Staphylococcal persistence due to biofilm formation in synovial fluid containing prophylactic cefazolin.
Publication/Presentation Date
4-1-2015
Abstract
Antibiotic prophylaxis is standard for patients undergoing surgical procedures, yet despite the wide use of antibiotics, breakthrough infections still occur. In the setting of total joint arthroplasty, such infections can be devastating. Recent findings have shown that synovial fluid causes marked staphylococcal aggregation, which can confer antibiotic insensitivity. We therefore asked in this study whether clinical samples of synovial fluid that contain preoperative prophylactic antibiotics can successfully eradicate a bacterial challenge by pertinent bacterial species. This study demonstrates that preoperative prophylaxis with cefazolin results in high antibiotic levels. Furthermore, we show that even with antibiotic concentrations that far exceed the expected bactericidal levels, Staphylococcus aureus bacteria added to the synovial fluid samples are not eradicated and are able to colonize model implant surfaces, i.e., titanium pins. Based on these studies, we suggest that current prophylactic antibiotic choices, despite high penetration into the synovial fluid, may need to be reexamined.
Volume
59
Issue
4
First Page
2122
Last Page
2128
ISSN
1098-6596
Published In/Presented At
Dastgheyb, S. S., Hammoud, S., Ketonis, C., Liu, A. Y., Fitzgerald, K., Parvizi, J., Purtill, J., Ciccotti, M., Shapiro, I. M., Otto, M., & Hickok, N. J. (2015). Staphylococcal persistence due to biofilm formation in synovial fluid containing prophylactic cefazolin. Antimicrobial agents and chemotherapy, 59(4), 2122–2128. https://doi.org/10.1128/AAC.04579-14
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
25624333
Department(s)
Administration and Leadership
Document Type
Article