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Published in: European Spine Journal 10/2018

Open Access 01-10-2018 | Original Article

Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery

Authors: Acke Ohlin, Emma Mattsson, Matthias Mörgelin, Julia R. Davies, Gunnel Svensäter, Stéphane Corvec, Pentti Tengvall, Kristian Riesbeck

Published in: European Spine Journal | Issue 10/2018

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Abstract

Purpose

Post-operative infections are relatively common after posterior spine surgery, and there are several observations reflecting different infection complications related to various metals implanted. Here, we selected an array of different bacterial species that are often found in infections associated with orthopaedic implants and tested for inhibition by hydrogen peroxide-treated titanium (Ti-peroxy).

Methods

To study the possibility of using Ti-peroxy as an antimicrobial prophylaxis, we developed a protocol for standardized susceptibility testing of bacteria.

Results

Importantly, we found that the resulting Ti-peroxy was highly antimicrobial against all aerobic species tested, among others, Staphylococcus aureus and Pseudomonas aeruginosa. Proteus mirabilis was slightly more resistant than, for example, Klebsiella pneumoniae and enterococci. In contrast, anaerobic bacteria Cutibacterium acnes and Parvimonas micra were equally susceptible compared to staphylococci.

Conclusions

Our findings suggest that the Ti-peroxy is a promising perioperative antimicrobial strategy that may be highly effective for prevention of post-operative infections. We therefore suggest application of hydrogen peroxide to implants prior to implantation.

Graphical abstract

These slides can be retrieved under Electronic supplementary material.
Appendix
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Literature
1.
go back to reference Abdul-Jabbar A et al (2013) Surgical site infections in spine surgery. Spine 38:E1425–E1431CrossRef Abdul-Jabbar A et al (2013) Surgical site infections in spine surgery. Spine 38:E1425–E1431CrossRef
2.
go back to reference Boody B et al (2015) Surgical site infections in spinal surgery. J Spinal Disord Tech 28:352–362CrossRef Boody B et al (2015) Surgical site infections in spinal surgery. J Spinal Disord Tech 28:352–362CrossRef
3.
go back to reference Clark CE, Shufflebarger HL (1999) Late-developing infection in instrumented idiopathic scoliosis. Spine 24:1909–1912CrossRef Clark CE, Shufflebarger HL (1999) Late-developing infection in instrumented idiopathic scoliosis. Spine 24:1909–1912CrossRef
4.
go back to reference Muschik M, Luck W, Schlenzka D (2004) Implant removal for late-developing infection after instrumented posterior spinal fusion for scoliosis: reinstrumentation reduces loss of correction. A retrospective analysis of 45 cases. Eur Spine J 13:645–651CrossRef Muschik M, Luck W, Schlenzka D (2004) Implant removal for late-developing infection after instrumented posterior spinal fusion for scoliosis: reinstrumentation reduces loss of correction. A retrospective analysis of 45 cases. Eur Spine J 13:645–651CrossRef
5.
go back to reference Wåxnäs T, Hasserius R, Ohlin A (2012) Implant associated late developing infection after posterior spinal surgery, presented at SRS 47th annual meeting, Chicago, IL Wåxnäs T, Hasserius R, Ohlin A (2012) Implant associated late developing infection after posterior spinal surgery, presented at SRS 47th annual meeting, Chicago, IL
6.
go back to reference LaGreca J et al (2014) Bacteriology and risk factors for development of late (greater than one year) deep infection following spinal fusion with instrumentation. Spine Deform 3:186–190CrossRef LaGreca J et al (2014) Bacteriology and risk factors for development of late (greater than one year) deep infection following spinal fusion with instrumentation. Spine Deform 3:186–190CrossRef
7.
go back to reference Di Silvestre M, Bakaloudis G, Lolli F, Giacomini S (2011) Late-developing infection following posterior fusion for adolescent idiopathic scoliosis. Eur Spine J Suppl 1:S121–S127CrossRef Di Silvestre M, Bakaloudis G, Lolli F, Giacomini S (2011) Late-developing infection following posterior fusion for adolescent idiopathic scoliosis. Eur Spine J Suppl 1:S121–S127CrossRef
8.
go back to reference Tengvall P, Lundström I (1992) Interaction between hydrogen peroxide and titanium: a possible role in the biocompatibility of titanium. Clin Mater 9:115–134CrossRef Tengvall P, Lundström I (1992) Interaction between hydrogen peroxide and titanium: a possible role in the biocompatibility of titanium. Clin Mater 9:115–134CrossRef
9.
go back to reference Tengvall P, Hörnsten EG, Elwing H, Lundström I (1990) Bactericidal properties of a titanium-peroxy gel obtained from metallic titanium and hydrogen peroxide. J Biomed Mater Res 24:319–330CrossRef Tengvall P, Hörnsten EG, Elwing H, Lundström I (1990) Bactericidal properties of a titanium-peroxy gel obtained from metallic titanium and hydrogen peroxide. J Biomed Mater Res 24:319–330CrossRef
10.
go back to reference Tengvall P et al (1990) Degradation of Ti-peroxy gels made from metallic titanium and hydrogen peroxide. J Colloid Interface Sci 139:575–580CrossRef Tengvall P et al (1990) Degradation of Ti-peroxy gels made from metallic titanium and hydrogen peroxide. J Colloid Interface Sci 139:575–580CrossRef
11.
go back to reference Mueller S, Arnhold J (1995) Fast and sensitive chemiluminiscence determination of H2O2 concentration in stimulated human neutrophils. J Biolumin 10:229–237CrossRef Mueller S, Arnhold J (1995) Fast and sensitive chemiluminiscence determination of H2O2 concentration in stimulated human neutrophils. J Biolumin 10:229–237CrossRef
12.
go back to reference Tengvall P, Vikinge TP, Lundström I, Lieberg B (1993) FT-Raman spectroscopic studies of the degradation of titanium peroxy gels made from metallic titanium and hydrogen peroxide. J Colloid Interface Sci 160:10–15CrossRef Tengvall P, Vikinge TP, Lundström I, Lieberg B (1993) FT-Raman spectroscopic studies of the degradation of titanium peroxy gels made from metallic titanium and hydrogen peroxide. J Colloid Interface Sci 160:10–15CrossRef
13.
go back to reference Aubin GG et al (2017) Interaction of cutibacterium (formerly propionibacterium) acnes with bone cells: a step toward understanding bone and joint infection development. Sci Rep 7:42918CrossRef Aubin GG et al (2017) Interaction of cutibacterium (formerly propionibacterium) acnes with bone cells: a step toward understanding bone and joint infection development. Sci Rep 7:42918CrossRef
14.
go back to reference Riesbeck K, Sanzén L (1999) Destructive knee joint infection caused by Peptostreptococcus micros: importance of early microbiological diagnosis. J Clin Microbiol 37:2737–2739PubMedPubMedCentral Riesbeck K, Sanzén L (1999) Destructive knee joint infection caused by Peptostreptococcus micros: importance of early microbiological diagnosis. J Clin Microbiol 37:2737–2739PubMedPubMedCentral
15.
go back to reference Foster HA, Ditta IB, Varghese S, Steele A (2011) Photocatalytic disinfection using titanium dioxide: spectrum and mechanism of antimicrobial activity. Appl Microbiol Biotechnol 90:1847–1868CrossRef Foster HA, Ditta IB, Varghese S, Steele A (2011) Photocatalytic disinfection using titanium dioxide: spectrum and mechanism of antimicrobial activity. Appl Microbiol Biotechnol 90:1847–1868CrossRef
16.
go back to reference Monetta T, Belluci F (2014) Strong and durable antibacterial effect of titanium treated in RF oxygen plasma: preliminary results. Plasma Chem Process 34:1247–1256CrossRef Monetta T, Belluci F (2014) Strong and durable antibacterial effect of titanium treated in RF oxygen plasma: preliminary results. Plasma Chem Process 34:1247–1256CrossRef
Metadata
Title
Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery
Authors
Acke Ohlin
Emma Mattsson
Matthias Mörgelin
Julia R. Davies
Gunnel Svensäter
Stéphane Corvec
Pentti Tengvall
Kristian Riesbeck
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 10/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-018-5619-8

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