Microbubble Cavitation Restores Staphylococcus Aureus Antibiotic Susceptibility in Vitro and in a Septic Arthritis Model
Treatment failure in joint infections is associated with fibrinous, antibiotic-resistant, floating and tissue-associated Staphylococcus aureus aggregates formed in synovial fluid (SynF). We explore whether antibiotic activity could be increased against Staphylococcus aureus aggregates using ultrasound-triggered microbubble destruction (UTMD), in vitro and in a porcine model of septic arthritis. In vitro, when bacterially laden SynF is diluted, akin to the dilution achieved clinically with lavage and local injection of antibiotics, amikacin and ultrasound application result in increased bacterial metabolism, aggregate permeabilization, and a 4-5 log decrease in colony forming units, independent of microbubble destruction. Without SynF dilution, amikacin + UTMD does not increase antibiotic activity. Importantly, in the porcine model of septic arthritis, no bacteria are recovered from the SynF after treatment with amikacin and UTMD-ultrasound without UTMD is insufficient. Our data suggest that UTMD + antibiotics may serve as an important adjunct for the treatment of septic arthritis.
Zhao, Neil; Curry, Dylan; Evans, Rachel E; Isguven, Selin; Freeman, Theresa A.; Eisenbrey, John R.; Forsberg, Flemming; Gilbertie, Jessica M; Boorman, Sophie; Hilliard, Rachel; Dastgheyb, Sana S.; Machado, Priscilla; Stanczak, Maria; Harwood, Marc I.; Chen, Antonia F; Parvizi, Javad; Shapiro, Irving; Hickok, Noreen J.; and Schaer, Thomas P, "Microbubble Cavitation Restores Staphylococcus Aureus Antibiotic Susceptibility in Vitro and in a Septic Arthritis Model" (2023). Department of Orthopaedic Surgery Faculty Papers. Paper 191.
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This work is licensed under a Creative Commons Attribution 4.0 License.
This article is the author’s final published version in Communications Biology, Volume 6, Issue 1, April 2023, Article number 425.
The published version is available at https://doi.org/10.1038/s42003-023-04752-y. Copyright © Zhao et al.