Optimizing the safety of intradiscal platelet-rich plasma: an in vitro study with Cutibacterium acnes

• Published in: Regenerative medicine Vol. 14; no. 10; pp. 955 - 967
• Main Authors: Prysak, Meredith H, Lutz, Cole G, Zukofsky, Tyler A, Katz, Jordan M, Everts, Peter A, Lutz, Gregory E
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.10.2019
• Subjects: Antibiotics; Antimicrobial agents; Bacteria; Blood Bactericidal Activity; Blood platelets; Blood products; Clinical medicine; Experiments; Female; Granulocytes; Humans; Intervertebral Disc Degeneration - microbiology; Intervertebral Disc Degeneration - therapy; Male; Medical research; Microbial Viability; Neutrophils; Pathogens; Platelet-Rich Plasma - microbiology; Propionibacteriaceae - growth & development; antimicrobial; intervertebral disc; Cutibacterium acnes; anti-infective; low back pain; regenerative medicine; leukocyte; disc degeneration; Propionibacterium acnes; neutrophil; platelet-rich plasma
• ISSN: 1746-0751; 1746-076X
• DOI: 10.2217/rme-2019-0098

The most common risk associated with intradiscal injection of platelet-rich plasma (PRP) is discitis with . It is hypothesized that antimicrobial activity of PRP can be enhanced through inclusion of leukocytes or antibiotics in the injectate. Multiple PRP preparations of varying platelet and leukocyte counts were co-cultured with with or without cefazolin, with viable bacterial colony counts being recovered at 0, 4, 24 and 48 hours post-inoculation. A direct correlation between recovery and granulocyte counts were observed. We observed the greatest antimicrobial activity with the leukocyte-rich, high platelet PRP preparation combined with an antibiotic in the injectate. However, cefazolin did not completely clear the bacteria in this assay.