Parker Ashley Cox, Beenken Karen E, Jennings Jessica Amber, Hittle Lauren, Shirtliff Mark E, Bumgardner Joel D, Smeltzer Mark S, Haggard Warren O
The University of Memphis, Memphis, Tennessee.
J Orthop Res. 2015 Mar;33(3):439-47. doi: 10.1002/jor.22760. Epub 2014 Nov 20.
Polymicrobial musculoskeletal wound infections are troublesome complications and can be difficult to treat when caused by invasive fungi or bacteria. However, few local antifungal delivery systems have been studied. Chitosan and polyethylene glycol (PEG) sponge local antifungal delivery systems have been developed for adjunctive therapy to reduce musculoskeletal wound contamination. This study evaluated the effects of blending PEG, at 6,000 or 8,000 g/mol, with chitosan in sponge form on in vitro amphotericin B and vancomycin elution, eluate activity, cytocompatibility, and in vivo prevention of a bacterial biofilm. Blended chitosan sponges released both amphotericin B and vancomycin in vitro. All tested amphotericin B eluates remained active against Candida albicans, and vancomycin eluates from blended sponges maintained activity against Staphylococcus aureus. Amphotericin B eluates obtained after 1 h from blended sponges elicited 62-95% losses in fibroblast viability, but 3 h eluates only caused 22-60% decreases in viability. In a Staphylococcus aureus infected mouse catheter biofilm prevention model, vancomycin loaded chitosan/PEG 6000 sponge cleared bacteria from 100% of the catheters, with reduced clearance rate observed in other sponges. These results indicate that the chitosan/PEG blended sponges have potential for local antifungal and/or antibiotic combination delivery as an adjunctive therapy to prevent wound infections.
多种微生物引起的肌肉骨骼伤口感染是麻烦的并发症,当由侵袭性真菌或细菌引起时可能难以治疗。然而,很少有局部抗真菌递送系统得到研究。壳聚糖和聚乙二醇(PEG)海绵局部抗真菌递送系统已被开发用于辅助治疗,以减少肌肉骨骼伤口污染。本研究评估了以6000或8000 g/mol的PEG与壳聚糖混合制成的海绵对体外两性霉素B和万古霉素洗脱、洗脱液活性、细胞相容性以及体内预防细菌生物膜的影响。混合壳聚糖海绵在体外释放两性霉素B和万古霉素。所有测试的两性霉素B洗脱液对白色念珠菌仍保持活性,混合海绵的万古霉素洗脱液对金黄色葡萄球菌保持活性。混合海绵1小时后获得的两性霉素B洗脱液使成纤维细胞活力损失62 - 95%,但3小时洗脱液仅导致活力下降22 - 60%。在金黄色葡萄球菌感染的小鼠导管生物膜预防模型中,负载万古霉素的壳聚糖/PEG 6000海绵使100%的导管清除细菌,其他海绵的清除率较低。这些结果表明,壳聚糖/PEG混合海绵有潜力作为预防伤口感染的辅助治疗进行局部抗真菌和/或抗生素联合递送。