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Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm - A Review
S Singh1, C L Tan1, A R Ahmad1
1Department of Orthopaedics, International Medical University, Seremban, Malaysia.
Abstract:
Osteomyelitis is a chronic infection of bones. Eradication of bone infection is usually with antibiotics and debridement, but it is slow and the infection can recur even after many years. It is now established that osteomyelitis is due to biofilm and a better understanding of the process is required. We review the development of biofilm and apply it to osteomyelitis management. The planktonic microbes' response to adverse conditions is the formation of biofilm. Bacterial infections in planktonic forms cause infections that can be controlled with antibiotics and immunisation, however the same microbe when its phenotype becomes biofilm is more resilient. The understanding of how planktonic bacteria convert to biofilm is one of the aims set out for this article.
Insights
Osteomyelitis, a persistent bone infection, is caused by resilient bacterial biofilms. Understanding biofilm development is crucial for improving treatment strategies and preventing infection recurrence.
Area of Science:
- Microbiology
- Infectious Diseases
- Biomedical Engineering
Background:
- Osteomyelitis is a chronic bone infection often resistant to conventional treatments.
- Recurrence is common even after prolonged antibiotic therapy and surgical debridement.
- Bacterial biofilms are increasingly recognized as the primary cause of persistent osteomyelitis.
Purpose of the Study:
- To review the process of bacterial biofilm development.
- To apply this understanding to the management of osteomyelitis.
- To elucidate the mechanisms by which planktonic bacteria transition to a biofilm phenotype.
Main Methods:
- Literature review on bacterial biofilm formation.
- Analysis of biofilm characteristics in the context of osteomyelitis.
- Discussion of current and potential therapeutic strategies targeting biofilms.
Main Results:
- Biofilm formation is a survival mechanism for bacteria under adverse conditions.
- Biofilm-embedded bacteria exhibit significantly increased resistance to antibiotics and host immune responses.
- Understanding the planktonic-to-biofilm transition is key to developing effective treatments.
Conclusions:
- Effective osteomyelitis management requires addressing the underlying biofilm.
- Further research into biofilm development mechanisms can lead to novel therapeutic interventions.
- Targeting biofilm formation presents a promising strategy to improve patient outcomes and reduce infection recurrence.
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