Department of Mechanical Engineering, Brigham Young University, Provo, Utah, USA.
Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.
J Orthop Res. 2022 Aug;40(8):1953-1960. doi: 10.1002/jor.25206. Epub 2021 Nov 2.
Periprosthetic joint infection (PJI) is a devastating complication of orthopedic implant surgeries, such as total knee and hip arthroplasties. Treatment requires additional surgeries because antibiotics have limited efficacy due to biofilm formation and resistant bacterial strains such as methicillin-resistant Staphylococcus aureus (MRSA). A non-pharmaceutical approach is needed, and examples of this are found in nature; dragonfly and cicada wings are antibacterial because of their nanopillar surface structure rather than their chemistry. Carbon-infiltrated carbon nanotube (CICNT) surfaces exhibit a similar nanopillar structure, and have been shown to facilitate osseointegration, and it is postulated that they might provide a structurally-derived resistance to bacterial proliferation and biofilm formation. The objective of this study was to test the biofilm resistance of CICNT coatings. Two types of CICNT were produced: a vertically aligned CNT forest on a silicon substrate using a layer of iron as the catalyst (CICNT-Si) and a random-oriented CNT forest on stainless steel (SS) substrate using the substrate as the catalyst (CICNT-SS). These were tested against SS and carbon controls. After 48 h in an MRSA biofilm reactor, samples demonstrated that both types of CICNT coatings significantly (p < 0.0001) reduced MRSA biofilm formation by 60%-80%. Morphologically, biofilm presence on both types of CICNT was also significantly reduced. Clinical Significance: Results suggest that a CICNT surface modification could be suitable and advantageous for medical devices susceptible to MRSA cell attachment and biofilm proliferation, particularly orthopedic implants.
假体周围关节感染（PJI）是骨科植入物手术（如全膝关节和髋关节置换术）的一种破坏性并发症。由于生物膜形成和耐甲氧西林金黄色葡萄球菌（MRSA）等耐药菌株的存在，抗生素的疗效有限，因此需要进行额外的手术治疗。需要一种非药物治疗方法，而自然界中就有这种方法的例子；蜻蜓和蝉的翅膀具有抗菌性，是因为它们的纳米柱表面结构，而不是它们的化学成分。碳渗透碳纳米管（CICNT）表面具有类似的纳米柱结构，已被证明有助于骨整合，并且据推测，它们可能提供一种结构衍生的抗细菌增殖和生物膜形成的能力。本研究的目的是测试 CICNT 涂层的抗生物膜能力。制备了两种类型的 CICNT：一种是在硅衬底上使用一层铁作为催化剂的垂直排列的 CNT 森林（CICNT-Si），另一种是在不锈钢（SS）衬底上使用衬底作为催化剂的随机取向的 CNT 森林（CICNT-SS）。将它们与 SS 和碳对照进行了比较。在 MRSA 生物膜反应器中培养 48 小时后，样品表明两种类型的 CICNT 涂层都显著（p < 0.0001）降低了 60%-80%的 MRSA 生物膜形成。形态上，两种类型的 CICNT 上的生物膜存在也明显减少。临床意义：结果表明，CICNT 表面改性可能适合且有利于易受 MRSA 细胞附着和生物膜增殖影响的医疗器械，特别是骨科植入物。
