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Journal of Clinical Microbiology, August 2009, p. 2496-2501, Vol. 47, No. 8
0095-1137/09/$08.00+0     doi:10.1128/JCM.02316-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

In Vitro Effect of Ultrasound on Bacteria and Suggested Protocol for Sonication and Diagnosis of Prosthetic Infections{triangledown}

Tor Monsen,1,4,5* Elisabeth Lövgren,1 Micael Widerström,3 and Lars Wallinder2

Department of Clinical Bacteriology,1 Department of Orthopedics, University Hospital of Umeå, SE-90185 Umeå, Sweden,2 Department of Infectious Diseases, Hospital of Östersund, SE-83183 Östersund, Sweden,3 Department of Medical Microbiology, St. Olavs University Hospital,4 Institute of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, N-7030 Trondheim, Norway5

Received 2 December 2008/ Returned for modification 5 December 2008/ Accepted 8 June 2009

Sonication of implants has been shown to be a promising method for diagnosis of prosthetic infections due to its improved sensitivity, simplicity, and low cost. The aim of the present study was to evaluate the effects of ultrasound performed under different conditions regarding temperature, duration, and composition of sonication tubes on bacterial species often associated with prosthetic infections. We found that ultrasound had an inhibitory effect on bacteria, of which gram-negative bacteria, in particular Escherichia coli, were almost eradicated after 5 min of sonication at 35°C. Gram-positive bacteria were found to be resistant to the effect of ultrasound. Four factors were important for the inhibitory effect of sonication: the type of microorganism, the temperature of the sonication buffer, the duration of exposure to ultrasound (minutes), and the material and composition of the sonication tube in which sonication is performed. On the basis of the results from the present study, we propose a protocol for sonication and recovery of bacteria associated with biofilm on infected implants prior to conventional culture. From the present protocol, we recommend sonication for 7 min at 22°C at the maximum effect which permits survival of gram-negative bacteria.

* Corresponding author. Mailing address: Department of Clinical Bacteriology, University Hospital of Umeå, S 901 85 Umeå, Sweden. Phone: 46 90 7851226. Fax: 46 90 7853591. E-mail: tor.monsen{at}climi.umu.se

{triangledown} Published ahead of print on 17 June 2009.

Journal of Clinical Microbiology, August 2009, p. 2496-2501, Vol. 47, No. 8
0095-1137/09/$08.00+0     doi:10.1128/JCM.02316-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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