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A long time ago in an Operating Room far, far away….

Biofilm Wars. With apologies to George Lucas. A long time ago in an Operating Room far, far away…. Shocking: Elimination of S. Aureus Biofilm from Stainless Steel by Electrolysis Matthew J. Dietz, MD; Jacob Conjeski MD; Vincent L. Kish AS; Brian R. Hamlin, MD

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A long time ago in an Operating Room far, far away….

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  1. Biofilm Wars With apologies to George Lucas A long time ago in an Operating Room far, far away….

  2. Shocking: Elimination of S. AureusBiofilm from Stainless Steel by Electrolysis Matthew J. Dietz, MD; Jacob Conjeski MD; Vincent L. Kish AS; Brian R. Hamlin, MD West Virginia University Department of Orthopaedics

  3. Orthopaedic Biofilm • Adherent Bacteria • EPS (extra-cellular polysaccharide) • Polymicrobial TOP SECRET

  4. Spork Implant S. Epi S. Aureus EPS

  5. “race for the surface” Bacterial Colonization vs. Tissue Integration 100 - 1000x Antibiotics to Eliminate Biofilm -- Gristina, A. “Biomaterial-Centered Infection: Microbial Adhesion Versus Tissue Integration. Science. Vol. 237, No. 4822. (Sep. 25, 1987), pp. 1588-1595

  6. “Strategerie”

  7. Debridement with Retention Staged Explant/Exchange Resection Arthroplasty Arthrodesis Amputation

  8. Hypothesis

  9. R I P S. aureus BIOFILM

  10. Biofilm and WVU Orthopaedics Create Biofilm --Goeres et. al. “Statistical assessment of a laboratory method for growing biofilms.” Microbiology. 2005; 151: 757-762.

  11. Where’s the Biofilm?

  12. -- Rabinovitch, C et al. “Removal and Inactivation of Staphylococcus epidermidisBiofilms by Electrolysis.” App and Enviromental Microbiology. Sept 2006: 6364-66.

  13. Anode vs. CathodeReduction CFU’s for S. aureus Control 1 Volts Avg. 52.65% reduction in CFU’s/cm2 Anode (n=5) Avg. 92.59% reduction in CFU’s/cm2 Cathode (n=5)

  14. Biofilm and WVU Orthopaedics

  15. Control 4 V 2 V 1 V 0.5 V

  16. However…

  17. Conclusions Need for adjuntive measures Connection to Cathode for S. aureus CFU reduction independent of voltage 98% of CFU’s via electrolysis

  18. To Do List… • Biofilm Models • Detection of Biofilm • Electrolysis • Various Metals • In-vivo • Vary biofilm makeup • Means of Removal

  19. The War Continues… Thank You

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