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Abstract
Prosthetic joint infection (PJI) is a complication of arthroplasty that results in significant morbidity. The presence of biofilm makes treatment difficult, and removal of the prosthesis is frequently required. We have developed a non-invasive approach for biofilm eradication from metal implants using intermittent alternating magnetic fields (iAMF) to generate targeted heating at the implant surface. The goal of this study was to determine whether iAMF demonstrated efficacy in an in vivo implant biofilm infection model. iAMF combined with antibiotics led to enhanced reduction of biofilm on metallic implants in vivo compared to antibiotics or untreated control. iAMF-antibiotic combinations resulted in a > 1 − log further reduction in biofilm burden compared to antibiotics or iAMF alone. This combination effect was seen in both S. aureus and P. aeruginosa and seen with multiple antibiotics used to treat infections with these pathogens. In addition, efficacy was temperature dependent with increasing temperatures resulting in a greater reduction of biofilm. Tissue damage was limited (< 1 mm from implant-tissue interface). This non-invasive approach to eradicating biofilm could serve as a new paradigm in treating PJI.
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1 Texas Prostate, Addison, USA
2 University of Texas Southwestern Medical School, Department of Radiology, Dallas, USA (GRID:grid.267313.2) (ISNI:0000 0000 9482 7121); University of Texas Southwestern Medical School, Advanced Imaging Research Center, Dallas, USA (GRID:grid.267313.2) (ISNI:0000 0000 9482 7121)
3 Solenic Medical, Addison, USA (GRID:grid.267313.2)
4 University of Texas Southwestern Medical School, Department of Internal Medicine, Infectious Diseases and Geographic Medicine, Dallas, USA (GRID:grid.267313.2) (ISNI:0000 0000 9482 7121)
5 University of Texas Southwestern Medical School, Department of Radiology, Dallas, USA (GRID:grid.267313.2) (ISNI:0000 0000 9482 7121)
6 University of Texas Southwestern Medical School, Department of Pathology, Dallas, USA (GRID:grid.267313.2) (ISNI:0000 0000 9482 7121)
7 University of Texas Southwestern Medical School, Department of Radiology, Dallas, USA (GRID:grid.267313.2) (ISNI:0000 0000 9482 7121); University of Texas Southwestern Medical School, Advanced Imaging Research Center, Dallas, USA (GRID:grid.267313.2) (ISNI:0000 0000 9482 7121); Solenic Medical, Addison, USA (GRID:grid.267313.2)
8 University of Texas Southwestern Medical School, Department of Internal Medicine, Infectious Diseases and Geographic Medicine, Dallas, USA (GRID:grid.267313.2) (ISNI:0000 0000 9482 7121); University of Texas Southwestern Medical School, Department of Microbiology, Dallas, USA (GRID:grid.267313.2) (ISNI:0000 0000 9482 7121)