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Does dithiothreitol improve bacterial detection from infected prostheses? A pilot study.
Lorenzo Drago1, Carlo Luca Romanò, Roberto Mattina
1Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Institute, 20161, Milan, Italy. lorenzo.drago@unimi.it
Clinical Orthopaedics and Related Research
|June 15, 2012
Summary
Dithiothreitol (DTT) effectively removes biofilm bacteria from prosthetic devices, offering a viable alternative to sonication for improved diagnosis of infections. This method enhances bacterial detection in clinical settings.
Area of Science:
- Biomedical Engineering
- Microbiology
- Infectious Diseases
Background:
- Diagnosing prosthetic infections often involves sonication and scraping to enhance bacterial detection and reduce false negatives.
- Chemical methods targeting biofilm disruption can potentially increase detection rates.
Purpose of the Study:
- To evaluate if dithiothreitol (DTT) and N-acetylcysteine (NAC) can remove bacteria from prosthetic biofilms.
- To determine the impact of DTT and NAC concentrations and incubation times on bacterial recovery.
- To compare the efficacy of DTT and NAC in detaching bacteria from biofilms against sonication and scraping.
- To assess the reproducibility of these bacterial detachment methods.
Main Methods:
- Polyethylene and titanium discs with biofilms of Pseudomonas aeruginosa and Staphylococcus aureus were treated with varying concentrations and incubation times of DTT and NAC.
- Colony counts were compared for Staphylococcus aureus, Pseudomonas aeruginosa, Staphylococcus epidermidis, and Escherichia coli following treatments with NAC, DTT, sonication, and scraping.
- Reproducibility was assessed by analyzing biofilm detachment from multiple discs over consecutive days.
Main Results:
- Treatment with 1 g/L DTT for 15 minutes yielded mean colony counts (5.3 LogCFU/mL) comparable to sonication (4.9 LogCFU/mL).
- DTT and sonication demonstrated superior bacterial detachment compared to scraping (3.4 LogCFU/mL) and 2 g/L NAC treatment for 30 minutes (1.9 LogCFU/mL).
- Both DTT and sonication exhibited good reproducibility in detaching bacteria from biofilms.
Conclusions:
- Dithiothreitol (DTT) presents a promising alternative to sonication for improving the detection of biofilm-associated bacteria on prosthetic devices.
- DTT treatment can supplement conventional laboratory culturing techniques for diagnosing periprosthetic infections.
- These findings support the use of chemical agents like DTT to enhance diagnostic accuracy in prosthetic joint infections.
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