2025 International Consensus Meeting on Musculoskeletal Infection: Summary From the Biofilm Workgroup on Biofilm Formation, Persistence, and Host‐Environment Interactions
Musculoskeletal infection (MSKI) remains a major problem after trauma and elective orthopedic surgery. Chronic MSKI is related to the formation of biofilm, which impairs diagnosis and effective treatments. Therefore, to understand and communicate global standards and best practices, the 2025 International Consensus Meeting (ICM) on MSKI created a Biofilm Section to address crucial aspects of biofilm biology pertaining to its mechanisms of drug resistance and immune evasion, and potential approaches to overcome them. This featured a 2-year process, with final voting and discussion on May 8-10, 2025, in Istanbul, Turkey. This Consensus Article is the effort of the Biofilm Basic Mechanisms Workgroup, which interpreted the results on ICM questions related to (1) the infectious microenvironment; (2) appropriate inocula in preclinical research; (3) biofilm behavior in infected tissues; and (4) synergy within biofilms and with other comorbidities. Collectively, we find that this field has the necessary research tools to discover the pathophysiology of orthopedic implant-associated biofilm development and maturation, perform clinically relevant studies in animal models, and elucidate mechanisms that allow opportunistic infections in compromised tissues and patients with other health issues.
Authors
- Jessica Amber Jennings (ORCID: https://orcid.org/0000-0002-2760-6948)
- Claudia Siverino (ORCID: https://orcid.org/0000-0002-4845-1922)
- Ebru Oral
- J.C. Tate (ORCID: https://orcid.org/0009-0002-1977-9264)
- Ferdinando Iannotti (ORCID: https://orcid.org/0000-0003-0988-5258)
- Joshua S. Bingham (ORCID: https://orcid.org/0000-0003-1540-852X)
- Gerald J. Atkins (ORCID: https://orcid.org/0000-0002-3123-9861)
- Mojieb Manzary
- Imre Sallai (ORCID: https://orcid.org/0000-0003-4123-1289)
- Amita Sekar (ORCID: https://orcid.org/0000-0002-2057-1332)
- Gowrishankar Muthukrishnan (ORCID: https://orcid.org/0000-0001-7521-6154)
- L. Drago
- K. Nishitani
- Tom Coenye (ORCID: https://orcid.org/0000-0002-6407-0601)
- Ezzuddin Abuhussein (ORCID: https://orcid.org/0009-0002-6730-3500)
- Ahmad Abbaszadeh (ORCID: https://orcid.org/0009-0008-8869-7709)
- Katya McDonald (ORCID: https://orcid.org/0000-0001-8919-3651)
- Kordo B. A. Saeed
- Schwarz Em
- Dina Raafat
- John Hamilton
- Andie R. Tubbs
- Bingyun Li
- T. Fintan Moriarty
- Noreen J. Hickok
- Armita A. Abedi
- Louise Kruse Jensen
- Nicholas Norton
- Débora C. Coraça‐Huber
- Margarita Trobos
- Kyle H. Cichos
- Javad M. Parvizi
Institutions
- Semmelweis University (HU)
- West Virginia University (US)
- University of Copenhagen (DK)
- Rush University Medical Center (US)
- Mayo Clinic (US)
- Johns Hopkins University (US)
- Thomas Jefferson University (US)
- University of Milan (IT)
- Kyoto University (JP)
- AO Foundation (CH)
- Universitätsmedizin Greifswald (DE)
- Saudi Aramco Medical Services Organization (SA)
- Harris Health System (US)
- University Hospital of Basel (CH)
- Copenhagen University Hospital (DK)
- University Hospital Southampton NHS Foundation Trust (GB)
- Acıbadem University (TR)
- Ghent University (BE)
- Massachusetts General Hospital (US)
- Hughston Clinic (US)
- MultiMedica (IT)
- Mayo Clinic in Arizona (US)
- Kent Hastanesi (TR)
- Mayo Clinic in Florida (US)
- University Hospital Innsbruck (AT)
- University of Rochester (US)
- The University of Adelaide (AU)
- Tehran University of Medical Sciences (IR)
- Alexandria University (EG)
- Sapienza University of Rome (IT)
- University of Gothenburg (SE)
- University of Memphis (US)
Publication Details
- Journal
- Journal of Orthopaedic Research®
- Published
- 2026-01-01
- DOI
- https://doi.org/10.1002/jor.70130
- Primary Topic
- Orthopedic Infections and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00