IN VITRO ASSESSMENT OF THE ANTIMICROBIAL PROPERTIES OF TRANEXAMIC ACID: IMPLICATIONS FOR INTRAOPERATIVE PROPHYLAXIS OF IMPLANT-ASSOCIATED INFECTIONS IN ORTHOPAEDIC SURGERY

Tranexamic Acid (TXA) is a potent antifibrinolytic agent widely used to reduce perioperative blood loss and transfusion in arthroplasty surgery. It effectively conserves blood without increasing the risk of thrombosis. TXA may lower infection risk post-surgery by reducing hematoma formation and wound complications. Emerging evidence suggests TXA may also possess antibacterial effect. The aim of this study is to evaluate the antibacterial and antifungal properties of TXA, with a focus on its potential role in prophylaxis against implant-associated infections in orthopaedic surgery. Microbial strains of S. aureus ATCC 29231, E. coli ATCC 25922, and C. albicans ATCC 90028 at final concentration of 1×10 2 (colony forming unit CFU/ml) were exposed to TXA at concentrations of 33 mg/ml and 67 mg/ml. Bacterial cultures were placed in 3 ml-glass ampules containing 1 ml of culture media and 2 ml of TXA. Ampoules were air-tightly sealed and introduced into the microcalorimeter at 37°C. Heat flow was recorded up to 60 hours. After that, all samples were plated on Tryptone Soy Agar (TSA) for colony counting. Prism GraphPad employed for analysis and creating the graphs. Microcalorimetry analysis showed that TXA exhibited a dose-dependent activity against the tested microorganisms. This was reflected by a delay in heat production or reduced heat flow in S. aureus and E. coli compared to untreated controls, and by the absence of heat-flow in C. albicans. Concordant results were observed with CFU counting method. While no significant difference in CFU counts for S. aureus and E. coli was observed at varying concentrations of TXA compared to untreated samples, higher concentrations of TXA led to complete eradication of C. albicans. The study demonstrated a mild bacteriostatic effect of TXA on S. aureus and E. coli, and a strong fungicidal effect on C. albicans. The complete eradication of C. albicans at higher concentrations highlights TXA's potent antifungal activity, which could be valuable in managing fungal infections. Further in vivo and in vitro research is needed to explore TXA's antimicrobial spectrum.