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Molecular techniques to detect biofilm bacteria in long bone nonunion: a case report
Journal article   Open access   Peer reviewed

Molecular techniques to detect biofilm bacteria in long bone nonunion: a case report

Michael Palmer, William Costerton, Jeffrey Sewecke and Daniel Altman
Clinical orthopaedics and related research, v 469(11), pp 3037-3042
01 Nov 2011
DOI: https://doi.org/10.1007/s11999-011-1843-9
PMID: 21416206
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc3183189View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Adult Bacterial Infections - diagnosis Bacterial Infections - microbiology Biofilms DNA, Bacterial - isolation & purification Fracture Healing Fractures, Ununited - diagnosis Fractures, Ununited - diagnostic imaging Fractures, Ununited - microbiology Humans In Situ Hybridization, Fluorescence Male Prosthesis-Related Infections - diagnosis Prosthesis-Related Infections - microbiology Radiography Tibial Fractures - microbiology Tibial Fractures - surgery
Biofilms cause chronic infections including those associated with orthopaedic hardware. The only methods that are Food and Drug Administration-approved for detecting and identifying bacterial infections are cultures and selected DNA-based polymerase chain reaction methods that detect only specific pathogens (eg, methicillin-resistant Staphylococcus aureus). New DNA-based technologies enable the detection and identification of all bacteria present in a sample and to determine the antibiotic sensitivities of the organisms. A 34-year-old man sustained an open tibia fracture. He experienced 3 years of delayed healing and episodic pain. In addition to his initial treatment, he underwent three additional surgeries to achieve fracture healing. During the last two procedures, cultures were taken and samples were tested with the IBIS T5000 and fluorescence in situ hybridization (FISH). In both cases, the cultures were negative, but the IBIS and FISH confirmed the presence of a biofilm within the tibial canal. Examinations of tissues from biofilm infections, by DNA-based molecular methods and by direct microscopy, have often found bacteria present despite negative cultures. Infections associated with orthopaedic hardware may be caused by bacteria living in biofilms, and these biofilm organisms are particularly difficult to detect by routine culture methods. Rapid DNA-based detection methods represent a potentially clinically useful tool in the detection of bacterial biofilms. The sensitivity and clinical impact of the technology has yet to be established.

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30 citations in Web of Science
34 citations in Scopus

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Web of Science research areas
Orthopedics
Surgery
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