Improving the bacterial recovery by using dithiothreitol with aerobic and anaerobic broth in biofilm-related prosthetic and joint infections

Biofilm-related infections are serious complications in the orthopaedic prosthetic field and an accurate, quick microbiological diagnosis is required to set up a specific antimicrobial therapy. It is well known that the diagnosis of these infections remains difficult due to the bacterial embedding within the biofilm matrix on the implant surfaces. Recently, the use of DL-dithiothreitol (DTT) has been proved effective in biofilm detachment from orthopaedic devices.The purpose of the study is to evaluate the efficacy of two DTT solutions enriched with specific broths for aerobic or anaerobic bacteria to dislodge pathogens from the biofilm, while supporting the bacterial recovery and viability. To do this, different experimental solutions were tested for efficacy and stability on strong biofilm producers: S. aureus and P. acnes. Mainly, we evaluate the capability of DTT dissolved in saline solution, brain heart infusion or thioglycollate broth to support the bacterial detachment from prosthetic materials and bacterial growth at different time points and storage conditions.We demonstrated that the use of DTT enriched with specific bacterial broths could be a suitable approach to optimize the bacterial detachment, recovery, growth and viability in the diagnosis of biofilm-related infections developed on orthopaedic prosthetic devices.