Bacterial biofilm and chronic osteomyelitis / 中华创伤骨科杂志

ABSTRACT

Due to increasing incidence of open fracture and increasing application of orthopedic implants, chronic osteomyelitis prevails in recent years, leading to failure of internal fixation, sinus tract formation, long-term abscess discharge and delayed recovery, etc., affecting prognosis and quality of life of the patients, and causing a huge medical and economic burden.The treatment of osteomyelitis has recently progressed from mere debridement to debridement + Masquelet bone reconstruction or osteotomy + llizarov bone transfer which has significantly improved the therapeutic efficacy. However, multiple surgeries, long healing time and massive surgical trauma of the current treatment cause poor compliance in the patients. Therefore, new therapeutic strategies are imperative. Various causes of chronic osteomyelitis involve autoimmunity, inflammatory factors, oxidative stress, local blood supply in osteomyelitis region, drug-resistant bacteria, bacterial virulence and bacterial biofilm which, as an important form of bacteria in the body, has a particularly significant impact on chronic osteomyelitis. Resistance to a variety of eliminating effects by bacteria is achieved mainly by biofilm, including reducing antibiotics concentration, barrier against immune clearance, improving bacterial resistance, spreading bacteria and promoting signal communication between bacteria. Aiming at the key factors and pathways for target research and intervention is the hotspot and trend in the research and treatment of osteomyelitis. Here we review the literature about the role of biofilm in chronic osteomyelitis, which is conducive for further understanding of the biofilm influence on chronic osteomyelitis and related targets, and for prevention and treatment of chronic osteomyelitis as well.