Living things are divided into the Animal, Plant, Fungi, Protist and Monera kingdoms. Bacteria are part of the Monera kingdom because they are single-celled organisms that don’t have a nucleus. Just as there are relatively harmless and dangerous animals (rabbit versus Great White shark) and fungi (portobella mushrooms versus black mold), there are also good and bad bacteria.
An example of good bacteria islactobacillus, which are natural inhabitants of our gut microbiome that aid digestion, nutrient absorption and immunity. On the other hand, there are several extremely dangerous bacteria such as E. coli, Staphylococcus aureus and Clostridioides difficile that can lead to serious illness and death. And good bacteria can also behave badly if they end up in the wrong place.
Bad bacteria (by themselves) are usually killed by our immune systems. However, the scenario changes once an orthopedic device is implanted into the body. Without an implant, it can take up to 100,000,000 bacteria to cause an infection. With an implant (even from a sterile package), as few as 100 bacteria can cause an infection.*
When medical device bacterial infection occurs, it is 10,000 times more likely to lead to sepsis as compared to injecting bacteria into the bloodstream—and there is no definitive evidence that blood-borne infections can lead to implant contamination. This could indicate that many device-related infections that are first believed to be caused by post-surgical events may actually be due to bacterial contamination during surgery.
The bacteria that are most likely to come in contact with an implant in the operating room—and represent nearly all device-related infections are:
- Staphylococcus aureus
- Pseudomonas aeruginosa
- E. coli
- Methicillin-resistantStaphylococcus aureus (MRSA)
- E. cloacae
- C. acnes
Studies have shown that between 70% and 100% of explanted (i.e. removed) failed devices have some degree of microbial contamination.** Implantable devices can become contaminated during surgery simply due to routine handling despite other sterility measures that are in place. Once a contaminated implant comes in contact with tissues and fluids within the body, a potentially dangerous community of bacteria can begin to form on the surface of the device.
The microbes that contaminate a device before it is placed in the body can begin to multiply and colonize the surface after implantation. This complex community of microbes is embedded in a self-produced matrix of proteins, lipids and sugars, eventually forming a film. This matrix helps protect its microbes from the immune system and antibiotics. A major concern about these microbial films is that they can be antibiotic-resistant, which allows them to persist on the implant surface. This can lead to chronic or recurrent infections even after antibiotic treatment that may require its removal or replacement.
After being tested on numerous surfaces against 12 microbes that represent nearly all cases of device-related infections, Ostaguard™ was shown to be highly effective in killing multiple strains of bacteria that could come in contact with an implant in the operating room. With a first-of-its-kind nod from the FDA, Ostaguard technology safely and effectively kills bacteria by mechanically rupturing pathogens—and without the use of antibiotics.
Contact Orthobond today to learn how Ostaguard can give your implantable devices an antibacterial advantage—and make you among the first to help save thousands of lives every year by minimizing implant contamination.
* Reviewed in Moriarty, T.F., D.W. Grainger, and R.G. Richards, Challenges in linking preclinical antimicrobial research strategies with clinical outcomes for device-associated infections. Eur Cell Mater, 2014. 28: p. 112-28; discussion 128.
* *Darouiche RO. Treatment of infections associated with surgical implants. N Engl J Med. 2004 Apr 1;350(14):1422-9. doi: 10.1056/NEJMra035415. PMID: 15070792.
