Abstract
Periprosthetic infection is a devastating consequence of implant insertion and can arise from hematogenous sources or surgical contamination. Microbes can preferentially colonize the implant surface and, by forming a biofilm, escape immune surveillance. We hypothesized that if an antibiotic can be tethered to a titanium alloy (Ti) surface, it will inhibit bacterial colonization, prevent biofilm formation, and avert late-stage infection. To test this hypothesis, a Ti rod was covalently derivatized with vancomycin. Reaction efficiencies were evaluated by colorimetric and spectrophotometric measurements. The vancomycin-modified surface was stable in aqueous solutions over extended time periods and maintained antibiotic coverage, even after press-fit insertion into a cadaverous rat femora. When evaluated using fluorescently labeled bacteria, or by direct colony counts, the surface-bound antibiotic prevented bacterial colonization in vitro after: (1) exposure to high levels of S. aureus; (2) extended incubation in physiological buffers; and (3) repeated bacterial challenges. Importantly, whereas the vancomycin-derivitized pins prevented bacterial colonization, S. aureus adhered to control pins, even in the presence of concentrations of vancomycin that exceeded the strain MIC. These results demonstrate that we have effectively engineered a stable, bactericidal Ti surface. This surface holds great promise in terms of mitigating or preventing periprosthetic infection. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
Original language | American English |
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Journal | Journal of Orthopaedic Research |
Volume | 25 |
State | Published - Jan 1 2007 |
Keywords
- Alloys
- Animals
- Anti-Bacterial Agents
- Implant
- Infection
- Microbial Sensitivity Tests
- Prostheses and Implants
- Prosthesis-Related Infections
- Rats
- S. aureus
- Staphylococcus aureus
- Titanium
- Vancomycin
- animal experiment
- antibacterial activity
- aqueous solution
- article
- bacterial colonization
- bacterial count
- bacterial strain
- bacterium adherence
- bacterium colony
- bacterium contamination
- biofilm
- buffer
- cadaver
- colorimetry
- controlled study
- covalent bond
- drug delivery system
- drug stability
- femur
- hypothesis
- in vitro study
- minimum inhibitory concentration
- nonhuman
- priority journal
- prosthesis infection
- rat
- spectrophotometry
Disciplines
- Life Sciences