Identification and Morphological Characterization of Biofilms Formed by Strains Causing Infection in Orthopedic Implants

<strong>Objectives:</strong> For a better understanding of the mechanisms involved in biofilm formation, we performed a broad identification and characterization of the strains affecting implants by evaluating the morphology of biofilms formed in vitro in correlation with tests of the st...

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Main Authors: Débora C. Coraça-Huber, Lisa Kreidl, Stephan Steixner, Maximilian Hinz, Dietmar Dammerer, Manfred Fille
Format: Article
Language:English
Published: MDPI AG 2020-08-01
Series:Pathogens
Subjects:
Online Access:https://www.mdpi.com/2076-0817/9/8/649
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language English
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author Débora C. Coraça-Huber
Lisa Kreidl
Stephan Steixner
Maximilian Hinz
Dietmar Dammerer
Manfred Fille
spellingShingle Débora C. Coraça-Huber
Lisa Kreidl
Stephan Steixner
Maximilian Hinz
Dietmar Dammerer
Manfred Fille
Identification and Morphological Characterization of Biofilms Formed by Strains Causing Infection in Orthopedic Implants
Pathogens
biofilm
in vitro conditions
antibiotic susceptibility
implant-related infections.
author_facet Débora C. Coraça-Huber
Lisa Kreidl
Stephan Steixner
Maximilian Hinz
Dietmar Dammerer
Manfred Fille
author_sort Débora C. Coraça-Huber
title Identification and Morphological Characterization of Biofilms Formed by Strains Causing Infection in Orthopedic Implants
title_short Identification and Morphological Characterization of Biofilms Formed by Strains Causing Infection in Orthopedic Implants
title_full Identification and Morphological Characterization of Biofilms Formed by Strains Causing Infection in Orthopedic Implants
title_fullStr Identification and Morphological Characterization of Biofilms Formed by Strains Causing Infection in Orthopedic Implants
title_full_unstemmed Identification and Morphological Characterization of Biofilms Formed by Strains Causing Infection in Orthopedic Implants
title_sort identification and morphological characterization of biofilms formed by strains causing infection in orthopedic implants
publisher MDPI AG
series Pathogens
issn 2076-0817
publishDate 2020-08-01
description <strong>Objectives:</strong> For a better understanding of the mechanisms involved in biofilm formation, we performed a broad identification and characterization of the strains affecting implants by evaluating the morphology of biofilms formed in vitro in correlation with tests of the strains’ antibiotic susceptibility in planktonic form. The ability of the strains to form biofilms in vitro was evaluated by means of colony forming units counting, metabolic activity tests of biofilm cells, and scanning electron microscopy. <strong>Methods: </strong>A total of 140 strains were isolated from patients with orthopedic implant-related infections during the period of 2015 to 2018. The identification of the isolates was carried out through microbiological cultures and confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility rates of the isolates were accessed according to EUCAST (European Committee on Antimicrobial Susceptibility Testing). The ability of all isolates to form biofilms in vitro was evaluated by counting the colony forming units, by measuring the metabolic activity of biofilm cells, and by analyzing the morphology of the formed biofilms using scanning electron microscopy. <strong>Results</strong>: From all the isolates, 41.84% (62 strains) were <em>Staphylococcus epidermidis </em>and 15.60% (22 strains) were <em>Staphylococcus aureus. </em>A significant difference in the capacity of biofilm formation was observed among the isolates. When correlating the biofilm forming capacity of the isolates to their antibiotic susceptibility rates, we observed that not all strains that were classified as resistant were biofilm producers in vitro. In other words, bacteria that are not good biofilm formers can show increased tolerance to multiple antibiotic substances. <strong>Conclusion</strong>: From 2015 until 2018, <em>Staphylococcus epidermidis </em>was the strain that caused most of the orthopedic implant-related infections in our hospital<em>. </em>Not all strains causing infection in orthopedic implants are able to form biofilms under in vitro conditions. Differences were observed in the number of cells and morphology of the biofilms. In addition, antibiotic resistance is not directly related to the capacity of the strains to form biofilms in vitro. Further studies should consider the use of in vitro culture conditions that better reproduce the joint environment and the growth of biofilms in humans.
topic biofilm
in vitro conditions
antibiotic susceptibility
implant-related infections.
url https://www.mdpi.com/2076-0817/9/8/649
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spelling doaj-47776406d3f4405b8f28fca1ad6dff332020-11-25T03:13:33ZengMDPI AGPathogens2076-08172020-08-01964964910.3390/pathogens9080649Identification and Morphological Characterization of Biofilms Formed by Strains Causing Infection in Orthopedic ImplantsDébora C. Coraça-Huber0Lisa Kreidl1Stephan Steixner2Maximilian Hinz3Dietmar Dammerer4Manfred Fille5Research Laboratory for Biofilms and Implant Associated Infections (BIOFILM LAB), Experimental Orthopedics, Department of Orthopedic Surgery, Medical University of Innsbruck, Peter-Mayr-Strasse 4b, Room 204, 6020 Innsbruck, AustriaResearch Laboratory for Biofilms and Implant Associated Infections (BIOFILM LAB), Experimental Orthopedics, Department of Orthopedic Surgery, Medical University of Innsbruck, Peter-Mayr-Strasse 4b, Room 204, 6020 Innsbruck, AustriaResearch Laboratory for Biofilms and Implant Associated Infections (BIOFILM LAB), Experimental Orthopedics, Department of Orthopedic Surgery, Medical University of Innsbruck, Peter-Mayr-Strasse 4b, Room 204, 6020 Innsbruck, AustriaResearch Laboratory for Biofilms and Implant Associated Infections (BIOFILM LAB), Experimental Orthopedics, Department of Orthopedic Surgery, Medical University of Innsbruck, Peter-Mayr-Strasse 4b, Room 204, 6020 Innsbruck, AustriaDepartment of Orthopedic Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, AustriaInstitute of Hygiene and Medical Microbiology, Medical University Innsbruck, Schöpfstrasse 41, 6020 Innsbruck, Austria<strong>Objectives:</strong> For a better understanding of the mechanisms involved in biofilm formation, we performed a broad identification and characterization of the strains affecting implants by evaluating the morphology of biofilms formed in vitro in correlation with tests of the strains’ antibiotic susceptibility in planktonic form. The ability of the strains to form biofilms in vitro was evaluated by means of colony forming units counting, metabolic activity tests of biofilm cells, and scanning electron microscopy. <strong>Methods: </strong>A total of 140 strains were isolated from patients with orthopedic implant-related infections during the period of 2015 to 2018. The identification of the isolates was carried out through microbiological cultures and confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility rates of the isolates were accessed according to EUCAST (European Committee on Antimicrobial Susceptibility Testing). The ability of all isolates to form biofilms in vitro was evaluated by counting the colony forming units, by measuring the metabolic activity of biofilm cells, and by analyzing the morphology of the formed biofilms using scanning electron microscopy. <strong>Results</strong>: From all the isolates, 41.84% (62 strains) were <em>Staphylococcus epidermidis </em>and 15.60% (22 strains) were <em>Staphylococcus aureus. </em>A significant difference in the capacity of biofilm formation was observed among the isolates. When correlating the biofilm forming capacity of the isolates to their antibiotic susceptibility rates, we observed that not all strains that were classified as resistant were biofilm producers in vitro. In other words, bacteria that are not good biofilm formers can show increased tolerance to multiple antibiotic substances. <strong>Conclusion</strong>: From 2015 until 2018, <em>Staphylococcus epidermidis </em>was the strain that caused most of the orthopedic implant-related infections in our hospital<em>. </em>Not all strains causing infection in orthopedic implants are able to form biofilms under in vitro conditions. Differences were observed in the number of cells and morphology of the biofilms. In addition, antibiotic resistance is not directly related to the capacity of the strains to form biofilms in vitro. Further studies should consider the use of in vitro culture conditions that better reproduce the joint environment and the growth of biofilms in humans.https://www.mdpi.com/2076-0817/9/8/649biofilmin vitro conditionsantibiotic susceptibilityimplant-related infections.