Effective Biofilm Eradication on Orthopedic Implants with Methylene Blue Based Antimicrobial Photodynamic Therapy In Vitro

• Published in: Antibiotics (Basel) Vol. 12; no. 1; p. 118
• Main Authors: Prinz, Julia, Wink, Marianne, Neuhaus, Sonja, Grob, Markus C, Walt, Heinrich, Bosshard, Philipp P, Achermann, Yvonne
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 08.01.2023; MDPI
• Subjects: Alloys; Antibiotics; Antiinfectives and antibacterials; Bacteria; Bacterial infections; biofilm; Biofilms; Biomedical materials; Bone cements; Bone implants; Cement; Cobalt; Drug resistance; E coli; in vitro; Light; Materials testing; Methylene blue; Microscopy; Morbidity; Orthopaedic implants; orthopedic implants; Orthopedics; Pathogens; periprosthetic joint infection; Photodynamic therapy; Polyethylene; Polyethylenes; Polymethyl methacrylate; Prostheses; Prosthetics; Quality of life; Severe acute respiratory syndrome coronavirus 2; Staphylococcus infections; Surgical implants; Titanium; Titanium alloys; Titanium base alloys; Transplants & implants; periprosthetic joint infection; methylene blue; orthopedic implants; photodynamic therapy; biofilm; in vitro
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics12010118

Periprosthetic joint infections (PJI) are difficult to treat due to biofilm formation on implant surfaces, often requiring removal or exchange of prostheses along with long-lasting antibiotic treatment. This in vitro study investigated the effect of methylene blue photodynamic therapy (MB-PDT) on PJI-causing biofilms on different implant materials. MB-PDT (664 nm LED, 15 J/cm ) was tested on different , and strains in both planktonic form and grown in early and mature biofilms on prosthetic materials (polyethylene, titanium alloys, cobalt-chrome-based alloys, and bone cement). The minimum bactericidal concentration with 100% killing (MBC ) was determined. Chemical and topographical alterations were investigated on the prosthesis surfaces after MB-PDT. Results showed a MBC of 0.5-5 μg/mL for planktonic bacteria and 50-100 μg/mL for bacteria in biofilms-independent of the tested strain, the orthopedic material, or the maturity of the biofilm. Material testing showed no relevant surface modification. MB-PDT effectively eradicated common PJI pathogens on arthroplasty materials without damage to the materials, suggesting that MB-PDT could be used as a novel treatment method, replacing current, more invasive approaches and potentially shortening the antibiotic treatment in PJI. This would improve quality of life and reduce morbidity, mortality, and high health-care costs.