title: Activity of N-acetyl-L-cysteine against biofilm of Staphylococcus aureus and Pseudomonas aeruginosa on orthopedic prosthetic materials.
abstract: OBJECTIVE
  Staphylococcus aureus and Pseudomonas aeruginosa are frequently isolated from biofilm-associated orthopedic implant infections. This study assessed the activity of N-acetyl-L-cysteine at inhibitory and subinhibitory concentrations against biofilm formed by S. aureus and P. aeruginosa on prosthetic materials.
  
  
  METHODS
  S. aureus and P. aeruginosa biofilm on smooth polyethylene and sand-blasted titanium discs was determined by means of a spectrophotometric assay before and at 3, 6, and 18 hours after addition of N-acetyl-L-cysteine.
  
  
  RESULTS
  N-acetyl-L-cysteine was able to disaggregate biofilm produced by S. aureus and P. aeruginosa on polyethylene and titanium discs after 3 h of incubation. A different rate in eradication of biofilm produced by P. aeruginosa was seen between polyethylene and titanium (50% vs. 20% respectively vs. biofilm formed before treatment). Results were confirmed by confocal laser scanning microscopy.
  
  
  CONCLUSIONS
  The results suggest a possible role of N-acetyl-L-cysteine in the treatment of orthopedic prosthetic infections.
authors.affiliation: Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopedic Institute, 20161 Milan, Italy. Iorenzo.drago@unimi.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Drago
authors.forename: Elena
authors.initials: E
authors.lastname: De Vecchi
authors.forename: Roberto
authors.initials: R
authors.lastname: Mattina
authors.forename: Carlo L
authors.initials: CL
authors.lastname: Romanò
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000295:instrumentation; D058491:Bacterial Load; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development; D007595:Joint Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D018613:Microscopy, Confocal; D020959:Polyethylene; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000254:growth & development; D013053:Spectrophotometry; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development; D013997:Time Factors; D014025:Titanium
chemical_list: D000900:Anti-Bacterial Agents; D020959:Polyethylene; D014025:Titanium; D000111:Acetylcysteine