Antimicrobial and Antibiofilm Effects of Ozonated Water for Prevention and Treatment of Bone and Joint Infections

  • Koyama Ryouta
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine
  • Okuda Ken-ichi
    Department of Bacteriology, The Jikei University School of Medicine
  • Matsushita Kazuhiko
    Department of Orthopaedic Surgery, Kawasaki Municipal Tama Hospital
  • Beppu Moroe
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine
  • Mizunoe Yoshimitsu
    Department of Bacteriology, The Jikei University School of Medicine

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Antimicrobial effects of ozonated water for the planktonic cells and the biofilm cells of staphylococci were examined for clinical applications in the orthopaedic field. As a result, 7 mg/L of ozonated water showed antimicrobial effects for not only the planktonic cells but also for the biofilm cells. Additionally, antimicrobial activity of ozonated water was examined after destroying the biofilm using 1 M NaCl or proteolytic enzymes (proteinase K and trypsin). Interaction between ozonated water and biofilm destruction was statistically significant in 2 strains (SE21, MR23) out of 8 strains. However, the effects of proteinase K or trypsin with ozonated water were statistically significant only in MRSA MR23. MRSA MR23 was previously reported to be a proteinaceous biofilm producer, and its biofilm was destructed by various proteases.

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