Lidocaine Shows Significant Antimicrobial Effects Against <i>Staphylococcus</i> Species: An In-Vitro Study Comparing Different Combinations of Lidocaine and Clinically Used Injectables, like Steroids and Hyaluronan, in the Context of Arthritis Management
Introduction: Intra-articular injections, commonly used in osteoarthritis treatment, are debated due to their potential link to septic arthritis, though its incidence remains low. Lidocaine, used as a “carrier” for therapeutic substances like hyaluronan or triamcinolone, has pain-relieving and antim...
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2025-01-01
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| author | Stephan Heller Ricarda Johanna Seemann Rainer Burgkart Andreas Obermeier Hermann Locher |
| author_facet | Stephan Heller Ricarda Johanna Seemann Rainer Burgkart Andreas Obermeier Hermann Locher |
| author_sort | Stephan Heller |
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| description | Introduction: Intra-articular injections, commonly used in osteoarthritis treatment, are debated due to their potential link to septic arthritis, though its incidence remains low. Lidocaine, used as a “carrier” for therapeutic substances like hyaluronan or triamcinolone, has pain-relieving and antimicrobial properties. This study investigates the concentration-dependent antimicrobial effects of lidocaine in combination with hyaluronan and triamcinolone in both standard and synovial fluid cultures. Methods: The antimicrobial efficacy of lidocaine against <i>Staphylococcus aureus</i> was investigated, with variations in bacterial and lidocaine concentrations. Bacterial growth was monitored using a UV/VIS spectrometer at 600 nm. Lidocaine solutions of 1% and 2% were tested, both alone and in combination with hyaluronic acid or Triam40, in tryptic soy broth (TSB), to reflect knee joint applications. The groups included pure lidocaine (L), Triam (T), hyaluronan (H), and combinations (LT, LH, TH, LTH) with 1% or 2% lidocaine. A bacterial inoculum of 300 CFU/mL was used, and samples were incubated for 12 and 24 h. Additional tests were conducted on <i>Staphylococcus epidermidis</i> and methicillin-resistant Staphylococcus aureus (MRSA), as well as on <i>S. aureus</i> in human synovial fluid. Results: Lidocaine showed a concentration-dependent antimicrobial effect, with greater inhibition at higher concentrations and lower bacterial densities. All lidocaine-containing combinations significantly reduced the bacterial levels of <i>S. aureus</i> in TSB. Similar results were seen for <i>S. epidermidis</i> and <i>MRSA</i>, with notable inhibition in synovial fluid after 12 h, especially with 2% lidocaine. Conclusions: Lidocaine exhibits dose-dependent antimicrobial effects against key pathogens responsible for septic arthritis. Its combination with Triam40 and hyaluronan may reduce the risk of septic arthritis, supporting its clinical relevance. |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| series | Biomedicines |
| spelling | doaj-art-1e7c40e449834903b650fc5bd70dcd992025-01-24T13:24:02ZengMDPI AGBiomedicines2227-90592025-01-0113110610.3390/biomedicines13010106Lidocaine Shows Significant Antimicrobial Effects Against <i>Staphylococcus</i> Species: An In-Vitro Study Comparing Different Combinations of Lidocaine and Clinically Used Injectables, like Steroids and Hyaluronan, in the Context of Arthritis ManagementStephan Heller0Ricarda Johanna Seemann1Rainer Burgkart2Andreas Obermeier3Hermann Locher4Department of Orthopaedics and Sports Orthopaedics, TUM School of Medicine and Health, TUM Universitätsklinikum Klinikum Rechts der Isar, 81675 Munich, GermanyCentre for Orthopaedics and Specialized Pain Therapy, 88069 Tettnang, GermanyDepartment of Orthopaedics and Sports Orthopaedics, TUM School of Medicine and Health, TUM Universitätsklinikum Klinikum Rechts der Isar, 81675 Munich, GermanyDepartment of Orthopaedics and Sports Orthopaedics, TUM School of Medicine and Health, TUM Universitätsklinikum Klinikum Rechts der Isar, 81675 Munich, GermanyDepartment of Orthopaedics and Sports Orthopaedics, TUM School of Medicine and Health, TUM Universitätsklinikum Klinikum Rechts der Isar, 81675 Munich, GermanyIntroduction: Intra-articular injections, commonly used in osteoarthritis treatment, are debated due to their potential link to septic arthritis, though its incidence remains low. Lidocaine, used as a “carrier” for therapeutic substances like hyaluronan or triamcinolone, has pain-relieving and antimicrobial properties. This study investigates the concentration-dependent antimicrobial effects of lidocaine in combination with hyaluronan and triamcinolone in both standard and synovial fluid cultures. Methods: The antimicrobial efficacy of lidocaine against <i>Staphylococcus aureus</i> was investigated, with variations in bacterial and lidocaine concentrations. Bacterial growth was monitored using a UV/VIS spectrometer at 600 nm. Lidocaine solutions of 1% and 2% were tested, both alone and in combination with hyaluronic acid or Triam40, in tryptic soy broth (TSB), to reflect knee joint applications. The groups included pure lidocaine (L), Triam (T), hyaluronan (H), and combinations (LT, LH, TH, LTH) with 1% or 2% lidocaine. A bacterial inoculum of 300 CFU/mL was used, and samples were incubated for 12 and 24 h. Additional tests were conducted on <i>Staphylococcus epidermidis</i> and methicillin-resistant Staphylococcus aureus (MRSA), as well as on <i>S. aureus</i> in human synovial fluid. Results: Lidocaine showed a concentration-dependent antimicrobial effect, with greater inhibition at higher concentrations and lower bacterial densities. All lidocaine-containing combinations significantly reduced the bacterial levels of <i>S. aureus</i> in TSB. Similar results were seen for <i>S. epidermidis</i> and <i>MRSA</i>, with notable inhibition in synovial fluid after 12 h, especially with 2% lidocaine. Conclusions: Lidocaine exhibits dose-dependent antimicrobial effects against key pathogens responsible for septic arthritis. Its combination with Triam40 and hyaluronan may reduce the risk of septic arthritis, supporting its clinical relevance.https://www.mdpi.com/2227-9059/13/1/106lidocaineseptic arthritisstaphylococciMRSAperiprosthetic joint infections |
| spellingShingle | Stephan Heller Ricarda Johanna Seemann Rainer Burgkart Andreas Obermeier Hermann Locher Lidocaine Shows Significant Antimicrobial Effects Against <i>Staphylococcus</i> Species: An In-Vitro Study Comparing Different Combinations of Lidocaine and Clinically Used Injectables, like Steroids and Hyaluronan, in the Context of Arthritis Management Biomedicines lidocaine septic arthritis staphylococci MRSA periprosthetic joint infections |
| title | Lidocaine Shows Significant Antimicrobial Effects Against <i>Staphylococcus</i> Species: An In-Vitro Study Comparing Different Combinations of Lidocaine and Clinically Used Injectables, like Steroids and Hyaluronan, in the Context of Arthritis Management |
| title_full | Lidocaine Shows Significant Antimicrobial Effects Against <i>Staphylococcus</i> Species: An In-Vitro Study Comparing Different Combinations of Lidocaine and Clinically Used Injectables, like Steroids and Hyaluronan, in the Context of Arthritis Management |
| title_fullStr | Lidocaine Shows Significant Antimicrobial Effects Against <i>Staphylococcus</i> Species: An In-Vitro Study Comparing Different Combinations of Lidocaine and Clinically Used Injectables, like Steroids and Hyaluronan, in the Context of Arthritis Management |
| title_full_unstemmed | Lidocaine Shows Significant Antimicrobial Effects Against <i>Staphylococcus</i> Species: An In-Vitro Study Comparing Different Combinations of Lidocaine and Clinically Used Injectables, like Steroids and Hyaluronan, in the Context of Arthritis Management |
| title_short | Lidocaine Shows Significant Antimicrobial Effects Against <i>Staphylococcus</i> Species: An In-Vitro Study Comparing Different Combinations of Lidocaine and Clinically Used Injectables, like Steroids and Hyaluronan, in the Context of Arthritis Management |
| title_sort | lidocaine shows significant antimicrobial effects against i staphylococcus i species an in vitro study comparing different combinations of lidocaine and clinically used injectables like steroids and hyaluronan in the context of arthritis management |
| topic | lidocaine septic arthritis staphylococci MRSA periprosthetic joint infections |
| url | https://www.mdpi.com/2227-9059/13/1/106 |
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