Antoci Valentin, Adams Christopher S, Hickok Noreen J, Shapiro Irving M, Parvizi Javad
Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
Clin Orthop Relat Res. 2007 Aug;461:88-95. doi: 10.1097/BLO.0b013e318073c2b2.
A major challenge in treating periprosthetic infection is the predilection of certain bacteria to colonize implants, form biofilms, and resist treatment. We engineered an innovative self-protective implant with covalently bound antibiotics that prevents bacterial colonization and remains stable for extended periods of time. To test this surface in vivo, we developed a rat periprosthetic infection model with an intramedullary implant in S. aureus-infected femora. Using the model, we then evaluated the effect of vancomycin-modified titanium rods on the clinical presentation of bone infection. Finally, assuming delayed and chronic periprosthetic infections originate from biofilms atop contaminated implants, the numbers of surface adherent bacteria were measured to assess the capability of the implant to prevent biofilms. S. aureus (1.5 x 10(3) colony forming units) with no known resistance were injected into the femoral canal of Wistar rats, followed by the implant. Signs of infection were assessed weekly by direct clinical observation of the animals, radiograph, and microCT, and counts of bacteria adherent to the implant. Vancomycin-modified implants showed superior inhibition of bacterial attachment and proliferation compared to control titanium surfaces.
治疗假体周围感染的一个主要挑战是某些细菌易于在植入物上定植、形成生物膜并抵抗治疗。我们设计了一种创新的自我保护植入物，其具有共价结合的抗生素，可防止细菌定植并在很长一段时间内保持稳定。为了在体内测试这种表面，我们开发了一种大鼠假体周围感染模型，在感染金黄色葡萄球菌的股骨中植入髓内植入物。然后使用该模型评估万古霉素修饰的钛棒对骨感染临床表现的影响。最后，假设延迟性和慢性假体周围感染源自受污染植入物上的生物膜，测量表面附着细菌的数量以评估植入物预防生物膜的能力。将无已知耐药性的金黄色葡萄球菌（1.5×10³ 菌落形成单位）注入Wistar大鼠的股骨髓腔，随后植入植入物。通过对动物的直接临床观察、X线片和微型计算机断层扫描（microCT）以及植入物上附着细菌的计数，每周评估感染迹象。与对照钛表面相比，万古霉素修饰的植入物对细菌附着和增殖的抑制作用更强。
