Vulnerability of geriatric patients to biomaterial associated infections: in vitro study of biofilm formation by Pseudomonas aeruginosa on orthopedic implants

TL;DR

This study investigates how fibronectin's adsorption on orthopedic implants promotes biofilm formation by Pseudomonas aeruginosa, increasing infection risk in elderly patients with compromised immunity.

Contribution

It reveals the role of fibronectin in biofilm development on biomaterials, highlighting a mechanism for increased infection risk in geriatric implant patients.

Findings

Fibronectin preferentially adsorbs on biomaterials over albumin.

Adsorbed fibronectin enhances Pseudomonas aeruginosa biofilm growth.

Geriatric patients' weakened immunity exacerbates infection risks.

Abstract

Fibronectin, a glycoprotein secreted by connective tissue cells is found in the human plasma as well as in the ECM. It is known to have an adhesive property and plays a role in cell-to-cell and cell-to-substratum adhesions. In rheumatoid arthritis (RA) and osteoarthritis (OA), fibronectin is locally synthesized by the synovial cells, and the synovial fluid level of fibronectin is found to be double that in plasma. The concentration of fibronectin in the synovial fluid under such conditions is found escalate to 2-3 times higher than in the corresponding plasma. The present article demonstrates that the protein has a strong tendency to get adsorbed on biomaterials after an implant surgery in preference to lighter proteins like albumin, which in turn enhances the growth of robust biofilms. The present article demonstrates that, heightened risk of dangerous implant infections due to the formation of such biofilms coupled with the degrading immunity levels of the geriatric patients have the potential to transform an implant surgery to a 'life threatening' event.