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Updated: Oct 6, 2025
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
In vitro effect of synovial fluid from patients undergoing arthroplasty surgery on MRSA biofilm formation
Narayan Pant1, Steven C Wallis2, Jason A Roberts2,3,4
1College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
Background:
Bacterial biofilm is a key component in the pathogenesis of prosthetic joint infection (PJI). Synovial fluid has been shown to have inhibitory activity against planktonic bacteria. However, the contribution of synovial fluid in prevention of Staphylococcus aureus (including MRSA) planktonic and biofilm forms is unknown.
Objectives:
To test the antibacterial and antibiofilm activities of synovial fluid, including that containing cefazolin, against MSSA and MRSA.
Materials And Methods:
We determined the antiplanktonic and antibiofilm activities of synovial fluid collected from patients given preoperative cefazolin while undergoing elective arthroplasty surgery. MICs of cefazolin were determined for planktonic and biofilm cultures of biofilm-forming strains of MSSA and MRSA.
Results:
Synovial fluid inhibited planktonic and biofilm cultures of MSSA and MRSA. Cefazolin-containing synovial fluid had greater antibacterial and antibiofilm activities than the same cefazolin concentration in glucose LB (GLB) broth. MSSA and MRSA MICs of cefazolin suspended in synovial fluid were 0.7 mg/L. The MICs of cefazolin diluted in GLB broth were higher, measuring 1.4 mg/L for MSSA and 23 mg/L for MRSA.
Conclusions:
Synovial fluid containing cefazolin inhibited biofilm- and planktonic-state MRSA cultures. This may explain the apparent effect of cefazolin in the prevention of MRSA PJI.
Insights
Synovial fluid effectively inhibits both planktonic and biofilm Staphylococcus aureus (including MRSA) growth. Cefazolin in synovial fluid shows enhanced antibacterial and antibiofilm activity, potentially aiding in prosthetic joint infection prevention.
Area of Science:
- Microbiology
- Infectious Diseases
- Biochemistry
Background:
- Bacterial biofilm formation is crucial in prosthetic joint infection (PJI) pathogenesis.
- Synovial fluid exhibits inhibitory effects against planktonic bacteria.
- The role of synovial fluid in preventing Staphylococcus aureus (including MRSA) planktonic and biofilm forms remains unclear.
Purpose of the Study:
- To evaluate the antibacterial and antibiofilm properties of synovial fluid against MSSA and MRSA.
- To assess the activity of cefazolin-containing synovial fluid against MSSA and MRSA.
Main Methods:
- Determined antiplanktonic and antibiofilm activities of synovial fluid from patients receiving preoperative cefazolin.
- Measured minimum inhibitory concentrations (MICs) of cefazolin for planktonic and biofilm cultures of MSSA and MRSA.
Main Results:
- Synovial fluid demonstrated inhibitory activity against both planktonic and biofilm MSSA and MRSA.
- Cefazolin in synovial fluid exhibited superior antibacterial and antibiofilm efficacy compared to cefazolin in glucose LB broth.
- MICs of cefazolin in synovial fluid were 0.7 mg/L for both MSSA and MRSA, significantly lower than in GLB broth (1.4 mg/L for MSSA, 23 mg/L for MRSA).
Conclusions:
- Synovial fluid with cefazolin effectively inhibits MRSA in both planktonic and biofilm states.
- This finding suggests a mechanism for cefazolin's efficacy in preventing MRSA PJI.
