Purpose: Hardware infections in orthopedic surgery, specifically those involving biofilm producing bacteria, are troublesome and are highly resistant to systemic antibiotics. The purpose of this study was to demonstrate the power of rifampin and vancomycin solutions in inhibiting as well as eliminating on staphylococcus aureus () biofilm on stainless-steel implants.

Methods: A suspension of either or a containing a plasmid that cods for the green fluorescence protein containing fluorescent protein plasmid was applied to 1 × 1cm sterile stainless steel orthopedic plating material (coupon). Biofilm development was confirmed by; the quantitative assay (colony forming unit [CFU/coupon]) and visualized using confocal laser scanning microscopy. With this established method of biofilm development, we determined the minimum biofilm inhibitory concentration (MBIC) and the minimum biofilm eradication concertation (MBEC) of Rifampicin and Vancomycin. To determine the MBIC, stainless steel plates were subjected to different concentrations of antibiotic solution and inoculated with overnight cultures of . After 24 h of incubation at 37 °C, the biofilms on the untreated and antibiotic-treated coupons were quantified. To determine the MBEC, partial biofilms were developed on the coupons and then treated with the different concentrations of each antibiotic for 24 h. The number of bacteria within the control untreated as well as treated coupons was determined.

Results: Both rifampin and vancomycin solutions inhibited biofilm production of on stainless steel mediums; the MBIC for rifampin and vancomycin were 80 ng/mL and 1 μg/mL respectively. The MBEC for Rifampicin was similar to the MBIC. However, the MBEC for Vancomycin was 6 mg/ml.

Conclusions: When applied to orthopedic stainless steel hardware , solutions of rifampin and vancomycin powder separately or in combination can completely prevent and eliminate biofilm produced by .

Level Of Evidence: II.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977531PMC
http://dx.doi.org/10.1016/j.jcot.2019.10.002DOI Listing

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