title: Animal Models of Implant-Related Low-Grade Infections. A Twenty-Year Review.
abstract: The demand for joint replacement and surgical treatment is continuously increasing, thus representing a clinical burden and a cost for the healthcare system. Among several pathogens involved in implant-related infections, staphylococci account for the two-thirds of clinically isolated bacteria. Despite most of them are highly virulent microorganisms (Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa), low virulent bacteria (Staphylococcus epidermidis, Propionibacterium acnes) are responsible for delayed, low-grade infections without specific clinical signs and hardly distinguishable from aseptic prosthetic failure. Therefore, there is a real need to study the pathogenesis of orthopedic infections through in vivo animal models. The present review of the literature provides a 20-year overview of animal models of acute, subclinical or chronic orthopedic infections according to the pathogen virulence and inocula. Through this analysis, a great variety of conditions in terms of bacterial strains and inocula emerged, thus encouraging the development of more reproducible in vivo studies to provide relevant information for a translational approach to humans.
authors.affiliation: Cell and Tissue Engineering Laboratory, IRCCS Galeazzi Orthopedic Institute, via R. Galeazzi 4, 20161, Milan, Italy. arianna.lovati@grupposandonato.it.
authors.forename: Arianna Barbara
authors.initials: AB
authors.lastname: Lovati
authors.affiliation: Cell and Tissue Engineering Laboratory, IRCCS Galeazzi Orthopedic Institute, via R. Galeazzi 4, 20161, Milan, Italy.|Department of Veterinary Medicine, University of Milan, via Celoria 10, 20133, Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Bottagisio
authors.affiliation: Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopedic Institute, via R. Galeazzi 4, 20161, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: de Vecchi
authors.affiliation: Department of Reconstructive Surgery of Osteo-articular Infections C.R.I.O. Unit, IRCCS Galeazzi Orthopedic Institute, via R. Galeazzi 4, 20161, Milan, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Gallazzi
authors.affiliation: Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Orthopedic Institute, via R. Galeazzi 4, 20161, Milan, Italy.|Department of Biomedical Science for Health, University of Milan, via L. Mangiagalli 31, 20133, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Drago
mesh_terms: D000818:Animals; D001424:Bacterial Infections / Q000382:microbiology*; D018441:Biofilms / Q000254:growth & development*; D023421:Models, Animal; D019736:Prostheses and Implants / Q000382:microbiology*; D016459:Prosthesis-Related Infections / Q000382:microbiology*
keywords: Animal models; Low inocula; Low virulence; Propionibacterium acnes; Staphylococcus