Introduction According to U.S. statistics, there were 51.4 million surgeries performed last year. Out of those, a little over one million surgeries were total knee and hip replacements and another million were due to cardiac catheterizations alone. These people put their lives and trust into the doctors performing the surgeries, which in turn require them to live the remainder of their lives with a foreign object in their bodies. What happens to these implants and devices inside the body post surgery could become threatening and dangerous to the patient and must therefore must be studied.
A) Why did the scientists perform the study (i.e. description of background)? Any medical device that is used in a surgery to replace any joint, used as an implantation, or any catheter or graft is known as a biomaterial because they are being used more often in modern medicine. Unfortunately, a biomaterial inside the body strongly increases the chances at developing a biomaterial-associated infection caused by staphylococci—specifically Staphylococcus epidermidis and Staphylococcus aureus. The hygiene measures, or lack thereof, are what cause the infections to take place. The patient’s skin and surgical equipment carry bacteria, and if these bacteria adhere to the device being implanted, a biofilm (is any group of microorganisms in which cells stick to each other on a surface) forms and are the factors in a biomaterial-associated infection. When this occurs, however, the effectiveness of antibiotics are often reduced, and therefore require a more intense method of intervention. In order to avoid these infections, the scientists studied whether or not bacteria being present on the implant itself is the source for colonization of bacteria in the surrounding tissue.

B) What was the hypothesis (or hypotheses) under investigation? The scientists were interested in the relationship between bacterium and an implant before or during surgery and any rising infection to the surrounding tissue that may occur because of it. Development and localization of Staphylococcus epidermidis infection in tissue surrounding the implant because of the bacteria previously present on the surface is the focus of investigation. To do this, the scientists inoculated Staphylococcus epidermidis on the surface of an implant and used it as a model for a biofilm. They then placed it in a mouse to be used as a mouse biomaterial-associated infection. Therefore, the scientists believed that bacteria in a biofilm on the implant are a potential source of infection of the surrounding tissue, and antimicrobial strategies should prevent both biofilm formation and tissue colonization.
C) What were the major results and did they support or negate the hypothesis? Which key techniques were used to achieve these results? The major results were that, S. epidermidis, either pre-seeded or pre-grown as biofilm on the surface of titanium implants, infected the tissue surrounding the implant, therefore supporting the hypothesis being tested. Techniques used to achieve these results included : culturing bacteria on biofilm, and then on titanium plates, implanting tissue into host mice, and constructing a fully virulent fluorescent S. epidermidis strain in order to study the pathogenesis of biomaterial-associated infection in murine model.
D) Why are the results significant and do they point to further/future studies? In other words, why does this article matter and what should or could be done next? The results in this study are significant because they show possible routes of infection at the interface between titanium implants and the surrounding tissue. The results show that S. epidermidis bacteria on the surface of titanium implants – both adhering and as a biofilm – are a source of infection of the surrounding tissue. This means that the same result could happen after surgeries in humans. For example, after removal of infected prosthetic joints, patients usually require prolonged antibiotic treatment in order to eradicate bacteria in the tissue prior to implantation of a new implant in two-stage surgery. Through this study, clinicians can be aware and find preventative means to keep from infections during and after surgery.
E) Why did you choose this particular article to review? Was it interesting, informative, clearly written, or none of the above? We chose this particular article to review because, frankly, it was easy to read. The ideas, methods, and explanations were clearly written and understandable. Not only that, the subject of investigation is interesting as we are studying the medical field. It is important to realize how critical careful and diligent hygiene is not only on a normal and daily basis for oneself, but also in a hospital setting when dealing with someone else’s life. Although it is obvious that our skin has bacteria on it—which is why we, as future healthcare providers, are urged and required to become obsessive about hand washing—it was interesting to read how easy it is for a sterile implant to develop bacteria previous to insertion. The study done seems simple but necessary in understanding the significance of antimicrobial policies.