Lipid-based nanosystems for targeting bone implant-associated infections: current approaches and future endeavors

Bone infections caused by Staphylococcus aureus are a major concern in medical care, particularly when associated with orthopedic-implant devices. The ability of the bacteria to form biofilms and their capacity to invade and persist within osteoblasts turn the infection eradication into a huge challenge. The reduction of antibiotic penetration through bacterial biofilms associated with the presence of persistent cells, ability to survive in the host, and high tolerance to antibiotics are some of the reasons for the difficult treatment of these infections. Effective therapeutic approaches are urgently needed. In this sense, lipid-based nanosystems, such as liposomes, have been investigated as an innovative and alternative strategy for the treatment of implant-associated S. aureus infections, due to their preferential accumulation at infected sites and interaction with S. aureus. This review highlights the recent advances on antibiotic-loaded liposome formulations both in vitro and in vivo and how the interaction with S. aureus biofilms may be improved by modulating the liposomal external surface.

Automated summary

Bone infections caused by Staphylococcus aureus, especially when associated with orthopedic-implant devices, are challenging to treat due to the bacteria's ability to form biofilms, invade and persist within cells, and high antibiotic tolerance. Lipid-based nanosystems, like liposomes, are being researched as an innovative strategy for treating implant-associated S. aureus infections by preferentially accumulating at infected sites and interacting with the bacteria. This review highlights recent advances in antibiotic-loaded liposome formulations and the potential improvement of targeting S. aureus biofilms by modulating the liposomal external surface.