@entity5938 is one of the leading causes of @entity281 associated with biofilm formation on implant devices. @entity4422 are at risk of @entity5938 transcutaneous contamination leading to higher non-union development compared to closed @entity174 . Although the role of @entity281 in delaying @entity174 healing is well recognized, no in vivo models investigated the impact of subclinical low-grade infections on bone repair and non-union. We hypothesized that the non-union rate is directly related to the load of this commonly retrieved pathogen and that a low-grade contamination delays the @entity174 healing without clinically detectable @entity281 . @entity35 femurs were osteotomized and stabilized with plates. @entity174 were infected with a characterized clinical-derived @entity3256 -resistant @entity5938 (103, 105, 108 colony forming units) and compared to uninfected controls. After 56 days, bone healing and @entity4034 were clinically assessed and further evaluated by micro-CT, microbiological and histological analyses. The biofilm formation was visualized by scanning electron microscopy. The control group showed no signs of @entity281 and a complete bone healing. The 103 group displayed variable response to @entity281 with a 67% of altered bone healing and positive bacterial cultures, despite no clinical signs of @entity281 present. The 105 and 108 groups showed severe signs of @entity4034 and a non-union rate of 83-100%, respectively. The cortical bone reaction related to the periosteal elevation in the control group and the metal scattering detected by micro-CT represented limitations of this study. Our model showed that an intra-operative low-grade @entity5938 contamination might prevent the bone healing, even in the absence of infectious signs. Our findings also pointed out a dose-dependent effect between the @entity5938 inoculum and non-union rate. This pilot study identifies a relevant preclinical model to assess the role of @entity4092 in orthopaedic and @entity130 surgery and to test specifically designed diagnostic, prevention and therapeutic strategies.

Modeling @entity5938 -Induced Non-Unions: Subclinical and Clinical Evidence in XXXX .

@entity3256 :: ('MESH:D008712', 'Chemical') :: ['methicillin'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'Fractures', 'fracture'] @entity4422 :: ('MESH:D005597', 'Disease') :: ['Open fractures'] @entity5938 :: ('1282', 'Species') :: ['S. epidermidis'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma'] @entity4034 :: ('MESH:D010019', 'Disease') :: ['osteomyelitis'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection', 'orthopaedic infections'] @entity35 :: ('10116', 'Species') :: ['Rat'] @entity4092 :: ('MESH:D058345', 'Disease') :: ['subclinical infections']
@entity35 :: (10116,Species) :: ['Rats']
