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

Journal article
Authors Acke Ohlin
Emma Mattsson
Matthias Mörgelin
Julia R. Davies
Gunnel Svensäter
Stéphane Corvec
Pentti Tengvall
Kristian Riesbeck
Published in European Spine Journal
Volume 27
Issue 10
Pages 2463–2468
ISSN 09406719
Publication year 2018
Published at Institute of Clinical Sciences, Department of Biomaterials
Pages 2463–2468
Language en
Keywords Bacteria, Growth, Hydrogen peroxide, Titanium, Titanium peroxy
Subject categories Biomaterials Science, Bio Materials


© 2018 The Author(s) 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.]

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