As a result of increasing life expectancy, osteomyelitis and periprosthetic joint infections (PJIs) are a major public health problem in Western countries. Infections usually result from bacterial spread through fractures, implants or by blood-borne transmission from surrounding sites. The occurrence of the pathogen leads to excessive inflammatory responses, which reduce the regenerative capacity of bone tissue. Additionally, the treatment of the infection necessitates a surgical approach, as bone tissue is poorly permeable to drug administration. This involves the precise removal of infected tissue, the thorough cleansing of the wound, and the administration of antibiotics directly on-site, complemented by systemic treatment. Despite an accurate surgical procedure, removal and replacement of the medical device is often necessary if it involves an infected prosthesis. Among the various pathogens that can infect bone, Staphylococcus aureus (SA) is the most frequently isolated etiologic agent of infection-induced osteomyelitis and PJIs. This bacterium is common and capable of forming a multilayered antimicrobial-resistant biofilm, frequently found in nosocomial environments. Here, we discuss a methodology for investigating the impact of SA infection on the (i) structure and (ii) chemical composition of the bone tissue, based on the integration of Raman microspectroscopy and AFT-FTIR spectroscopy. We aim to enhance the understanding of SA infection effects on bone tissue and to point out specific markers that can be used to detect the damaged tissue or even the presence of the pathogen with micrometric resolution. Indeed, Raman spectroscopy is a non-destructive, non-contact scattering technique that doesn't require labelling and has the possibility of being utilised for in vivo applications in the future (e.g., helping the surgeon during bone resection or implant revision procedures). On the other hand, ATR-FTIR's rapid measurement speed can be taken advantage of for analysing bone tissue biopsies.
Brillouin and Raman microspectroscopy (BRamS) is a scattering technique that simultaneously assesses the mechanical and chemical properties of tissues with micrometric resolution. It has gained increasing attention in the biomedical field over the last decade and has been successfully used for both single-cell studies and whole-tissue characterization under physiological and pathological conditions. In addition, it is non-destructive, non-contact, and does not require labeling, offering the potential for future in vivo applications. The close interdependence between morphology, biochemistry, and mechanics is particularly relevant in the case of musculoskeletal tissues, where the complex structure is well-designed to ensure exceptional mechanical performance. The ability of tissues to resist and adapt to the mechanical and chemical stresses to which they are subjected depends to a large extent on maintaining the correct arrangement of all their components, starting from the microscopic level. In several common degenerative diseases, such as osteoarthritis (OA), the tissue architecture is destroyed by inflammatory processes, resulting in a rearrangement of its entire structure, leading to a complete loss of function and, often the need for prosthetic replacement. In this case, the use of minimally invasive techniques to explore the lesions could become a valuable resource for the surgeon in formulating a more precise diagnosis and, therefore, in providing more appropriate treatments. Here we discuss some of the results obtained by our group in characterizing human musculoskeletal tissue and detecting OA lesions in joints using BRamS.
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