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Image-guided in situ detection of bacterial biofilms in a human prosthetic knee infection model: a feasibility study for clinical diagnosis of prosthetic joint infections.

Authors
  • Schoenmakers, Jorrit W A1, 2
  • Heuker, Marjolein2
  • López-Álvarez, Marina2
  • Nagengast, Wouter B3
  • van Dam, Gooitzen M4
  • van Dijl, Jan Maarten5
  • Jutte, Paul C1
  • van Oosten, Marleen2
  • 1 Department of Orthopaedics, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands. , (Netherlands)
  • 2 Department of Medical Microbiology, University of Groningen, UMCG, Hanzeplein 1, PO Box 30001, 9700 RB, Groningen, The Netherlands. , (Netherlands)
  • 3 Department of Gastroenterology and Hepatology, University of Groningen, UMCG, Groningen, The Netherlands. , (Netherlands)
  • 4 Department of Surgery, University of Groningen, UMCG, Groningen, The Netherlands. , (Netherlands)
  • 5 Department of Medical Microbiology, University of Groningen, UMCG, Hanzeplein 1, PO Box 30001, 9700 RB, Groningen, The Netherlands. [email protected] , (Netherlands)
Type
Published Article
Journal
European Journal of Nuclear Medicine
Publisher
Springer-Verlag
Publication Date
Mar 01, 2021
Volume
48
Issue
3
Pages
757–767
Identifiers
DOI: 10.1007/s00259-020-04982-w
PMID: 32901352
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Due to an increased human life expectancy, the need to replace arthritic or dysfunctional joints by prosthetics is higher than ever before. Prosthetic joints are unfortunately inherently susceptible to bacterial infection accompanied by biofilm formation. Accurate and rapid diagnosis is vital to increase therapeutic success. Yet, established diagnostic modalities cannot directly detect bacterial biofilms on prostheses. Therefore, the present study was aimed at investigating whether arthroscopic optical imaging can accurately detect bacterial biofilms on prosthetic joints. Here, we applied a conjugate of the antibiotic vancomycin and the near-infrared fluorophore IRDye800CW, in short vanco-800CW, in combination with arthroscopic optical imaging to target and visualize biofilms on infected prostheses. We show in a human post-mortem prosthetic knee infection model that a staphylococcal biofilm is accurately detected in real time and distinguished from sterile sections in high resolution. In addition, we demonstrate that biofilms associated with the clinically most relevant bacterial species can be detected using vanco-800CW. The presented image-guided arthroscopic approach provides direct visual diagnostic information and facilitates immediate appropriate treatment selection.

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