Evidence for inoculum size and gas interfaces as critical factors in bacterial biofilm formation on magnesium implants in an animal model.
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Authors
Rahim, Muhammad ImranSzafrański, Szymon P
Ingendoh-Tsakmakidis, Alexandra
Stiesch, Meike
Mueller, Peter P
Issue Date
2019-11-28
Metadata
Show full item recordAbstract
Infections of medical implants caused by bacterial biofilms are a major clinical problem. Bacterial colonization is predicted to be prevented by alkaline magnesium surfaces. However, in experimental animal studies, magnesium implants prolonged infections. The reason for this peculiarity likely lies within the ‒still largely hypothetical‒ mechanism by which infection arises. Investigating subcutaneous magnesium implants infected with bioluminescent Pseudomonas aeruginosa via in vivo imaging, we found that the rate of implant infections was critically dependent on a surprisingly high quantity of injected bacteria. At high inocula, bacteria were antibiotic-refractory immediately after infection. High cell densities are known to limit nutrient availability, restricting proliferation and trigger quorum sensing which could both contribute to the rapid initial resistance. We propose that gas bubbles such as those formed during magnesium corrosion, can then act as interfaces that support biofilm formation and permit long-term survival. This model could provide an explanation for the apparent ineffectiveness of innovative contact-dependent bactericidal implant surfaces in patients. In addition, the model points toward air bubbles in tissue, either by inclusion during surgery or by spontaneous gas bubble formation later on, could constitute a key risk factor for clinical implant infectionsCitation
olloids Surf B Biointerfaces. 2019 Nov 28;186:110684. doi: 10.1016/j.colsurfb.2019.110684.Affiliation
HZI,Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7,38124 Braunschweig, Germany.Publisher
ElsevierPubMed ID
31812076Type
ArticleLanguage
enISSN
1873-4367ae974a485f413a2113503eed53cd6c53
10.1016/j.colsurfb.2019.110684
Scopus Count
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