
Abstract:
In spite of its incidence decreasing to 1% nowadays, prosthesis-related infection remains a research, diagnostic, therapeutic and cost-related problem. It can be defined as a presence of bacteria in the artificial joint space, which is significantly associated with evident laboratory and/or tissue markers, and clinical signs of running infection. We believe that the more precise understanding of pathogenesis, the more effective preventative and therapeutic measures, and the lower infection rate. The implants are colonized by airborne, skin-, and/ or surgeon-related bacteria during surgery despite being operated in closely respected operating regime. Some prosthetic characteristics are advantageous and may play important roles in the process of bacterial adherence. After successful attachment on the biomaterial surface bacteria multiply and physiologically transform into a "biofilm" community, making them much more resistant to antibiotic therapy and host immunity. Bacterial resistance is a complex phenomenon influenced by intrinsic and extrinsic factors, including the cell configuration in the biofilm community. So the cure of periprosthetic sepsis without removing of all foreign bodies and necrotic bone fragments is often ineffective. Acute hematogenous sepsis is suggestive of a distortion of a previously aseptic joint space by invasion of bacteria through the vessels.
Insights
Prosthesis-related infections, though rare, pose significant challenges. Understanding bacterial biofilm formation on implants is key to developing better treatments and reducing infection rates.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biomaterials Science
Background:
- Prosthesis-related infection is a persistent clinical challenge, despite decreasing incidence.
- Infection involves bacterial presence in artificial joint spaces, indicated by clinical and laboratory markers.
- Understanding pathogenesis is crucial for improved prevention and treatment strategies.
Purpose of the Study:
- To elucidate the pathogenesis of prosthesis-related infections.
- To identify factors contributing to bacterial adherence and biofilm formation on implants.
- To inform the development of more effective preventative and therapeutic measures.
Main Methods:
- Review of existing literature on prosthesis-related infections.
- Analysis of bacterial colonization mechanisms on biomaterial surfaces.
- Examination of factors influencing bacterial resistance within biofilms.
Main Results:
- Implants can be colonized by bacteria during surgery despite sterile protocols.
- Bacterial adherence to prosthetic surfaces is facilitated by certain implant characteristics.
- Biofilm formation significantly increases bacterial resistance to antibiotics and host immunity.
- Effective treatment often requires removal of implants and infected tissue.
Conclusions:
- Bacterial biofilm formation on prosthetic implants is a primary driver of treatment resistance.
- Targeting biofilm development and enhancing host immune response are critical for future interventions.
- Further research into pathogenesis will lead to reduced infection rates and improved patient outcomes.
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