Antibiotic susceptibility of planktonic- and biofilm-grown staphylococci isolated from implant-associated infections: should MBEC and nature of biofilm formation replace MIC?

Brady, Aaron; Laverty, Garry; Gilpin, D.F.; Kearney, Patricia M.; Tunney, Michael

doi:10.1099/jmm.0.000466

Cited by 42 publications

(29 citation statements)

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“…Compared to the conventional minimally inhibitory concentrations (MIC) reported for planktonic pathogens typically involved in PJI 17 , 18 , the drain fluid concentrations we found in our study were approximately 30-60 times higher for gentamicin and vancomycin, respectively. Local antibiotic concentrations at these levels have been shown to eradicate planktonic bacteria and prevent implant surface colonisation in-vitro 8 , which may potentially translate to a risk reduction for PJI.…”

Section: Discussioncontrasting

confidence: 84%

“…Local antibiotic concentrations at these levels have been shown to eradicate planktonic bacteria and prevent implant surface colonisation in-vitro 8 , which may potentially translate to a risk reduction for PJI. It has been reported, however, that mature biofilm requires significantly higher threshold-levels and MBEC (minimal biofilm eradicating concentrations) - over 1000 times greater than the corresponding MIC 18 , 19 . Together with other researchers in a previous study investigating the same antibiotic carrier in-vivo , we found local gentamicin concentrations of up to 2000 mg/L, indicating that antibiotic concentrations significantly above MBEC levels are achievable using the tested material as a local antibiotic carrier 11 .…”

Section: Discussionmentioning

confidence: 99%

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Antibiotic Elution Characteristics and Pharmacokinetics of Gentamicin and Vancomycin from a Mineral Antibiotic Carrier: An in vivo Evaluation of 32 Clinical Cases

Colding-Rasmussen

Horstmann

Petersen

et al. 2018

J. Bone Joint Infect.

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Introduction: Locally implanted antibiotic-eluting carriers may be a valuable adjuvant to the management of prosthetic joint infections. Aim: to assess local and plasma antibiotic concentrations as well as cumulative antibiotic urine excretion associated with clinical use of a gentamicin - or vancomycin-loaded mineral composite antibiotic carrier.Methods: 32 patients (male/female=19/13, mean age=56; 21-82 years) were prospectively followed after implantation of gentamicin (n=11), vancomycin (n=15), or a combination (n=7), using an antibiotic carrier (CERAMENT™|G or CERAMENT™|V, mean amount 11 (3-20) mL) during resection arthroplasty of the hip/knee. We measured antibiotic concentrations in plasma (1h, 3h, 24h, 48h and 72h post-implantation), urine (24h, 48h and 72h post-implantation) and in drain (n=15).Results: We observed low antibiotic concentrations in plasma (Gentamicin: 0.33 mg/L (95%-CI: 0.25-0.44) and vancomycin: 1.33 mg/L (95%-CI: 1.02-1.66)) and high concentrations in drain (Gentamicin: mean 57.8 mg/L (95%-CI: 45.8-69.7) and vancomycin: mean 234.4 mg/L (95%-CI: 198.9-269.7)). Use of a drain was associated with a statistically significant reduction in vancomycin urine excretion (55.6% (95% CI: 36.45-74.92) to 28.71% (95% CI: 13.07-44.35), p=0.042). A similar trend was observed for gentamicin (34.17% (95% CI: 24.62-43.72) to 16.22% (95% CI: 0-33.86), p=0.078).Conclusions: CERAMENT™G/V was associated with safe plasma concentrations and high local concentrations above minimum inhibitory concentration. Installation of a surgical drain results in removal of a substantial amount of antibiotics and reduces antibiotic urine excretion.

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Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Antibiotic Elution Characteristics and Pharmacokinetics of Gentamicin and Vancomycin from a Mineral Antibiotic Carrier: An in vivo Evaluation of 32 Clinical Cases

Colding-Rasmussen

Horstmann

Petersen

et al. 2018

J. Bone Joint Infect.

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“…The implant surface provides the best environmental condition for microbial attachment and growth, with benefits to microorganisms including increased availability of nutrients, maturation, and potential for symbiotic relationships. [6] The researcher has shown that S. aureus can produce the same slime as S. epidermidis. The fact that S. aureus, unlike S. epidermidis, is virulent enough to routinely produce biofilms on native tissue alone without the presence of foreign material makes elucidating its particular biofilm physiology essential for devising strategies to combat its biofilms more effectively.…”

Section: Original Articlementioning

confidence: 99%

Untitled

Al-Ouqaili¹

2018

AJP

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Background and Objective: The most important tool which helps bacteria to tolerate survival in unwanted conditions and resistance to new generations of antimicrobial agents is biofilm formation through quorum sensing. This study aimed to detect biofilm formation using study isolates of staphylococci quantitatively. Further, concerning minimal inhibitory concentration (MICs), biofilm inhibitory concentration (BICs), and minimum biofilm eradication concentrations (MBECs), to determine biofilm antimicrobial susceptibility test for selected antimicrobial agents against the study isolates. Patients and Methods: A total of 28 catheter urine specimens and wound swabs belonged to 32 patients admitted to Ramadi Teaching Hospital during the period from February to June 2009 were included in this study. Quantitative assay by a spectrophotometric method with ELISA reader was achieved. Planktonic and biofilm antimicrobial susceptibility tests for planktonic and sessile cells performed. Results: Out of 12 (37.5%) isolates of Staphylococcus epidermidis and 20 (62.5%) isolates of Staphylococcus aureus, biofilms were produced in 100% of all study isolates and produced biofilm actively in the glucose supplemented media. Our result revealed that MICs were 2.1 ± 1.2 µg/ml, 46.7 ± 18.6 µg/ ml, and 3.25 ± 1.86 µg/ml for ciprofloxacin, piperacillin, and amikacin, respectively, against logarithmic phase planktonic cells of Staphylococcus spp. Furthermore, BICs and MBECs for the selected antimicrobial agents were reached ×50-100 folds higher than MICs to inhibit and eradicate staphylococcal biofilm. Conclusion: All study isolates of staphylococci produced biofilm quantitatively in glucose supplemented media. Furthermore, in biofilm antimicrobial susceptibility test, the biofilm producing isolate isolates of staphylococci required ×50-100 fold higher than those values for MICs for the same strains with the planktonic state to inhibit and remove bacterial biofilm from the surface of catheters.

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“…81 The comparison may be complicated further by different methods used to quantify antibacterial activity (which also often differ from those used for evaluation of surface-immobilised antimicrobial agents). [82][83][84] Oil from Australian native plant Melaleuca alternifolia has been reported to have the broad-spectrum activity against bacteria, including drug-resistant strains, fungi, viruses, and protozoa, [85][86][87][88] but similar to other phytochemicals, in vivo and in vitro characterisation of tea tree oil thus far remains inadequate. Nonetheless, various preparations that include tea tree oil are readily available commercially in many countries, including in Australia, Europe, and North America.…”

Section: Antimicrobial Secondary Plant Metabolitesmentioning

confidence: 99%

Anti-bacterial surfaces: natural agents, mechanisms of action, and plasma surface modification

et al. 2015

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REVIEW This journal isStrategies that confine antibacterial and/or antifouling property to the surface of the implant, by modifying the surface chemistry and morphology or by encapsulating the material in an antibiotic-loaded coating, are most promising as they do not alter bulk integrity of the material. Among them, plasma-assisted modification and catechol chemistry stand out for their ability to modify a wide range of substrates. By controlling processing parameters, plasma environment can be used for surface nano structuring, chemical activation, and deposition of biologically active and passive coatings. Catechol chemistry can be used for material-independent, highlycontrolled surface immobilisation of active molecules and fabrication of biodegradable drugloaded hydrogel coatings. In this article, we comprehensively review the role plasma-assisted processing and catechol chemistry can play in combating bacterial colonisation on medically relevant coatings, and how these strategies can be coupled with the use of natural antimicrobial agents to produce synthetic antibiotic-free antibacterial surfaces.

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Antibiotic susceptibility of planktonic- and biofilm-grown staphylococci isolated from implant-associated infections: should MBEC and nature of biofilm formation replace MIC?

Abstract: The use of biofilm-relevant susceptibility tests would improve patient outcomes by enabling correct antimicrobial regimens to be rapidly identified, reducing treatment failure and halting the spread of antimicrobial-resistant strains.

Cited by 42 publications

References 45 publications

Antibiotic Elution Characteristics and Pharmacokinetics of Gentamicin and Vancomycin from a Mineral Antibiotic Carrier: An in vivo Evaluation of 32 Clinical Cases

Antibiotic Elution Characteristics and Pharmacokinetics of Gentamicin and Vancomycin from a Mineral Antibiotic Carrier: An in vivo Evaluation of 32 Clinical Cases

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Anti-bacterial surfaces: natural agents, mechanisms of action, and plasma surface modification

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