Topical adjuvants incompletely remove adherent Staphylococcus aureus from implant materials

ABSTRACT Adjuvant treatments including Betadine, Dakin's solution (sodium hypochlorite), or hydrogen peroxide (H2O2) have been attempted to eradicate prosthetic joint infection caused by biofilm or intracellular bacteria. The purpose of this study was to evaluate the in vitro abilities of chemical adjuvants to decrease Staphylococcus aureus (S. aureus) biofilm presence on orthopaedic implant grade materials, including titanium, stainless steel, and cobalt chrome. S. aureus biofilms were grown for 48 h and evaluated for baseline colony forming units/centimeter squared (CFU/cm2) and compared to treatments with Betadine, Dakin's solution, H2O2, or 1% chlorine dioxide (ClO2). Control discs (n = 18) across all metals had an average of 4.2 × 107 CFU/cm2. All treatments had statistically significant reductions in CFU/cm2 when compared to respective control discs (p