• Acke Ohlin, Emma Mattsson, Matthias Mörgelin, Julia R Davies, Gunnel Svensäter, Stéphane Corvec, Pentti Tengvall, and Kristian Riesbeck.
• Dept. of Orthopaedics, Department of Clinical Sciences, Faculty of Medicine, Lund University, Jan Waldenströms gata 35, 205 02, Malmö, Sweden.
• Eur Spine J. 2018 Oct 1; 27 (10): 2463-2468.

PurposePost-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).MethodsTo study the possibility of using Ti-peroxy as an antimicrobial prophylaxis, we developed a protocol for standardized susceptibility testing of bacteria.ResultsImportantly, 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.ConclusionsOur 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. These slides can be retrieved under Electronic supplementary material.

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