Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery

Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery

Acke Ohlin, Emma Mattsson, Matthias Mörgelin, Julia R. Davies, Gunnel Svensäter, Stéphane Corvec, Pentti Tengvall, Kristian Riesbeck

October 2018, Volume 27, Issue 10, pp 2463 - 2468
DOI
10.1007/s00586-018-5619-8
First Online: 07 May 2018
Abstract

Purpose

Post-operative infections are relatively common after posterior spine surgery, and there are several observations reflecting different infection complications related to various metals implanted. Here, we selected an array of different bacterial species that are often found in infections associated with orthopaedic implants and tested for inhibition by hydrogen peroxide-treated titanium (Ti-peroxy).

Methods

To study the possibility of using Ti-peroxy as an antimicrobial prophylaxis, we developed a protocol for standardized susceptibility testing of bacteria.

Results

Importantly, we found that the resulting Ti-peroxy was highly antimicrobial against all aerobic species tested, among others, Staphylococcus aureus and Pseudomonas aeruginosa. Proteus mirabilis was slightly more resistant than, for example, Klebsiella pneumoniae and enterococci. In contrast, anaerobic bacteria Cutibacterium acnes and Parvimonas micra were equally susceptible compared to staphylococci.

Conclusions

Our findings suggest that the Ti-peroxy is a promising perioperative antimicrobial strategy that may be highly effective for prevention of post-operative infections. We therefore suggest application of hydrogen peroxide to implants prior to implantation.

Graphical abstract

These slides can be retrieved under Electronic supplementary material.[Figure not available: see fulltext.]