Bacteria antibiotic resistance: New challenges and opportunities for implant‐associated orthopedic infections

TLDR

Antibiotic‑resistant bacteria have surged, limiting treatment options, costing $55–70 billion annually in the U.S., and raising morbidity and mortality in orthopedic implant infections. This review examines the global severity of antibiotic resistance, its consequences, and bacterial pathways that drive resistance. It discusses opportunities and challenges for limiting resistance via novel, non‑drug strategies that target bacterial functions in orthopedic implant‑associated infections. © 2017 Orthopaedic Research Society and published by Wiley Periodicals, Inc.

Abstract

ABSTRACT There has been a dramatic increase in the emergence of antibiotic‐resistant bacterial strains, which has made antibiotic choices for infection control increasingly limited and more expensive. In the U.S. alone, antibiotic‐resistant bacteria cause at least 2 million infections and 23,000 deaths a year resulting in a $55–70 billion per year economic impact. Antibiotics are critical to the success of surgical procedures including orthopedic prosthetic surgeries, and antibiotic resistance is occurring in nearly all bacteria that infect people, including the most common bacteria that cause orthopedic infections, such as Staphylococcus aureus ( S. aureus ). Most clinical cases of orthopedic surgeries have shown that patients infected with antibiotic‐resistant bacteria, such as methicillin‐resistant S. aureus (MRSA), are associated with increased morbidity and mortality. This paper reviews the severity of antibiotic resistance at the global scale, the consequences of antibiotic resistance, and the pathways bacteria used to develop antibiotic resistance. It highlights the opportunities and challenges in limiting antibiotic resistance through approaches like the development of novel, non‐drug approaches to reduce bacteria functions related to orthopedic implant‐associated infections. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:22–32, 2018.