title: Antibiofilm agents against MDR bacterial strains: is bioactive glass BAG-S53P4 also effective?
abstract: OBJECTIVE
  The treatment of bone and joint infections is challenging due to the presence of bacterial biofilm and the increasing emergence of multiresistant strains. BAG-S53P4 is a bone substitute that is characterized by osteoconductive and antimicrobial properties. The aim of this study was to assess the effectiveness of BAG-S53P4 against biofilm produced in vitro by multiresistant bacterial strains.
  
  
  METHODS
  Multiresistant Staphylococcus epidermidis, Acinetobacter baumannii and Klebsiella pneumoniae isolated from bone and joint infections were used in this study. Titanium discs covered by bacterial biofilm were incubated with BAG-S53P4 or inert glass as a control. The amount of biofilm on each titanium disc was evaluated after 48 h of incubation by means of confocal laser scanning microscopy.
  
  
  RESULTS
  Significantly lower total biomass volumes were observed for all strains after treatment with BAG-S53P4 when compared with controls. Moreover, the percentage of dead cells was significantly higher in treated samples than in controls for all the tested strains.
  
  
  CONCLUSIONS
  BAG-S53P4 is able to reduce the biofilm produced by multiresistant S. epidermidis, A. baumannii and K. pneumoniae on titanium substrates in vitro, probably by interfering with cell viability. Owing to its osteoconductive, antibacterial and antibiofilm properties, the use of BAG-S53P4 may be a successful strategy for the treatment of bone and prosthetic joint infections.
authors.affiliation: Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Bortolin
authors.affiliation: Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: De Vecchi
authors.affiliation: Centre for Reconstructive Surgery and Bone Infections, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
authors.forename: Carlo Luca
authors.initials: CL
authors.lastname: Romanò
authors.affiliation: Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Toscano
authors.affiliation: Department of Public Health, Microbiology and Virology, University of Milan, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Mattina
authors.affiliation: Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy Laboratory of Technical Sciences for Laboratory Medicine, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy lorenzo.drago@unimi.it.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Drago
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification / Q000502:physiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001424:Bacterial Infections / Q000382:microbiology; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development; D024901:Drug Resistance, Multiple, Bacterial; D005898:Glass; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000302:isolation & purification / Q000502:physiology; D050296:Microbial Viability / Q000187:drug effects; D010003:Osteoarthritis / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000382:microbiology; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000302:isolation & purification / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; C403922:bioactive glass S53P4