Orthopedics Research Today is a free monthly online journal that collates and summarizes the latest research about Orthopedics, including details on chronic injuries, muscoskeletal disorders, surgery, reconstruction.

The role of small-colony variants in failure to diagnose and treat biofilm infections in orthopedics.

Neut D, Van Der Mei HC, Bulstra SK, Busscher HJ

Department of Biomedical Engineering, University Medical Center Groningen, and University of Groningen. Groningen. the Netherlands.

Biomaterial-related infection of joint replacements is the second most common cause of implant failure, with serious consequences. Chronically infected replacements cannot be treated without removal of the implant, as the biofilm mode of growth protects the bacteria against antibiotics. This review discusses biofilm formation on joint replacements and the important clinical phenomenon of small-colony variants (SCVs). These slow-growing phenotypic variants often remain undetected or are misdiagnosed using hospital microbiological analyses due to their unusual morphological appearance and biochemical reactions. In addition, SCVs make the infection difficult to eradicate. They often lead to recurrence since they respond poorly to standard antibiotic treatment and can sometimes survive intracellularly.

Published 5 July 2007 in Acta Orthop, 78(3): 299-308.
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