Antoci Valentin, Adams Christopher S, Parvizi Javad, Davidson Helen M, Composto Russell J, Freeman Theresa A, Wickstrom Eric, Ducheyne Paul, Jungkind Donald, Shapiro Irving M, Hickok Noreen J
Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Biomaterials. 2008 Dec;29(35):4684-90. doi: 10.1016/j.biomaterials.2008.08.016. Epub 2008 Sep 23.
Peri-prosthetic infections are notoriously difficult to treat as the biomaterial implant is ideal for bacterial adhesion and biofilm formation, resulting in decreased antibiotic sensitivity. Previously, we reported that vancomycin covalently attached to a Ti alloy surface (Vanc-Ti) could prevent bacterial colonization. Herein we examine the effect of this Vanc-Ti surface on Staphylococci epidermidis, a Gram-positive organism prevalent in orthopaedic infections. By direct colony counting and fluorescent visualization of live bacteria, S. epidermidis colonization was significantly inhibited on Vanc-Ti implants. In contrast, the gram-negative organism Escherichia coli readily colonized the Vanc-Ti rod, suggesting retention of antibiotic specificity. By histochemical and SEM analysis, Vanc-Ti prevented S. epidermidis biofilm formation, even in the presence of serum. Furthermore, when challenged multiple times with S. epidermidis, Vanc-Ti rods resisted bacterial colonization. Finally, when S. epidermidis was continuously cultured in the presence of Vanc-Ti, the bacteria maintained a Vanc sensitivity equivalent to the parent strain. These findings indicate that antibiotic derivatization of implants can result in a surface that can resist bacterial colonization. This technology holds great promise for the prevention and treatment of periprosthetic infections.
人工关节周围感染 notoriously 难以治疗，因为生物材料植入物是细菌粘附和生物膜形成的理想场所，导致抗生素敏感性降低。此前，我们报道了共价连接到钛合金表面的万古霉素（Vanc-Ti）可以防止细菌定植。在此，我们研究了这种Vanc-Ti表面对表皮葡萄球菌的影响，表皮葡萄球菌是一种在骨科感染中普遍存在的革兰氏阳性菌。通过直接菌落计数和活细菌的荧光可视化，发现表皮葡萄球菌在Vanc-Ti植入物上的定植受到显著抑制。相比之下，革兰氏阴性菌大肠杆菌很容易在Vanc-Ti棒上定植，这表明抗生素具有特异性。通过组织化学和扫描电子显微镜分析，Vanc-Ti即使在有血清存在的情况下也能防止表皮葡萄球菌生物膜的形成。此外，当多次用表皮葡萄球菌攻击时，Vanc-Ti棒能抵抗细菌定植。最后，当表皮葡萄球菌在Vanc-Ti存在的情况下连续培养时，细菌保持了与亲本菌株相当的万古霉素敏感性。这些发现表明，植入物的抗生素衍生化可以产生一种能够抵抗细菌定植的表面。这项技术在预防和治疗人工关节周围感染方面具有巨大的潜力。
