Antoci Valentin, Adams Christopher S, Parvizi Javad, Ducheyne Paul, Shapiro Irving M, Hickok Noreen J
Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Clin Orthop Relat Res. 2007 Aug;461:81-7. doi: 10.1097/BLO.0b013e3181123a50.
Despite improved strategies for treating periprosthetic infection, current antibiotic delivery approaches are imperfect and can result in bacterial resistance and recalcitrant bio-films. To address the issues, we developed a covalently linked vancomycin-titanium implant interface that prevents and possibly eliminates bacterial colonization. We determined the amount of vancomycin immobilized on the titanium surface and assessed vancomycin stability and activity over time. When incubated with Staphylococcus aureus, the vancomycin-titanium surface showed an almost complete absence of adherent bacteria. To determine if continual exposure to vancomycin-titanium would cause decreased susceptibility to the antibiotic, S. aureus was incubated with vancomycin-titanium for 1 week or 4 weeks; these bacteria did not show an increased minimum inhibitory concentration for vancomycin. We tested the long-term stability of the vancomycin-titanium surface by incubation in phosphate-buffered saline for 11 months and then challenging the surface with S. aureus. Fluorescent staining for bacteria indicated the vancomycin-titanium retained its bactericidal activity. Finally, osteoblasts seeded on the vancomycin-titanium surface exhibited no change in viability, indicating the surface supports bone cell adhesion. Based on these observations, covalent modification of the titanium surface with an antibiotic may be viewed as a potential new tool in preventing or eliminating periprosthetic infection.
尽管治疗假体周围感染的策略有所改进，但目前的抗生素递送方法并不完美，可能会导致细菌耐药性和顽固的生物膜形成。为了解决这些问题，我们开发了一种共价连接的万古霉素 - 钛植入物界面，可防止并可能消除细菌定植。我们测定了固定在钛表面的万古霉素量，并评估了万古霉素随时间的稳定性和活性。当与金黄色葡萄球菌一起孵育时，万古霉素 - 钛表面几乎完全没有附着细菌。为了确定持续暴露于万古霉素 - 钛是否会导致对抗生素的敏感性降低，将金黄色葡萄球菌与万古霉素 - 钛一起孵育1周或4周；这些细菌对万古霉素的最低抑菌浓度没有增加。我们通过在磷酸盐缓冲盐水中孵育11个月，然后用金黄色葡萄球菌挑战该表面，测试了万古霉素 - 钛表面的长期稳定性。细菌的荧光染色表明万古霉素 - 钛保留了其杀菌活性。最后，接种在万古霉素 - 钛表面的成骨细胞活力没有变化，表明该表面支持骨细胞粘附。基于这些观察结果，用抗生素对钛表面进行共价修饰可被视为预防或消除假体周围感染的一种潜在新工具。
