Bacterial survival in the interfacial gap in gentamicin-loaded acrylic bone cements

Hendriks, Johannes G.E.; Neut, Daniëlle; Horn, Van; Mei, van der Henny C.; Busscher, Henk J.

doi:10.1302/0301-620x.87b2.14781

Cited by 63 publications

(48 citation statements)

References 35 publications

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“…36 The bacteria that survived on the NT surface could lead to implant infection; especially when the NT surface was covered with protein. The in vitro study may predict that the NTs cannot prevent implant infection in vivo.…”

mentioning

confidence: 99%

Improved antibacterial activity and biocompatibility on vancomycin-loaded TiO2 nanotubes: in vivo and in vitro studies

Zhang¹,

Sun²,

Tian³

et al. 2013

IJN

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The goal for current orthopedic implant research is to design implants that have not only good biocompatibility but also antibacterial properties. TiO 2 nanotubes (NTs) were fabricated on the titanium surface through electrochemical anodization, which added new properties, such as enhanced biocompatibility and potential utility as drug nanoreservoirs. The aim of the present study was to investigate the antibacterial properties and biocompatibility of NTs loaded with vancomycin (NT-V), both in vitro and in vivo. Staphylococcus aureus was used to study the antibacterial properties of the NT-V. There were three study groups: the commercially pure titanium (Cp-Ti) group, the NT group (nonloaded vancomycin), and the NT-V group. We compared NT-V biocompatibility and antibacterial efficacy with those of the NT and Cp-Ti groups. Compared with Cp-Ti, NT-V showed good antibacterial effect both in vitro and in vivo. Although the NTs reduced the surface bacterial adhesion in vitro, implant infection still developed in in vivo studies. Furthermore, the results also revealed that both NTs and NT-V showed good biocompatibility. Therefore, the NTs loaded with antibiotic might be potentially used for future orthopedic implants.

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mentioning

confidence: 99%

Improved antibacterial activity and biocompatibility on vancomycin-loaded TiO2 nanotubes: in vivo and in vitro studies

Zhang¹,

Sun²,

Tian³

et al. 2013

IJN

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“…One of the prophylactic strategies that are currently used is to provide a constant flow of a subinhibitory (sub-MIC) concentration of antibiotic (17). Another alternative is to use biomaterials impregnated with antibiotic (21,32). However, besides the reduced abilities of bacteria to form biofilms, little is known about other changes implicated in the virulence of CoNS that might occur due to the presence of low concentrations of antibiotics.…”

mentioning

confidence: 99%

Effects of Growth in the Presence of Subinhibitory Concentrations of Dicloxacillin on Staphylococcus epidermidis and Staphylococcus haemolyticus Biofilms

Cerca

Martins

Sillankorva

et al. 2005

Appl Environ Microbiol

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Low concentrations of antibiotics can inhibit microbial adherence to medical device surfaces. However, little is known about the changes that occur in the physiology of bacteria within biofilms formed in the presence of subinhibitory (sub-MIC) concentrations of antibiotics. In this study, the densities and matrix compositions of biofilms formed by two coagulase-negative Staphylococcus species in the absence and in the presence of sub-MIC concentrations of dicloxacillin were evaluated. Biofilms formed in the presence of sub-MIC concentrations of dicloxacillin contained less biomass, and there were notable changes in the composition of the biofilm matrix. Changes in the spatial structure were also verified by confocal scanning laser microscopy, indicating that biofilms grown in the presence of sub-MIC concentrations of dicloxicilln had a lower cell density. Physiological alterations in the bacteria within biofilms grown in the presence of subinhibitory concentrations of the antibiotic were also evaluated. The results showed that there were differences in bacterial surface characteristics when cultures were grown in the presence of sub-MIC concentrations of dicloxacillin, including decreased hydrophobicity and decreased expression of the exopolysaccharide poly-N-acetylglucosamine. The elemental composition of the cell surface was also analyzed, and whereas in Staphylococcus epidermidis there were decreases in the oxygen and nitrogen contents, in Staphylococcus haemolyticus there were increases in these two parameters. Additionally, increases in resistance to several antibiotics were observed for the cells within biofilms formed in the presence of dicloxacillin.

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“…The exact mechanism by which this antibiotic resistance evolves is not clear and different options have been reported, including 24 stated that gentamicin-loaded bone cement has an optimum surface for bacterial colonization and prolonged exposure to gentamicin allows mutational resistance to occur. However, it is important to realize that antibiotics probably do not directly cause mutation; rather, they provide an environment favoring the natural selection of resistant strains 3,25 that arise spontaneously. The drug kills the sensitive bacteria, leaving behind those that can resist it.…”

Section: Discussionmentioning

confidence: 99%

“…In a more clinically relevant situation, the volume-to-area ratio is very small, however, for which reason we developed our so-called ''interfacial gap'' model, in which the amount of fluid in between the surfaces to be colonized is small. 25 This model, simulating the in vivo interfacial gap, existing between bone cement and bone or prosthesis, offers an additional in vitro test that can be used to estimate the value of antibiotic additions to bone cement. 19,25 Hendriks et al 19 demonstrated that concentrations up to 1000-fold the antibiotic resistance levels for most bacterial strains causing implant infection can be achieved in this more realistic in vitro model.…”

Section: Discussionmentioning

confidence: 99%

“…25 This model, simulating the in vivo interfacial gap, existing between bone cement and bone or prosthesis, offers an additional in vitro test that can be used to estimate the value of antibiotic additions to bone cement. 19,25 Hendriks et al 19 demonstrated that concentrations up to 1000-fold the antibiotic resistance levels for most bacterial strains causing implant infection can be achieved in this more realistic in vitro model. Within 2 h, gentamicin concentrations in the interfacial gaps made in several commercially available gentamicin-loaded bone cements reached up to 2500-4000 mg/mL.…”

Section: Discussionmentioning

confidence: 99%

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Antimicrobial efficacy of gentamicin‐loaded acrylic bone cements with fusidic acid or clindamycin added

Neut

Hendriks

Horn

et al. 2005

Journal Orthopaedic Research

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The increasing gentamicin resistance among bacteria in septic joint arthroplasty has stimulated interest in adding a second antibiotic into gentamicin-loaded bone cement. A first aim of this in vitro study is to investigate whether addition of fusidic acid or clindamycin to gentamicinloaded bone cement has an additional antimicrobial effect against a collection of 38 clinical isolates, including 16 gentamicin-resistant strains. A modified Kirby-Bauer test, involving measurement of the inhibition zone around antibiotic-loaded bone cement discs on agar plates, was used to investigate whether adding a second antibiotic has an additional antimicrobial effect. Second, a selected number of strains was used to study their survival in an interfacial gap made in the different bone cements to mimic the gap between bone and cement as existing near a prosthesis. Gentamicinloaded bone cement had an antimicrobial activity against 58% of the 38 bacterial strains included in this study, while 68% of the strains were affected by bone cement loaded with a combination of gentamicin and clindamycin. Bone cement loaded with the combination of gentamicin and fusidic acid had antimicrobial activity against 87% of the bacterial strains. In the prosthesis-related gap model, there was a clear trend toward less bacterial survival for gentamicin-loaded bone cement after adding clindamycin or fusidic acid. Addition of clindamycin or fusidic acid into gentamicin-loaded bone cement yields an additional antimicrobial effect. The combination gentamicin and fusidic acid was effective against a higher number of clinical isolates than the combination of gentamicin with clindamycin, including gentamicin-resistant strains. ß

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Bacterial survival in the interfacial gap in gentamicin-loaded acrylic bone cements

Cited by 63 publications

References 35 publications

Improved antibacterial activity and biocompatibility on vancomycin-loaded TiO2 nanotubes: in vivo and in vitro studies

Improved antibacterial activity and biocompatibility on vancomycin-loaded TiO2 nanotubes: in vivo and in vitro studies

Effects of Growth in the Presence of Subinhibitory Concentrations of Dicloxacillin on Staphylococcus epidermidis and Staphylococcus haemolyticus Biofilms

Antimicrobial efficacy of gentamicin‐loaded acrylic bone cements with fusidic acid or clindamycin added

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