Antibiotic Resistance of Biomaterial-Adherent Coagulase-Negative and Coagulase-Positive Staphylococci

Naylor, Paul T.; Myrvik, Quentin N.; Gristina, Anthony G.

doi:10.1097/00003086-199012000-00015

Cited by 80 publications

(56 citation statements)

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“…In these studies, mild to severe soft tissue traumata were induced, but no progression was made from a trauma to an infection model. On the other hand, numerous infection models in animals have been described for the investigation of osteomyelitis, implant-related infection, efficiency of antibiotic therapy or other microbiological aspects [18,20,26,28,29,40], but these rarely focus on the relation between infection and isolated soft tissue trauma. Wichmann et al (1998) demonstrated the influence of a closed fracture with only minimal soft tissue injury and an incisional soft tissue trauma (laparatomy) with severe soft tissue injury-both in combination with hemorrhage-on systemic immune depression (lymphocyte function) in mice [38,39].…”

Section: Discussionmentioning

confidence: 99%

Influence of a standardized closed soft tissue trauma on resistance to local infection. An experimental study in rats

Kälicke

Schlegel

Printzen

et al. 2003

Journal Orthopaedic Research

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Purpose: The etiology of local posttraumatic infection in the locomotor system depends on the amount, virulence and pathogenicity of the inoculated microorganisms and the locallsystemic host damage due to the type and extent of the accident or iatrogenic trauma. The relative effect of these factors remains unclear. In particular, it is still unclear today whether-in presence of microorganisms-soft tissue damage and its pathophysiological consequences lead to infection after soft tissue trauma, or whether the bacterial contamination is the primarily cause for posttraumatic infection. The aim of the project was to gain information on the consequences of a soft tissue injury in terms of resistance to local infection. Since clinical populations are too heterogeneous, the problem was investigated in a standardized, reduced (no surgery or implants) experimental in vivo model.Met/zod In female Sprague-Dawley-rats with a standardized closed soft tissue trauma to the tibialis anterior muscle (group 1: n = 13) or without (group 11: n = 13), we compared the incidence of local infection after a pairwise local, percutaneously injected bacterial challenge with various concentrations of Staphylococcus aureus (2 x 104-2 x lo6 colony forming units, CFU). The standardized closed soft tissue trauma was created by application of a specially designed, computer controlled impact device. The contaminated soft tissue and the underlying bone were removed under sterile conditions after five days and quantitatively evaluated for bacterial growths. Infection was defined as positive bacterial growth at the soft tissue and/or bone. A stepwise experimental design with an "up-and-down" dosage technique was used to adjust the bacterial challenge in the area of the ID50 (50% infection dose). Statistical evaluation of the difference between the infection rates of both groups was performed by two-sided fisher exact test (p < 0.05). Results:The overall infection rate was 46%. For the group with soft tissue trauma the ID50 was 1.32 x lo5 CFU and 1.05 x lo6 CFU for the group without soft tissue trauma. The infection rate was 69% (9 of 13 animals) for the group with soft tissue trauma and 23%) (3 of 13 animals) for the group without soft tissue trauma. This difference is statistically significant 0, = 0.047).Conclusions: The infection rate after a standardized closed soft tissue injury was significantly higher and the ID50 lower than without soft tissue trauma. Our results demonstrate that in presence of microorganisms it is not primarily the bacterial contamination but rather the soft tissue damage and its pathophysiological consequences resulting in decreased infection resistance that secondarily lead to infection.

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Section: Discussionmentioning

confidence: 99%

Influence of a standardized closed soft tissue trauma on resistance to local infection. An experimental study in rats

Kälicke

Schlegel

Printzen

et al. 2003

Journal Orthopaedic Research

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“…Escherichia coli and Pseudomonas aeruginosa were chosen as examples of gram-negative bacteria which have been found in biomaterial-related infection sites (16), with the high intrinsic antibiotic resistance of P. aeruginosa also being a consideration (24). Staphylococcus aureus is a gram-positive bacterium which represents a major concern for prosthetic devices and in other surgery-related infections (16,23).…”

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confidence: 99%

Broad-Spectrum Bactericidal Activity of Ag ₂ O-Doped Bioactive Glass

Bellantone¹,

Williams

Hench³

2002

Antimicrob Agents Chemother

355

220

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Bioactive glass has found extensive application as an orthopedic and dental graft material and most recently also as a tissue engineering scaffold. Here we report an initial investigation of the in vitro antibacterial properties of AgBG, a novel bioactive glass composition doped with Ag 2 O. The bacteriostatic and bactericidal properties of this new material and of two other bioactive glass compositions, 45S5 Bioglass and BG, have been studied by using Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus as test microorganisms. Concentrations of AgBG in the range of 0.05 to 0.20 mg of AgBG per ml of culture medium were found to inhibit the growth of these bacteria. Not only was AgBG bacteriostatic, but it also elicited a rapid bactericidal action. A complete bactericidal effect was elicited within the first hours of incubation at AgBG concentrations of 10 mg ml ؊1 . 45S5 Bioglass and BG had no effect on bacterial growth or viability. The antibacterial action of AgBG is attributed exclusively to the leaching of Ag ؉ ions from the glass matrix. Analytical measurements rule out any contribution to AgBG-mediated bacterial killing by changes in pH or ionic strength or the dissolution of other ionic species from the biomaterials. Our observations of the dissolution profiles of Ag ؉ from AgBG in the presence and absence of bacteria are consistent with silver accumulation by the bacteria.Bioactive glasses are special glass systems which are generally composed of SiO 2 , CaO, P 2 O 5 , and Na 2 O. They can be produced by the traditional melting process or by the more versatile sol-gel process (14, 15). The bioactive behavior of these glasses is defined as the ability to bond to soft and hard tissues by means of a series of reactions, which produces a strong, compliant interface between the glass and the tissue (14). Due to their high level of tissue integration and regeneration (15, 34), bioactive glasses have been used clinically in a variety of situations. Bioactive glass devices are now available to treat conductive deafness and alveolar ridge resorption and bone loss due to periodontal disease and to fill cystic and surgically created defects, particularly in craniomaxillofacial sites (19,25,33).The material under investigation in the present work is a novel bioactive glass system composed of SiO 2 , CaO, P 2 O 5 , and Ag 2 O. The introduction of Ag 2 O into the bioactive glass composition is aimed at minimizing the risk of microbial contamination through the potential antimicrobial activity of the leaching Ag ϩ ions (7, 13). The introduction of silver has recently become one of the preferred methods to confer microbial resiliency on biomedical materials and devices (1,6,17,18,21), since the incidence of biomaterial-centered infections is one of the main causes of revision surgery (12). The production of the material via the sol-gel process allows the tailoring of the textural characteristics of the matrix in order to obtain a controlled Ag ϩ delivery system. Here we report an initial investigation of ...

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“…It has the major disadvantage of promoting bacterial adherence (15). Antibiotics have been incorporated into this material for the prophylaxis of bone infections, but adherence studies have shown that bacteria can adhere to such pretreated PMMA and survive despite high antibiotic concentrations that would be lethal to bacteria in suspension (15,22).…”

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confidence: 99%

Control of Staphylococcal Adhesion to Polymethylmethacrylate and Enhancement of Susceptibility to Antibiotics by Poloxamer 407

Veyries

Faurisson

Joly-Guillou

et al. 2000

Antimicrob Agents Chemother

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We studied the antiadhesive effect of Poloxamer 407 (P407), together with modifications in the antimicrobial susceptibility of residual adherent staphylococci. Bacterial adherence was markedly inhibited (77% to more than 99.9%) whether polymethylmethacrylate was exposed to P407 before or during the adherence assay. Furthermore, residual adherent staphylococci appeared to be more susceptible to antibiotic activity, suggesting that combination of P407 with antibiotics could be a promising approach to the prevention of infection of foreign material.

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Antibiotic Resistance of Biomaterial-Adherent Coagulase-Negative and Coagulase-Positive Staphylococci

Cited by 80 publications

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Influence of a standardized closed soft tissue trauma on resistance to local infection. An experimental study in rats

Influence of a standardized closed soft tissue trauma on resistance to local infection. An experimental study in rats

Broad-Spectrum Bactericidal Activity of Ag ₂ O-Doped Bioactive Glass

Control of Staphylococcal Adhesion to Polymethylmethacrylate and Enhancement of Susceptibility to Antibiotics by Poloxamer 407

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Antibiotic Resistance of Biomaterial-Adherent Coagulase-Negative and Coagulase-Positive Staphylococci

Cited by 80 publications

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Influence of a standardized closed soft tissue trauma on resistance to local infection. An experimental study in rats

Influence of a standardized closed soft tissue trauma on resistance to local infection. An experimental study in rats

Broad-Spectrum Bactericidal Activity of Ag 2 O-Doped Bioactive Glass

Control of Staphylococcal Adhesion to Polymethylmethacrylate and Enhancement of Susceptibility to Antibiotics by Poloxamer 407

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Broad-Spectrum Bactericidal Activity of Ag ₂ O-Doped Bioactive Glass