Shikonin Inhibits MRSA Biofilm Formation to Alleviate Periprosthetic Joint Infection

Objective To alleviate periprosthetic joint infection (PJI) with methicillin-resistant Staphylococcus aureus (MRSA), shikonin (SKN) had been used to intervene the biofilm formation of MRSA in vivo and in vitro, which provides theoretical support and practical foundation for SKN as a novel drug against drug-resistant bacterial infection.Methods The rat model of periprosthetic joint infection was established, utilizing techniques such as scanning electron microscopy and pathology test to evaluate the MRSA inhibitory of bacterial load and biofilm formation effects of SKN. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) experiments were conducted to assess the antibacterial activity of SKN. The crystal violet staining method was employed to evaluate the effects of SKN on MRSA biofilm formation and eradication. Transcriptomic and amino acid metabolomics analyses were used to investigate the mechanism of SKN inhibition in MRSA biofilm formation. Total thiol detection was used to assess the impact of SKN on the intracellular cysteine levels in MRSA. Finally, MIC and crystal violet staining were used to evaluate the antibacterial effects and biofilm eradication efficacy of SKN against clinical MRSA strains.