Abstract
Prosthetic joint infections are generally caused by a variety of Gram-positive and Gram-positive microrganisms. New species are continuously isolated, including anaerobes. The pathogenic mechanisms responsible for joint infections are well studied only for some bacteria, e.g. Staphylococcus aureus and Pseudomonas aeruginosa, while others are only partially understood. The most important virulence and microbiological factors involved in these infections are the bacterial adhesion on the native joint or prosthetic material and the biofilm production by bacteria involved in the infection. Biofilm formation results from a developmental programme of gene expression involving an intracellular signaling, or quorum-sensing. The biofilm consists of bacteria embedded within an extracellular polysaccharide matrix (EPS), where microrganims are protected from environmental influences including host immune responses and normal levels of conventional antimicrobial agents. Biofilm resistance is a multifactorial mechanism, which makes biofilm eradication difficult, and thus most biofilm-related infections often require prompt removal of the device. Some antibacterials are better than others in treating biofilm-associated bacteria.
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Drago, L. Infezioni impianto-correlate e biofilm batterico. LO SCAL 23, 153–159 (2009). https://doi.org/10.1007/s11639-009-0040-z
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DOI: https://doi.org/10.1007/s11639-009-0040-z