Abstract
There is evidence that microbes including bacteria and
macrophages are associated with in the presence biomedical
alloys implants for orthopedic procedures [1-4]. The corrosion
of metal alloys (A316L Surgical stainless steel; ASTM F136 ELI
Ti6Al4V; ASTM F75/F1537/F799 CoCrMoC) in-vivo has also
been well documented [5-8]. Proprionibacterium acnes as well as
Staphylococcus Epidermis are considered sulfur reducing bacteria
in the petroleum industry and have been found in petroleum
stockpiles and pipelines [9,10]. These bacteria are associated with
pipeline corrosion in oil fields and refineries [9]. In our own clinical
experiences, we have noted a large number of spine metallosis
cases and believe that the corrosion of implants and surgical site
infections with P. acnes bacteria, or other sulfur reducing bacteria,
are intimately connected in revisions and clinical infections. In our
practice we observed an association between infection and implant
corrosion leading to the initiation of a study examining revision
of spinal instrumentation and patient outcomes. In patients who
underwent spine instrumentation revision, who had grey or black
stained tissues taken for culture in the OR and subsequent to the
revision, we found 4 of 10 having P. acnes and Staph. epidermis
present as a latent infection. A few patients showed clinical signs
of infection, requiring subsequent drains and wash-out to clear
all presence of bacteria. As early as 1999, P. acnes and Staph spp.
were shown to be associated with orthopedic infections, where it
was detected in 63% of sonicated samples taken from 120 patients
receiving total hip revision [4]. As recently as 2016, P. acnes were
highlighted as a possible contributor to post operative infections
in orthopedic procedures [1]. These commensal skin dwelling
microbes are anaerobic, sulfur reducing bacteria [11-13]. P. acnes,
Staph. aureus and epidermis have been isolated as biofilm forming
bacteria in orthopedics as well [3].
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.