477 posters, 14 topics, 2,052 authors, 1,056 institutions
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The Joint EBJIS-MSIS 2026 Conference
17 - 19 September, 2026 | Porto, Portugal
EP018
Synovial fluid alters S. aureus metabolism and antibiotic tolerance and is alkaline
Poster Presenter
Authors
Noreen Hickok, Asia Winslow, Caroline Purtill, Megan Seraydarian, Rachel Butler, Caleb Durst, Antonia Chen, Christopher Snyder, Thomas Schaer
Affiliations
Thomas Jefferson University, Philadelphia, United States, University of Pennsylvania School of Veterinary Medicine, Kennett Square, United States, University of Nevada at Reno, Reno, United States, UT Southwestern Medical Center, Dallas, United States, Thomas Jefferson University
Part of Topic
Basic Science
Introduction:
•Prophylaxis for preventing periprosthetic joint infection (PJI) ultimately relies on antibiotic activity in the joint space for success.
•Antibiotics activity is sensitive to pH.
•Cephalosporins (cefazolin/Ancef): most active in acidic pH
•Aminoglycosides (gentamicin): most active in alkaline pH
•Vancomycin: minimal pH sensitivity
ØWe asked the effect of the synovial fluid environment, as well as its pH on bacterial phenotype.
Conclusions:
•SynF pH remains alkaline, even in the presence of bacterial growth, whereas serum pH remains stable.
•SynF suppresses bacterial growth and agr P3 expression, independent of a pH reflective of blood or native SynF.
•AMK shows enhanced activity (vs. VAN) in native SynF.
•We suggest that aminoglycosides, which retain efficacy across a broader pH range, warrant greater consideration for PJI prophylaxis.