Masters Applied Projects

Project 26

In Vitro Bactericidal Efficacy of Different Antibacterial Irrigations against High Resistant Human Skin Micro-Organisms

Student: Christine Tran

Mentors: Dr. Brent Vernon – SBHSE
Dr. Vincent Pizziconi – SBHSE
Dr. Douglas Montgomery – SCIDSE
Dr. Zachary Christopher – Orthopedic Surgery, Mayo Clinic Arizona

YouTube Link: View the video link below before joining the zoom meeting

Zoom link: https://asu.zoom.us/j/3833279728?pwd=anZESXRsRW84bVNldHh1QTUrdXo5QT09

Time: 10am – 2pm

Abstract

Surgical Site Infections (SSIs), including Prosthetic Joint Infections (PJIs), continue to create a significant problem associated with prolonged patient mobility and increased mortality. In the U.S, hip and knee arthroplasties alone account for approximately 1.2 million procedures annually. The rate of PJIs is estimated to be between 0.5% and 2.4% of primary operations. These complications after surgeries can place a significantly physiologic burden on the patients and a substantial financial burden on the healthcare economy. Therefore, it is critical to continue to look for improved infection prevention and management strategies in orthopedic surgery. Antiseptic and antibacterial solutions have shown to be effective in eliminating most planktonic bacteria in certain surgical settings. Although the effectiveness of multiple antiseptic solutions, such as chlorhexidine, dilute povidone-iodine, polyhexanide biguanide, and sodium hypochlorite, have been demonstrated with irrigation times of two minutes or longer, the antibacterial efficacy at shorter time intervals has not been well defined. Besides, the effectiveness of these antiseptic solutions on Cutibacterium acnes, an organism that has become more problematic in the orthopedic world lately, has not been studied. In this study, the antimicrobial efficacy of those antiseptic irrigations against the high resistant human skin bacteria, including Staphylococcus aureus, Staphylococcus epidermidis, and Cutibacterium acnes, is examined at clinically relevant concentrations and limited exposure times. Furthermore, the study also includes more novel commercially available antibacterial solutions such as Bactisure. Results show that different antiseptic irrigations have different kill time points on different bacteria. The most effective antimicrobial solutions against all three organisms tested at the shortest time interval (15 seconds) employed in this study are diluted povidone-iodine, following by chlorhexidine and Bactisure. Data also indicates the combination of an effective antimicrobial with the application appropriate irrigation process for a specified timepoint will result in the most effective treatment methodology for treating surgical site infections.