Bacterial biofilms in orthopedics: the problem and possible prospects for prevention

E.M. Gordina, S.A. Bozhkova

Vreden National Medical Research Center of Traumatology and Orthopedics, St. Petersburg

This review presents modern views on the formation of a chronic orthopedic infection associated with the biofilm formation of bacteria. The stages of biofilm formation, the phenotypes of bacterial cells existing in them, as well as their role in the pathogenesis of implant-associated infection are briefly considered. The biofilm state allows pathogens to be resistant to antibiotic treatment and to the effects of immune system factors due to structural and metabolic heterogeneity because of simultaneous coexistence of microbial cells in various states, combined with active synthesis of the intercellular matrix. Currently, there are several directions in the prevention of microbial adhesion and maturation of films on orthopedic implants. For preventive and therapeutic purposes in traumatology and orthopedics, in addition to systemic and local antibacterial drugs, materials can be used to create implants with certain physical and chemical properties of surfaces. The main action targets of anti-biofilm agents are given This review shows the results of the clinical use of silver and iodine for the prevention and treatment of infectious complications during orthopedic operations. It is concluded that, despite all the optimistic results, most of the applied methods are still to be studied and difficult to scale up to industry standards, which requires further research.

Keywords: biofilms, biofilm formation, periprosthetic joint infection, implant-associated infection, implants.

For citation: Gordina E.M., Bozhkova S.A. Bacterial biofilms in orthopedics: the problem and possible prospects for prevention.
RMJ. 2021;8:29–32.