Nanoparticle ultrasonication: a promising approach for reducing bacterial biofilm in total joint infection—an in vivo rat model investigation

Abstract Background While the benefits of sonication for improving periprosthetic joint infection (PJI) are well-documented, its potential therapeutic effect against bacterial biofilm remains unstudied. This study aimed to investigate the safety and efficacy of a novel nanoparticle ultrasonication p...

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Main Authors: Itay Ashkenazi, Mark Longwell, Barbara Byers, Rachael Kreft, Roi Ramot, Muhammad A. Haider, Yair Ramot, Ran Schwarzkopf
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Arthroplasty
Subjects:
Online Access:https://doi.org/10.1186/s42836-024-00279-7
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author Itay Ashkenazi
Mark Longwell
Barbara Byers
Rachael Kreft
Roi Ramot
Muhammad A. Haider
Yair Ramot
Ran Schwarzkopf
author_facet Itay Ashkenazi
Mark Longwell
Barbara Byers
Rachael Kreft
Roi Ramot
Muhammad A. Haider
Yair Ramot
Ran Schwarzkopf
author_sort Itay Ashkenazi
collection DOAJ
description Abstract Background While the benefits of sonication for improving periprosthetic joint infection (PJI) are well-documented, its potential therapeutic effect against bacterial biofilm remains unstudied. This study aimed to investigate the safety and efficacy of a novel nanoparticle ultrasonication process on methicillin-resistant Staphylococcus aureus (MRSA) bacterial biofilm formation in a PJI rat model. Methods This novel ultrasonication process was designed to remove attached bacterial biofilm from implant and peri-articular tissues, without damaging native tissues or compromising implant integrity. Twenty-five adult Sprague–Dawley rats underwent a surgical procedure and were colonized with intra-articular MRSA, followed by the insertion of a titanium screw. Three weeks after the index surgery, the animals received a second procedure during which the screws were explanted, and soft tissue was sampled. The intraoperative use of the nanoparticle sonication treatment was employed to assess the device’s safety, while ex vivo treatment on the retrieved tissue and implants was used to evaluate its efficacy. Results Clinical and histological assessments did not indicate any macro- or micro-damage to the host tissue. Sonication of the retrieved tissues demonstrated an average bacterial removal of 2 × 103 CFU/mL and 1 × 104 CFU/gram of tissue. Compared to the standard-of-care group (n = 10), implants treated with sonication (n = 15) had significantly lower remaining bacteria, as indicated by crystal violet absorbance measurements (P = 0.012). Conclusions This study suggests that nanoparticle sonication technology can successfully remove attached bacterial biofilms from explanted orthopedic hardware and the joint capsule, without negatively affecting native tissue. The study provides initial results supporting the potential of nanoparticle sonication as an adjuvant treatment option during a DAIR (debridement, antibiotics, and implant retention) procedure for PJI, paving the way for future clinical trials.
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spelling doaj-art-d8e8c0a0ce5e40d491d9c548910bd2742024-11-10T12:08:06ZengBMCArthroplasty2524-79482024-11-01611910.1186/s42836-024-00279-7Nanoparticle ultrasonication: a promising approach for reducing bacterial biofilm in total joint infection—an in vivo rat model investigationItay Ashkenazi0Mark Longwell1Barbara Byers2Rachael Kreft3Roi Ramot4Muhammad A. Haider5Yair Ramot6Ran Schwarzkopf7Department of Orthopaedic Surgery, NYU Langone HealthCenter for Excellence in Biofilm Research, Allegheny Health Network Research InstituteCenter for Excellence in Biofilm Research, Allegheny Health Network Research InstituteCenter for Excellence in Biofilm Research, Allegheny Health Network Research InstituteRamot Biomedical Eng. Ltd.Department of Orthopaedic Surgery, NYU Langone HealthRamot Biomedical Eng. Ltd.Department of Orthopaedic Surgery, NYU Langone HealthAbstract Background While the benefits of sonication for improving periprosthetic joint infection (PJI) are well-documented, its potential therapeutic effect against bacterial biofilm remains unstudied. This study aimed to investigate the safety and efficacy of a novel nanoparticle ultrasonication process on methicillin-resistant Staphylococcus aureus (MRSA) bacterial biofilm formation in a PJI rat model. Methods This novel ultrasonication process was designed to remove attached bacterial biofilm from implant and peri-articular tissues, without damaging native tissues or compromising implant integrity. Twenty-five adult Sprague–Dawley rats underwent a surgical procedure and were colonized with intra-articular MRSA, followed by the insertion of a titanium screw. Three weeks after the index surgery, the animals received a second procedure during which the screws were explanted, and soft tissue was sampled. The intraoperative use of the nanoparticle sonication treatment was employed to assess the device’s safety, while ex vivo treatment on the retrieved tissue and implants was used to evaluate its efficacy. Results Clinical and histological assessments did not indicate any macro- or micro-damage to the host tissue. Sonication of the retrieved tissues demonstrated an average bacterial removal of 2 × 103 CFU/mL and 1 × 104 CFU/gram of tissue. Compared to the standard-of-care group (n = 10), implants treated with sonication (n = 15) had significantly lower remaining bacteria, as indicated by crystal violet absorbance measurements (P = 0.012). Conclusions This study suggests that nanoparticle sonication technology can successfully remove attached bacterial biofilms from explanted orthopedic hardware and the joint capsule, without negatively affecting native tissue. The study provides initial results supporting the potential of nanoparticle sonication as an adjuvant treatment option during a DAIR (debridement, antibiotics, and implant retention) procedure for PJI, paving the way for future clinical trials.https://doi.org/10.1186/s42836-024-00279-7Periprosthetic joint infection (PJI)UltrasonicationBiofilmAnimal modelDAIR
spellingShingle Itay Ashkenazi
Mark Longwell
Barbara Byers
Rachael Kreft
Roi Ramot
Muhammad A. Haider
Yair Ramot
Ran Schwarzkopf
Nanoparticle ultrasonication: a promising approach for reducing bacterial biofilm in total joint infection—an in vivo rat model investigation
Arthroplasty
Periprosthetic joint infection (PJI)
Ultrasonication
Biofilm
Animal model
DAIR
title Nanoparticle ultrasonication: a promising approach for reducing bacterial biofilm in total joint infection—an in vivo rat model investigation
title_full Nanoparticle ultrasonication: a promising approach for reducing bacterial biofilm in total joint infection—an in vivo rat model investigation
title_fullStr Nanoparticle ultrasonication: a promising approach for reducing bacterial biofilm in total joint infection—an in vivo rat model investigation
title_full_unstemmed Nanoparticle ultrasonication: a promising approach for reducing bacterial biofilm in total joint infection—an in vivo rat model investigation
title_short Nanoparticle ultrasonication: a promising approach for reducing bacterial biofilm in total joint infection—an in vivo rat model investigation
title_sort nanoparticle ultrasonication a promising approach for reducing bacterial biofilm in total joint infection an in vivo rat model investigation
topic Periprosthetic joint infection (PJI)
Ultrasonication
Biofilm
Animal model
DAIR
url https://doi.org/10.1186/s42836-024-00279-7
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