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Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
Low-Virulence Organisms and Periprosthetic Joint Infection-Biofilm Considerations of These Organisms
K Keely Boyle1, Stuart Wood2, T David Tarity3
1Department of Orthopaedics, Erie County Medical Center, State University of New York at Buffalo, 462 Grider, Street, Buffalo, NY, 14215, USA. kkboyle@buffalo.edu.
Purpose Of Review:
The purpose of this manuscript is to provide a critical review of peer-reviewed literature over the last 5 years related to low virulent organisms associated with periprosthetic joint infection (PJI). We evaluated the most common organisms, the diagnostic challenges, and the novel tools available in the perioperative workup of PJI as well as the current understanding of how biofilm potentiates the indolent clinical presentation and explore a possible shift in the surgical management of these patients.
Recent Findings:
Biofilm actively prevents macrophage phagocytosis by suppressing proinflammatory activity through the recruitment of myeloid-derived suppressor cells. Given the appropriate host and organism conditions, increased utilization of one-stage exchange arthroplasty in the surgical treatment of these low virulent infections may be on the rise. Biomarkers and molecular techniques offer encouraging results to diagnose low virulent organisms and future research focused on the disruption of biofilm may ultimately give rise to improved treatment strategies.
Insights
Low virulent organisms in periprosthetic joint infection (PJI) are challenging to diagnose. Biofilm formation complicates treatment, but new biomarkers and surgical approaches like one-stage exchange arthroplasty show promise.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biomaterials Science
Background:
- Periprosthetic joint infection (PJI) poses significant challenges in orthopedic surgery.
- Low virulent organisms often cause indolent infections, making diagnosis difficult.
- Biofilm formation is a key factor in the persistence and challenging management of PJI.
Purpose of the Study:
- To critically review recent literature (last 5 years) on low virulent organisms in PJI.
- To examine diagnostic challenges and novel tools for perioperative workup.
- To explore the role of biofilm and potential shifts in surgical management.
Main Methods:
- Comprehensive literature review of peer-reviewed articles.
- Analysis of diagnostic techniques and biomarkers for low virulent pathogens.
- Evaluation of the impact of biofilm on PJI pathogenesis and clinical presentation.
Main Results:
- Biofilm suppresses host immune response by inhibiting macrophage phagocytosis via myeloid-derived suppressor cells.
- One-stage exchange arthroplasty may see increased use for treating these indolent infections.
- Biomarkers and molecular techniques show promise for diagnosing low virulent organisms.
Conclusions:
- Understanding biofilm's role is crucial for managing PJI caused by low virulent organisms.
- Novel diagnostic tools and surgical strategies, including one-stage exchange, are emerging.
- Future research targeting biofilm disruption could lead to improved PJI treatment outcomes.
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