Biofilms-What Should the Orthopedic Surgeon know?
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Published on: December 27, 2016
Mandeep Singh Dhillon1, Aman Hooda2, Thomas Fintan Moriarty3
1Foot & Ankle Biomechanics, Experimentation and Research Laboratory, Department of Orthopedics, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Background:
Musculoskeletal infections are a major source of morbidity for orthopedic and trauma patients, are associated with prolonged treatment times, and, unfortunately, suffer from poor functional outcomes. Further complicating the issue, antimicrobial resistance (AMR) is increasingly impacting the treatment of musculoskeletal infections with a diminishing repertoire of effective antibiotic agents for some highly resistant pathogens. Most orthopedic surgical procedures involve implants, and the formation of bacterial biofilms on these implants is now recognized as a major factor contributing to the failure of antibiotic therapy in orthopedic surgery.
Methods:
This review presents an overview of the types, structure, formation, and pathogenesis of biofilms as they pertain to musculoskeletal infections. Furthermore, it describes the key concepts in the management of biofilms and future perspectives for the better treatment of patients with biofilm-related musculoskeletal infections.
Results:
A bacterial biofilm is a dynamic, living conglomerate of bacteria encased in an extracapsular polysaccharide matrix (EPS). Biofilms are a natural mode of survival for virtually all bacterial species, including both Grampositive and Gram-negative bacteria, as well as fungi. The biofilm model of growth confers resistance by several well-defined mechanisms regardless of the species of the microorganism. In most cases, biofilm management often necessitates radical measures to ensure eradication including both surgical and medical interventions.
Conclusions:
Orthopedic surgeons should be aware of the key concepts pertaining to biofilms, and the impact that these can have on clinical practice.
Insights
Bacterial biofilms on orthopedic implants complicate musculoskeletal infections, leading to treatment failure. Understanding biofilm formation and management is crucial for improving patient outcomes in orthopedic surgery.
Area of Science:
- Orthopedics
- Infectious Diseases
- Microbiology
Background:
- Musculoskeletal infections pose significant challenges in orthopedic and trauma care, leading to prolonged treatment and poor functional outcomes.
- Antimicrobial resistance (AMR) exacerbates treatment difficulties, limiting effective antibiotic options for resistant pathogens.
- Bacterial biofilm formation on orthopedic implants is a primary driver of antibiotic therapy failure in these infections.
Purpose of the Study:
- To review the characteristics, development, and disease mechanisms of biofilms in musculoskeletal infections.
- To outline key strategies for managing biofilms and explore future treatment approaches for biofilm-related infections.
Main Methods:
- Literature review focusing on biofilm types, structure, formation, and pathogenesis in musculoskeletal infections.
- Discussion of current biofilm management concepts and emerging therapeutic perspectives.
Main Results:
- Biofilms are resilient bacterial communities encased in an extracellular matrix, providing inherent resistance to antimicrobial agents.
- Both Gram-positive and Gram-negative bacteria, as well as fungi, can form biofilms, complicating treatment across various pathogens.
- Effective biofilm eradication often requires aggressive interventions, combining surgical and medical approaches.
Conclusions:
- Orthopedic surgeons must understand the fundamental principles of biofilm formation and its clinical implications.
- Awareness of biofilm-related challenges is essential for optimizing treatment strategies and improving patient care in orthopedic surgery.
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