The stability of Staphylococcal bacteriophages with commonly used prosthetic joint infection lavage solutions

The aim of this study was to assess the viability of four Staphylococcal bacteriophages when exposed to different concentrations of commonly used lavage solutions in the surgical treatment of prosthetic joint infections (PJI). Four tailed Staphylococcal bacteriophages and six different lavage soluti...

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Bibliographic Details
Published in:Journal of orthopaedic research 2024-03, Vol.42 (3), p.555-559
Main Authors: Doub, James B., Fogel, Jessa, Urish, Ken L.
Format: Article
Language:English
Subjects:
Acetates - therapeutic use
bacteriophage therapy
Bacteriophages
Chlorhexidine
Humans
lavage solutions
Povidone-Iodine
prosthetic joint infections
Staphylococcal Infections - drug therapy
Staphylococcus aureus
Staphylococcus Phages
Therapeutic Irrigation - methods
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Summary:The aim of this study was to assess the viability of four Staphylococcal bacteriophages when exposed to different concentrations of commonly used lavage solutions in the surgical treatment of prosthetic joint infections (PJI). Four tailed Staphylococcal bacteriophages and six different lavage solutions (chlorhexidine 4%, hydrogen peroxide 3%, acetic acid 3%, povidone iodine 10%, sodium hypochlorite 0.5%, and Vashe solution) at 100%, 1%, and 0.01% concentrations were used in this experiment. In addition, the temporal impact of exposing bacteriophages to these lavage solutions was also evaluated at 5‐min exposures and 24‐h exposures. The results show that the titers of the four bacteriophages were statistically significantly decreased for all lavage solutions (100% and 1%) at 5‐min exposures and 24‐h exposures. However, with 0.01% concentrations of the lavage solutions, only acetic acid caused a statistically significant decrease in bacteriophage titers compared to normal saline control. Our findings suggest that tailed Staphylococcal bacteriophages do not remain stable in high concentrations of the most commonly used lavage solutions. However, at very dilute concentrations the bacteriophages do remain viable. This has important clinical ramifications in that it shows when using bacteriophage therapy for PJI it is critical to thoroughly wash out any lavage solutions before the introduction of therapeutic bacteriophages especially when acetic acid is used.
ISSN:0736-0266
1554-527X
1554-527X
DOI:10.1002/jor.25731