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Employing high-frequency alternating magnetic fields for the non-invasive treatment of prosthetic joint infections.

ABSTRACT: Treatment of prosthetic joint infection (PJI) usually requires surgical replacement of the infected joint and weeks of antibiotic therapy, due to the formation of biofilm. We introduce a non-invasive method for thermal destruction of biofilm on metallic implants using high-frequency (>100?kHz) alternating magnetic fields (AMF). In vitro investigations demonstrate a >5-log reduction in bacterial counts after 5?minutes of AMF exposure. Confocal and scanning electron microscopy confirm removal of biofilm matrix components within 1?minute of AMF exposure, and combination studies of antibiotics and AMF demonstrate a 5-log increase in the sensitivity of Pseudomonas aeruginosa to ciprofloxacin. Finite element analysis (FEA) simulations demonstrate that intermittent AMF exposures can achieve uniform surface heating of a prosthetic knee joint. In vivo studies confirm thermal damage is confined to a localized region (<2 mm) around the implant, and safety can be achieved using acoustic monitoring for the presence of surface boiling. These initial studies support the hypothesis that AMF exposures can eradicate biofilm on metal implants, and may enhance the effectiveness of conventional antibiotics.

SUBMITTER: Chopra R

PROVIDER: S-EPMC5548742 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Employing high-frequency alternating magnetic fields for the non-invasive treatment of prosthetic joint infections.

Chopra Rajiv R Shaikh Sumbul S Chatzinoff Yonatan Y Munaweera Imalka I Cheng Bingbing B Daly Seth M SM Xi Yin Y Bing Chenchen C Burns Dennis D Greenberg David E DE

Scientific reports 20170808 1

Treatment of prosthetic joint infection (PJI) usually requires surgical replacement of the infected joint and weeks of antibiotic therapy, due to the formation of biofilm. We introduce a non-invasive method for thermal destruction of biofilm on metallic implants using high-frequency (>100 kHz) alternating magnetic fields (AMF). In vitro investigations demonstrate a >5-log reduction in bacterial counts after 5 minutes of AMF exposure. Confocal and scanning electron microscopy confirm removal of b ...[more]

PMID: 28790407

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Project description:ImportanceDentists in the United States are under pressure from orthopedic surgeons and their patients with prosthetic joints to provide antibiotic prophylaxis before invasive dental procedures (IDP) to reduce the risk of late prosthetic joint infection (LPJI). This has been a common practice for decades, despite a lack of evidence for an association between IDP and LPJI, a lack of evidence of antibiotic prophylaxis efficacy, cost of providing antibiotic prophylaxis, and risk of both adverse drug reactions and the potential for promoting antibiotic resistance.ObjectiveTo quantify any temporal association between IDP and subsequent LPJI.Design, setting, and participantsThis cohort study used a case-crossover and time trend design to examine any potential association between IDP and LPJI. The population of England (55 million) was chosen because antibiotic prophylaxis has never been recommended to prevent LPJI in England, and any association between IDP and LPJI would therefore be fully exposed. All patients admitted to hospitals in England for LPJI from December 25, 2011, through March 31, 2017, and for whom dental records were available were included. Analyses were performed between May 2018 and June 2021.ExposuresExposure to IDP.Main outcomes and measuresThe main outcome was the incidence of IDP in the 3 months before LPJI hospital admission (case period) compared with the incidence in the 12 months before that (control period).ResultsA total of 9427 LPJI hospital admissions with dental records (mean [SD] patient age, 67.8 [13.1] years) were identified, including 4897 (52.0%) men and 4529 (48.0%) women. Of these, 2385 (25.3%) had hip prosthetic joints, 3168 (33.6%) had knee prosthetic joints, 259 (2.8%) had other prosthetic joints, and 3615 (38.4%) had unknown prosthetic joint types. There was no significant temporal association between IDP and subsequent LPJI. Indeed, there was a lower incidence of IDP in the 3 months prior to LPJI (incidence rate ratio, 0.89; 95% CI, 0.82-0.96; P = .002).Conclusions and relevanceThese findings suggest that there is no rationale to administer antibiotic prophylaxis before IDP in patients with prosthetic joints.

Project description:The widespread use of electricity raises the question of whether or not 50 Hz (power line frequency in Europe) magnetic fields (MFs) affect organisms. We investigated the transcription of Escherichia coli K-12 MG1655 in response to extremely low-frequency (ELF) MFs. Fields generated by three signal types (sinusoidal continuous, sinusoidal intermittent, and power line intermittent; all at 50 Hz, 1 mT), were applied and gene expression was monitored at the transcript level using an Affymetrix whole-genome microarray. Bacterial cells were grown continuously in a chemostat (dilution rate D = 0.4 h-1) fed with glucose-limited minimal medium and exposed to 50 Hz MFs with a homogenous flux density of 1 mT. For all three types of MFs investigated, neither bacterial growth (determined using optical density) nor culturable counts were affected. Likewise, no statistically significant change (fold-change > 2, P ≤ 0.01) in the expression of 4,358 genes and 714 intergenic regions represented on the gene chip was detected after MF exposure for 2.5 h (1.4 generations) or 15 h (8.7 generations). Moreover, short-term exposure (8 min) to the sinusoidal continuous and power line intermittent signal neither affected bacterial growth nor showed evidence for reliable changes in transcription. In conclusion, our experiments did not indicate that the different tested MFs (50 Hz, 1 mT) affected the transcription of E. coli. A total of 60 chips are included in this study. Each comparison (treated vs. sham-treated cultures; untreated negative control cultures) consists of three replicates. The three magnetic field test conditions include sinusoidal continous, sinusoidal intermittent (2 min on, 4 min off) and power line intermittent (2 min on, 4 min off). Exposure periods were 8 min, 2.5 h, or 15 h. The response control consists of E. coli cells treated for 10 min with 1 mM H2O2 or the equivalent water volume. The negative control comprises samples taken from cultures grown with the exposure chambers swiched off.

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Employing high-frequency alternating magnetic fields for the non-invasive treatment of prosthetic joint infections.

Publications

Employing high-frequency alternating magnetic fields for the non-invasive treatment of prosthetic joint infections.

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