A novel synthetic synovial fluid model for investigating biofilm formation and antibiotic susceptibility in prosthetic joint infections

Abstract

Infections after joint replacement are rare but can lead to severe complications as they are difficult to treat due to the ability of pathogens to form surface-attached biofilms on the prosthesis as well as biofilm aggregates in the tissue and synovial fluid. This biofilm phenotype, combined with the microenvironment at the infection site, substantially increases antimicrobial tolerance. Conventional in vitro models typically use standard growth media, which do not consider the microenvironment at the site of infection. By replacing these standard growth media with an in vivo -like medium, such as the synthetic synovial fluid medium, we hope to expand our knowledge on the aggregation of pathogens in the context of PJI. In addition, we believe that inclusion of in vivo -like media in antimicrobial susceptibility testing might be able to more accurately predict the in vivo susceptibility, which could ultimately result in a better clinical outcome after antimicrobial treatment.