Antimicrobial and Antibiofilm Effects of Ozonated Water for Prevention and Treatment of Bone and Joint Infections

Antimicrobial effects of ozonated water for the planktonic cells and the biofilm cells of staphylococci were examined for clinical applications in the orthopaedic field. As a result, 7 mg/L of ozonated water showed anti‐ microbial effects for not only the planktonic cells but also for the biofilm cells. Additionally, antimicrobial ac‐ tivity of ozonated water was examined after destroying the biofilm using 1 M NaCl or proteolytic enzymes (pro‐ teinase K and trypsin). Interaction between ozonated water and biofilm destruction was statistically significant in 2 strains (SE21, MR23) out of 8 strains. However, the effects of proteinase K or trypsin with ozonated water were statistically significant only in MRSA MR23. MRSA MR23 was previously reported to be a proteinaceous biofilm producer, and its biofilm was destructed by various proteases.