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Kaspiris A, Vasiliadis E, Pantazaka E, Lianou I, Melissaridou D, Savvidis M, Panagopoulos F, Tsalimas G, Vavourakis M, Kolovos I, Savvidou OD, Pneumaticos SG. Current Progress and Future Perspectives in Contact and Releasing-Type Antimicrobial Coatings of Orthopaedic Implants: A Systematic Review Analysis Emanated from In Vitro and In Vivo Models. Infect Dis Rep 2024; 16:298-316. [PMID: 38667751 PMCID: PMC11050497 DOI: 10.3390/idr16020025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/05/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Despite the expanding use of orthopedic devices and the application of strict pre- and postoperative protocols, the elimination of postoperative implant-related infections remains a challenge. Objectives: To identify and assess the in vitro and in vivo properties of antimicrobial-, silver- and iodine-based implants, as well as to present novel approaches to surface modifications of orthopedic implants. Methods: A systematic computer-based review on the development of these implants, on PubMed and Web of Science databases, was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Overall, 31 in vitro and 40 in vivo entries were evaluated. Regarding the in vitro studies, antimicrobial-based coatings were assessed in 12 entries, silver-based coatings in 10, iodine-based in 1, and novel-applied coating technologies in 8 entries. Regarding the in vivo studies, antimicrobial coatings were evaluated in 23 entries, silver-coated implants in 12, and iodine-coated in 1 entry, respectively. The application of novel coatings was studied in the rest of the cases (4). Antimicrobial efficacy was examined using different bacterial strains, and osseointegration ability and biocompatibility were examined in eukaryotic cells and different animal models, including rats, rabbits, and sheep. Conclusions: Assessment of both in vivo and in vitro studies revealed a wide antimicrobial spectrum of the coated implants, related to reduced bacterial growth, inhibition of biofilm formation, and unaffected or enhanced osseointegration, emphasizing the importance of the application of surface modification techniques as an alternative for the treatment of orthopedic implant infections in the clinical settings.
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Affiliation(s)
- Angelos Kaspiris
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Elias Vasiliadis
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Evangelia Pantazaka
- Synthetic Organic Chemistry Laboratory, Department of Chemistry, University of Patras, 26504 Patras, Greece;
| | - Ioanna Lianou
- Department of Orthopedic Surgery, “Rion” University Hospital and Medical School, School of Health Sciences, University of Patras, 26504 Patras, Greece; (I.L.); (F.P.)
| | - Dimitra Melissaridou
- First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Rimini 1, 12462 Athens, Greece; (D.M.); (O.D.S.)
| | - Matthaios Savvidis
- Second Orthopedic Department, 424 General Military Hospital, 56429 Thessaloniki, Greece;
| | - Fotios Panagopoulos
- Department of Orthopedic Surgery, “Rion” University Hospital and Medical School, School of Health Sciences, University of Patras, 26504 Patras, Greece; (I.L.); (F.P.)
| | - Georgios Tsalimas
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Michail Vavourakis
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Ioannis Kolovos
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Olga D. Savvidou
- First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Rimini 1, 12462 Athens, Greece; (D.M.); (O.D.S.)
| | - Spiros G. Pneumaticos
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
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Bouloussa H, Durand Z, Gibon E, Chen AF, Grant M, Saleh-Mghir A, Mirza M, Stutzman B, Vergari C, Yue J, Anzala N, Bonnot D, Albac S, Bouloussa O, Croisier D. A novel antibacterial compound decreases MRSA biofilm formation without the use of antibiotics in a murine model. J Orthop Res 2024; 42:202-211. [PMID: 37283215 DOI: 10.1002/jor.25638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/04/2023] [Accepted: 05/30/2023] [Indexed: 06/08/2023]
Abstract
Despite significant advancements in material science, surgical site infection (SSI) rates remain high and prevention is key. This study aimed to demonstrate the in vivo safety and antibacterial efficacy of titanium implants treated with a novel broad-spectrum biocidal compound (DBG21) against methicillin-resistant Staphylococcus aureus (MRSA). Titanium (Ti) discs were covalently bound with DBG21. Untreated Ti discs were used as controls. All discs were implanted either untreated for 44 control mice or DBG21-treated for 44 treated mice. After implantation, 1 × 107 colony forming units (CFU) of MRSA were injected into the operating site. Mice were killed at 7 and 14 days to determine the number of adherent bacteria (biofilm) on implants and in the peri-implant surrounding tissues. Systemic and local toxicity were assessed. At both 7 and 14 days, DBG21-treated implants yielded a significant decrease in MRSA biofilm (3.6 median log10 CFU [99.97%] reduction [p < 0.001] and 1.9 median log10 CFU [98.7%] reduction [p = 0.037], respectively) and peri-implant surrounding tissues (2.7 median log10 CFU/g [99.8%] reduction [p < 0.001] and 5.6 median log10 CFU/g [99.9997%] reduction [p < 0.001], respectively). There were no significant differences between control and treated mice in terms of systemic and local toxicity. DBG-21 demonstrated a significant decrease in the number of biofilm bacteria without associated toxicity in a small animal implant model of SSI. Preventing biofilm formation has been recognized as a key element of preventing implant-related infections.
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Affiliation(s)
| | - Zoe Durand
- DeBogy Molecular Inc., Farmington, Connecticut, USA
| | | | - Antonia F Chen
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Matthew Grant
- Section of Infectious Diseases, New Haven, Connecticut, USA
| | - Azzam Saleh-Mghir
- UVSQ-Inserm, UMR 1173 Infection and Inflammation, Montigny-le-Bretonneux, France
| | - Mohsin Mirza
- DeBogy Molecular Inc., Farmington, Connecticut, USA
| | | | - Claudio Vergari
- Arts et Métiers Sciences et Technologie, Institut de Biomécanique Humaine Georges Charpak, Paris, France
| | - James Yue
- CT Orthopaedic Specialists, Department of Surgery, Frank H Netter School of Medicine Quinnipiac University, North Haven, Connecticut, USA
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Antimicrobial-Loaded Polyacrylamide Hydrogels Supported on Titanium as Reservoir for Local Drug Delivery. Pathogens 2023; 12:pathogens12020202. [PMID: 36839473 PMCID: PMC9962340 DOI: 10.3390/pathogens12020202] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/11/2023] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
Arthroplasty is a highly successful treatment to restore the function of a joint. The contamination of the implant via bacterial adhesion is the first step toward the development of device-associated infections. The emerging concern about antimicrobial resistance resulted in a growing interest to develop alternative therapeutic strategies. Thus, the increment in the incidence of bacterial periprosthetic infections, the complexity of treating infections caused by organisms growing in biofilms, together with the rise in antibiotic resistant bacteria, expose the need to design novel surfaces that provide innovative solutions to these rising problems. The aim of this work is to develop a coating on titanium (Ti) suitable for inhibiting bacterial adhesion and proliferation, and hence, biofilm formation on the surface. We have successfully prepared polyacrylamide hydrogels containing the conventional antibiotic ampicillin (AMP), silver nanoparticles (AgNPs), and both, AMP and AgNPs. The release of the antibacterial agents from the gelled to aqueous media resulted in an excellent antibacterial action of the loaded hydrogels against sessile S. aureus. Moreover, a synergic effect was achieved with the incorporation of both AMP and AgNPs in the hydrogel, which highlights the importance of combining antimicrobial agents having different targets. The polyacrylamide hydrogel coating on the Ti surface was successfully achieved, as it was demonstrated by FTIR, contact angle, and AFM measurements. The modified Ti surfaces having the polyacrylamide hydrogel film containing AgNPs and AMP retained the highest antibacterial effect against S. aureus as it was found for the unsupported hydrogels. The modified surfaces exhibit an excellent cytocompatibility, since healthy, flattened MC3T3-E1 cells spread on the surfaces were observed. In addition, similar macrophage RAW 264.7 adhesion was found on all the surfaces, which could be related to a low macrophage activation. Our results indicate that AMP and AgNP-loaded polyacrylamide hydrogel films on Ti are a good alternative for designing efficient antibacterial surfaces having an excellent cytocompatibility without inducing an exacerbated immune response. The approach emerges as a superior alternative to the widely used direct adsorption of therapeutic agents on surfaces, since the antimicrobial-loaded hydrogel coatings open the possibility of modulating the concentration of the antimicrobial agents to enhance bacterial killing, and then, reducing the risk of infections in implantable materials.
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Li J, Cheung WH, Chow SK, Ip M, Leung SYS, Wong RMY. Current therapeutic interventions combating biofilm-related infections in orthopaedics : a systematic review of in vivo animal studies. Bone Joint Res 2022; 11:700-714. [PMID: 36214177 PMCID: PMC9582863 DOI: 10.1302/2046-3758.1110.bjr-2021-0495.r3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aims Biofilm-related infection is a major complication that occurs in orthopaedic surgery. Various treatments are available but efficacy to eradicate infections varies significantly. A systematic review was performed to evaluate therapeutic interventions combating biofilm-related infections on in vivo animal models. Methods Literature research was performed on PubMed and Embase databases. Keywords used for search criteria were “bone AND biofilm”. Information on the species of the animal model, bacterial strain, evaluation of biofilm and bone infection, complications, key findings on observations, prevention, and treatment of biofilm were extracted. Results A total of 43 studies were included. Animal models used included fracture-related infections (ten studies), periprosthetic joint infections (five studies), spinal infections (three studies), other implant-associated infections, and osteomyelitis. The most common bacteria were Staphylococcus species. Biofilm was most often observed with scanning electron microscopy. The natural history of biofilm revealed that the process of bacteria attachment, proliferation, maturation, and dispersal would take 14 days. For systemic mono-antibiotic therapy, only two of six studies using vancomycin reported significant biofilm reduction, and none reported eradication. Ten studies showed that combined systemic and topical antibiotics are needed to achieve higher biofilm reduction or eradication, and the effect is decreased with delayed treatment. Overall, 13 studies showed promising therapeutic potential with surface coating and antibiotic loading techniques. Conclusion Combined topical and systemic application of antimicrobial agents effectively reduces biofilm at early stages. Future studies with sustained release of antimicrobial and biofilm-dispersing agents tailored to specific pathogens are warranted to achieve biofilm eradication. Cite this article: Bone Joint Res 2022;11(10):700–714.
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Affiliation(s)
- Jie Li
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Simon K. Chow
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Margaret Ip
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Sharon Y. S. Leung
- School of Pharmacy, The Chinese University of Hong Kong, Hong Kong, China
| | - Ronald M. Y. Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China, Ronald Man Yeung Wong. E-mail:
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Smart Bacteria-Responsive Drug Delivery Systems in Medical Implants. J Funct Biomater 2022; 13:jfb13040173. [PMID: 36278642 PMCID: PMC9589986 DOI: 10.3390/jfb13040173] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022] Open
Abstract
With the rapid development of implantable biomaterials, the rising risk of bacterial infections has drawn widespread concern. Due to the high recurrence rate of bacterial infections and the issue of antibiotic resistance, the common treatments of peri-implant infections cannot meet the demand. In this context, stimuli-responsive biomaterials have attracted attention because of their great potential to spontaneously modulate the drug releasing rate. Numerous smart bacteria-responsive drug delivery systems (DDSs) have, therefore, been designed to temporally and spatially release antibacterial agents from the implants in an autonomous manner at the infected sites. In this review, we summarized recent advances in bacteria-responsive DDSs used for combating bacterial infections, mainly according to the different trigger modes, including physical stimuli-responsive, virulence-factor-responsive, host-immune-response responsive and their combinations. It is believed that the smart bacteria-responsive DDSs will become the next generation of mainstream antibacterial therapies.
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Bohara S, Suthakorn J. Surface coating of orthopedic implant to enhance the osseointegration and reduction of bacterial colonization: a review. Biomater Res 2022; 26:26. [PMID: 35725501 PMCID: PMC9208209 DOI: 10.1186/s40824-022-00269-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/11/2022] [Indexed: 12/11/2022] Open
Abstract
The use of orthopedic implants in surgical technology has fostered restoration of physiological functions. Along with successful treatment, orthopedic implants suffer from various complications and fail to offer functions correspondent to native physiology. The major problems include aseptic and septic loosening due to bone nonunion and implant site infection due to bacterial colonization. Crucial advances in material selection in the design and development of coating matrixes an opportunity for the prevention of implant failure. However, many coating materials are limited in in-vitro testing and few of them thrive in clinical tests. The rate of implant failure has surged with the increasing rates of revision surgery creating physical and sensitive discomfort as well as economic burdens. To overcome critical pathogenic activities several systematic coating techniques have been developed offering excellent results that combat infection and enhance bone integration. This review article includes some more common implant coating matrixes with excellent in vitro and in vivo results focusing on infection rates, causes, complications, coating materials, host immune responses and significant research gaps. This study provides a comprehensive overview of potential coating technology, with functional combination coatings which are focused on ultimate clinical practice with substantial improvement on in-vivo tests. This includes the development of rapidly growing hydrogel coating techniques with the potential to generate several accurate and precise coating procedures.
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Affiliation(s)
- Smriti Bohara
- Department of Biomedical Engineering, Center for Biomedical and Robotics Technology (BART LAB), Faculty of Engineering, Mahidol University, Salaya, Thailand
| | - Jackrit Suthakorn
- Department of Biomedical Engineering, Center for Biomedical and Robotics Technology (BART LAB), Faculty of Engineering, Mahidol University, Salaya, Thailand.
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Esteban J, Vallet-Regí M, Aguilera-Correa JJ. Antibiotics- and Heavy Metals-Based Titanium Alloy Surface Modifications for Local Prosthetic Joint Infections. Antibiotics (Basel) 2021; 10:1270. [PMID: 34680850 PMCID: PMC8532710 DOI: 10.3390/antibiotics10101270] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 01/04/2023] Open
Abstract
Prosthetic joint infection (PJI) is the second most common cause of arthroplasty failure. Though infrequent, it is one of the most devastating complications since it is associated with great personal cost for the patient and a high economic burden for health systems. Due to the high number of patients that will eventually receive a prosthesis, PJI incidence is increasing exponentially. As these infections are provoked by microorganisms, mainly bacteria, and as such can develop a biofilm, which is in turn resistant to both antibiotics and the immune system, prevention is the ideal approach. However, conventional preventative strategies seem to have reached their limit. Novel prevention strategies fall within two broad categories: (1) antibiotic- and (2) heavy metal-based surface modifications of titanium alloy prostheses. This review examines research on the most relevant titanium alloy surface modifications that use antibiotics to locally prevent primary PJI.
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Affiliation(s)
- Jaime Esteban
- Clinical Microbiology Department, Jiménez Díaz Foundation Health Research Institute, Autonomous University of Madrid, Av. Reyes Católicos 2, 28040 Madrid, Spain
- Networking Research Centre on Infectious Diseases (CIBER-ID), 28029 Madrid, Spain
| | - María Vallet-Regí
- Department of Chemistry in Pharmaceutical Sciences, Research Institute Hospital 12 de Octubre (i+12), School of Pharmacy, Complutense University of Madrid, Pza. Ramón y Cajal s/n, 28040 Madrid, Spain
- Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| | - John J Aguilera-Correa
- Networking Research Centre on Infectious Diseases (CIBER-ID), 28029 Madrid, Spain
- Department of Chemistry in Pharmaceutical Sciences, Research Institute Hospital 12 de Octubre (i+12), School of Pharmacy, Complutense University of Madrid, Pza. Ramón y Cajal s/n, 28040 Madrid, Spain
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Understanding and optimizing the antibacterial functions of anodized nano-engineered titanium implants. Acta Biomater 2021; 127:80-101. [PMID: 33744499 DOI: 10.1016/j.actbio.2021.03.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 12/15/2022]
Abstract
Nanoscale surface modification of titanium-based orthopaedic and dental implants is routinely applied to augment bioactivity, however, as is the case with other cells, bacterial adhesion is increased on nano-rough surfaces. Electrochemically anodized Ti implants with titania nanotubes (TNTs) have been proposed as an ideal implant surface with desirable bioactivity and local drug release functions to target various conditions. However, a comprehensive state of the art overview of why and how such TNTs-Ti implants acquire antibacterial functions, and an in-depth knowledge of how topography, chemistry and local elution of potent antibiotic agents influence such functions has not been reported. This review discusses and details the application of nano-engineered Ti implants modified with TNTs for maximum local antibacterial functions, deciphering the interdependence of various characteristics and the fine-tuning of different parameters to minimize cytotoxicity. An ideal implant surface should cater simultaneously to ossoeintegration (and soft-tissue integration for dental implants), immunomodulation and antibacterial functions. We also evaluate the effectiveness and challenges associated with such synergistic functions from modified TNTs-implants. Particular focus is placed on the metallic and semi-metallic modification of TNTs towards enabling bactericidal properties, which is often dose dependent. Additionally, there are concerns over the cytotoxicity of these therapies. In that light, research challenges in this domain and expectations from the next generation of customizable antibacterial TNTs implants towards clinical translation are critically evaluated. STATEMENT OF SIGNIFICANCE: One of the major causes of titanium orthopaedic/dental implant failure is bacterial colonization and infection, which results in complete implant failure and the need for revision surgery and re-implantation. Using advanced nanotechnology, controlled nanotopographies have been fabricated on Ti implants, for instance anodized nanotubes, which can accommodate and locally elute potent antibiotic agents. In this pioneering review, we shine light on the topographical, chemical and therapeutic aspects of antibacterial nanotubes towards achieving desirable tailored antibacterial efficacy without cytotoxicity concerns. This interdisciplinary review will appeal to researchers from the wider scientific community interested in biomaterials science, structure and function, and will provide an improved understanding of controlling bacterial infection around nano-engineered implants, aimed at bridging the gap between research and clinics.
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Ghimire A, Song J. Anti-Periprosthetic Infection Strategies: From Implant Surface Topographical Engineering to Smart Drug-Releasing Coatings. ACS APPLIED MATERIALS & INTERFACES 2021; 13:20921-20937. [PMID: 33914499 PMCID: PMC8130912 DOI: 10.1021/acsami.1c01389] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Despite advanced implant sterilization and aseptic surgical techniques, periprosthetic bacterial infection remains a major challenge for orthopedic and dental implants. Bacterial colonization/biofilm formation around implants and their invasion into the dense skeletal tissue matrices are difficult to treat and could lead to implant failure and osteomyelitis. These complications require major revision surgeries and extended antibiotic therapies that are associated with high treatment cost, morbidity, and even mortality. Effective preventative measures mitigating risks for implant-related infections are thus in dire need. This review focuses on recent developments of anti-periprosthetic infection strategies aimed at either reducing bacterial adhesion, colonization, and biofilm formation or killing bacteria directly in contact with and/or in the vicinity of implants. These goals are accomplished through antifouling, quorum-sensing interfering, or bactericidal implant surface topographical engineering or surface coatings through chemical modifications. Surface topographical engineering of lotus leaf mimicking super-hydrophobic antifouling features and cicada wing-mimicking, bacterium-piercing nanopillars are both presented. Conventional physical coating/passive release of bactericidal agents is contrasted with their covalent tethering to implant surfaces through either stable linkages or linkages labile to bacterial enzyme cleavage or environmental perturbations. Pros and cons of these emerging anti-periprosthetic infection approaches are discussed in terms of their safety, efficacy, and translational potentials.
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Affiliation(s)
- Ananta Ghimire
- Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Jie Song
- Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Tamayo JA, Riascos M, Vargas CA, Baena LM. Additive manufacturing of Ti6Al4V alloy via electron beam melting for the development of implants for the biomedical industry. Heliyon 2021; 7:e06892. [PMID: 34027149 PMCID: PMC8120950 DOI: 10.1016/j.heliyon.2021.e06892] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/27/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
Additive Manufacturing (AM) or rapid prototyping technologies are presented as one of the best options to produce customized prostheses and implants with high-level requirements in terms of complex geometries, mechanical properties, and short production times. The AM method that has been more investigated to obtain metallic implants for medical and biomedical use is Electron Beam Melting (EBM), which is based on the powder bed fusion technique. One of the most common metals employed to manufacture medical implants is titanium. Although discovered in 1790, titanium and its alloys only started to be used as engineering materials for biomedical prostheses after the 1950s. In the biomedical field, these materials have been mainly employed to facilitate bone adhesion and fixation, as well as for joint replacement surgeries, thanks to their good chemical, mechanical, and biocompatibility properties. Therefore, this study aims to collect relevant and up-to-date information from an exhaustive literature review on EBM and its applications in the medical and biomedical fields. This AM method has become increasingly popular in the manufacturing sector due to its great versatility and geometry control.
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Affiliation(s)
- José A. Tamayo
- Grupo Calidad, Metrología y Producción, Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Mateo Riascos
- Grupo Calidad, Metrología y Producción, Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Carlos A. Vargas
- Grupo Materiales Avanzados y Energía (Matyer), Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Libia M. Baena
- Grupo de Química Básica, Aplicada y Ambiente (Alquimia), Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
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Ghimire A, Skelly JD, Song J. Micrococcal-Nuclease-Triggered On-Demand Release of Vancomycin from Intramedullary Implant Coating Eradicates Staphylococcus aureus Infection in Mouse Femoral Canals. ACS CENTRAL SCIENCE 2019; 5:1929-1936. [PMID: 31893222 PMCID: PMC6935889 DOI: 10.1021/acscentsci.9b00870] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Indexed: 05/25/2023]
Abstract
Preventing orthopedic implant-associated bacterial infections remains a critical challenge. Current practices of physically blending high-dose antibiotics with bone cements is known for cytotoxicity while covalently tethering antibiotics to implant surfaces is ineffective in eradicating bacteria from the periprosthetic tissue environment due to the short-range bactericidal actions, which are limited to the implant surface. Here, we covalently functionalize poly(ethylene glycol) dimethacrylate hydrogel coatings with vancomycin via an oligonucleotide linker sensitive to Staphylococcus aureus (S. aureus) micrococcal nuclease (MN) (PEGDMA-Oligo-Vanco). This design enables the timely release of vancomycin in the presence of S. aureus to kill the bacteria both on the implant surface and within the periprosthetic tissue environment. Ti6Al4V intramedullary (IM) pins surface-tethered with dopamine methacrylamide (DopaMA) and uniformly coated with PEGDMA-Oligo-Vanco effectively prevented periprosthetic infections in mouse femoral canals inoculated with bioluminescent S. aureus. Longitudinal bioluminescence monitoring, μCT quantification of femoral bone changes, end point quantification of implant surface bacteria, and histological detection of S. aureus in the periprosthetic tissue environment confirmed rapid and sustained bacterial clearance by the PEGDMA-Oligo-Vanco coating. The observed eradication of bacteria was in stark contrast with the significant bacterial colonization on implants and osteomyelitis development found in the absence of the MN-sensitive bactericidal coating. The effective vancomycin tethering dose presented in this on-demand release strategy was >200 times lower than the typical prophylactic antibiotic contents used in bone cements and may be applied to medical implants and bone/dental cements to prevent periprosthetic infections in high-risk clinical scenarios. This study also supports the timely bactericidal action by MN-triggered release of antibiotics as an effective prophylactic method to bypass the notoriously harder to treat periprosthetic biofilms and osteomyelitis.
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Affiliation(s)
- Ananta Ghimire
- Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts 01655, United States
| | - Jordan D. Skelly
- Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts 01655, United States
| | - Jie Song
- Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts 01655, United States
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Alaee F, Angerame M, Bradbury T, Blackwell R, Booth RE, Brekke AC, Courtney PM, Frenkel T, Grieco Silva FR, Heller S, Hube R, Ismaily S, Jennings J, Lee M, Noble PC, Ponzio D, Saxena A, Simpson H, Smith BM, Smith EB, Stephens S, Vasarhelyi E, Wang Q, Yeo SJ. General Assembly, Prevention, Operating Room - Surgical Technique: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019; 34:S139-S146. [PMID: 30348556 DOI: 10.1016/j.arth.2018.09.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Aboltins CA, Antoci V, Bhattacharyya S, Cross M, Ducheyne P, Freiberg AA, Hailer N, Kay P, Ketonis C, Klement MR, Köse N, Lee M, Mitchell P, Nandi S, Palacio JC, Perry K, Prieto H, Shahi A, Trebše R, Turner D, Wu CT, Yazdi H. Hip and Knee Section, Prevention, Prosthesis Factors: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019; 34:S309-S320. [PMID: 30348551 DOI: 10.1016/j.arth.2018.09.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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14
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Chouirfa H, Bouloussa H, Migonney V, Falentin-Daudré C. Review of titanium surface modification techniques and coatings for antibacterial applications. Acta Biomater 2019; 83:37-54. [PMID: 30541702 DOI: 10.1016/j.actbio.2018.10.036] [Citation(s) in RCA: 408] [Impact Index Per Article: 81.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 10/09/2018] [Accepted: 10/23/2018] [Indexed: 02/07/2023]
Abstract
Implanted biomaterials play a key role in the current success of orthopedic and dental procedures. Pure titanium and its alloys are the most commonly used materials for permanent implants in contact with bone. However, implant-related infections remain among the leading reasons for failure. The most critical pathogenic event in the development of infection on biomaterials is biofilm formation, which starts immediately after bacterial adhesion. In the last decade, numerous studies reported the ability of titanium surface modifications and coatings to minimize bacterial adhesion, inhibit biofilm formation and provide effective bacterial killing to protect implanted biomaterials. In the present review, the different strategies to prevent infection onto titanium surfaces are reported: surface modification and coatings by antibiotics, antimicrobial peptides, inorganic antibacterial metal elements and antibacterial polymers. STATEMENT OF SIGNIFICANCE: Implanted biomaterials play a key role in the current success of orthopedic and dental procedures. Pure titanium and its alloys are the most commonly used materials for permanent implants in contact with bone. Microbial infection is one of the main causes of implant failure. Currently, the global infection risk is 2-5% in orthopedic surgery. Numerous solutions exist to render titanium surfaces antibacterial. The LBPS team is an expert on the functionalization of titanium surfaces by using bioactive polymers to improve the biologiocal response. In this review, the different strategies to prevent infection are reported onto titanium and titanium alloy surfaces such as surface modification by antibiotics, antimicrobial peptides, inorganic antibacterial metal elements and antibacterial polymers.
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15
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Peeters E, Hooyberghs G, Robijns S, De Weerdt A, Kucharíková S, Tournu H, Braem A, Čeh K, Majdič G, Španič T, Pogorevc E, Claes B, Dovgan B, Girandon L, Impellizzeri F, Erdtmann M, Krona A, Vleugels J, Fröhlich M, Garcia-Forgas J, De Brucker K, Cammue BPA, Thevissen K, Van Dijck P, Vanderleyden J, Van der Eycken E, Steenackers HP. An antibiofilm coating of 5-aryl-2-aminoimidazole covalently attached to a titanium surface. J Biomed Mater Res B Appl Biomater 2018; 107:1908-1919. [PMID: 30549192 DOI: 10.1002/jbm.b.34283] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 09/21/2018] [Accepted: 09/30/2018] [Indexed: 12/25/2022]
Abstract
Biofilms, especially those formed by Staphylococcus aureus, play a key role in the development of orthopedic implant infections. Eradication of these infections is challenging due to the elevated tolerance of biofilm cells against antimicrobial agents. In this study, we developed an antibiofilm coating consisting of 5-(4-bromophenyl)-N-cyclopentyl-1-octyl-1H-imidazol-2-amine, designated as LC0024, covalently bound to a titanium implant surface (LC0024-Ti). We showed in vitro that the LC0024-Ti surface reduces biofilm formation of S. aureus in a specific manner without reducing the planktonic cells above the biofilm, as evaluated by plate counting and fluorescence microscopy. The advantage of compounds that only inhibit biofilm formation without affecting the viability of the planktonic cells, is that reduced development of bacterial resistance is expected. To determine the antibiofilm activity of LC0024-Ti surfaces in vivo, a biomaterial-associated murine infection model was used. The results indicated a significant reduction in S. aureus biofilm formation (up to 96%) on the LC0024-Ti substrates compared to pristine titanium controls. Additionally, we found that the LC0024-Ti substrates did not affect the attachment and proliferation of human cells involved in osseointegration and bone repair. In summary, our results emphasize the clinical potential of covalent coatings of LC0024 on titanium implant surfaces to reduce the risk of orthopedic implant infections. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1908-1919, 2019.
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Affiliation(s)
- Elien Peeters
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Geert Hooyberghs
- Department of Chemistry, Laboratory for Organic and Microwave-Assisted Chemistry (LOMAC), KU Leuven, Celestijnenlaan 200F, 3001 Leuven, Belgium
| | - Stijn Robijns
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Ami De Weerdt
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Soňa Kucharíková
- Department of Molecular Microbiology, VIB, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium.,Department of Biology, Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium
| | - Hélène Tournu
- Department of Molecular Microbiology, VIB, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium.,Department of Biology, Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium
| | - Annabel Braem
- Department of Materials Engineering (MTM), KU Leuven, Kasteelpark Arenberg 44 Box 2450, 3001 Leuven, Belgium
| | - Katerina Čeh
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Gregor Majdič
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Tanja Španič
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Estera Pogorevc
- Center for Animal Genomics, Veterinary Faculty, University of Ljubljana, Gerbiceva 60, 1000 Ljubljana, Slovenia
| | - Birgit Claes
- Centre for Surface Chemistry and Catalysis, KU Leuven, Kasteelpark Arenberg 23, 3001 Leuven, Belgium
| | | | | | | | | | - Annika Krona
- RISE - Research Institutes of Sweden, Bioscience and Materials, Box 5401, 402 29 Gothenburg, Sweden
| | - Jef Vleugels
- Department of Materials Engineering (MTM), KU Leuven, Kasteelpark Arenberg 44 Box 2450, 3001 Leuven, Belgium
| | - Mirjam Fröhlich
- Educell Ltd., Prevale 9, 1236 Trzin, Slovenia.,Faculty of Medicine, Institute of Cell Biology, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | | | - Katrijn De Brucker
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Bruno P A Cammue
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium.,VIB Center for Plant Systems Biology, Technologiepark 927, 9052 Ghent, Belgium
| | - Karin Thevissen
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Patrick Van Dijck
- Department of Molecular Microbiology, VIB, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium.,Department of Biology, Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31 Box 2438, 3001 Leuven, Belgium
| | - Jozef Vanderleyden
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
| | - Erik Van der Eycken
- Department of Chemistry, Laboratory for Organic and Microwave-Assisted Chemistry (LOMAC), KU Leuven, Celestijnenlaan 200F, 3001 Leuven, Belgium
| | - Hans P Steenackers
- Department of Microbial and Molecular Systems, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Kasteelpark Arenberg 20 Box 2460, 3001 Leuven, Belgium
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16
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Abstract
The sol-gel method was used to synthesize the silver doped hydroxyapatite (Ag:HAp) gels in order to produce the antifungal composite layers. The pure Ti disks were used as the substrate for the composite layers. Important information about suspensions used to make Ag:HAp composite layers were obtained from an ultrasonic technique. The identification of the phase composition of the Ag:HAp composite layers was accomplished X-ray diffraction (XRD). The morphology and the thickness of the layers was evaluated using scanning electron microscopy (SEM). The uniform distribution of the constituent elements (Ag, Ca, P, and O) in both analyzed samples was observed. The antifungal activity of the samples against Candida albicans ATCC 10231 microbial strain were investigated immediately after their preparation and six months later. SEM and confocal laser scanning microscopy (CLSM) images showed that the composite layers at the two time intervals exhibited a strong antifungal activity against Candida albicans ATCC 10231 and completely inhibited the biofilm formation.
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17
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Cattò C, Villa F, Cappitelli F. Recent progress in bio-inspired biofilm-resistant polymeric surfaces. Crit Rev Microbiol 2018; 44:633-652. [DOI: 10.1080/1040841x.2018.1489369] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Cristina Cattò
- Department of Food Environmental and Nutritional Sciences, Università degli Studi di Milano, Milano, Italy
| | - Federica Villa
- Department of Food Environmental and Nutritional Sciences, Università degli Studi di Milano, Milano, Italy
| | - Francesca Cappitelli
- Department of Food Environmental and Nutritional Sciences, Università degli Studi di Milano, Milano, Italy
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18
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Affiliation(s)
- Matthew J Allen
- Department of Veterinary Medicine, Surgical Discovery Centre, University of Cambridge, Cambridge, United Kingdom
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19
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Braem A, De Brucker K, Delattin N, Killian MS, Roeffaers MBJ, Yoshioka T, Hayakawa S, Schmuki P, Cammue BPA, Virtanen S, Thevissen K, Neirinck B. Alternating Current Electrophoretic Deposition for the Immobilization of Antimicrobial Agents on Titanium Implant Surfaces. ACS APPLIED MATERIALS & INTERFACES 2017; 9:8533-8546. [PMID: 28211996 DOI: 10.1021/acsami.6b16433] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
One prominent cause of implant failure is infection; therefore, research is focusing on developing surface coatings that render the surface resistant to colonization by micro-organisms. Permanently attached coatings of antimicrobial molecules are of particular interest because of the reduced cytoxicity and lower risk of developing resistance compared to controlled release coatings. In this study, we focus on the chemical grafting of bioactive molecules on titanium. To concentrate the molecules at the metallic implant surface, we propose electrophoretic deposition (EPD) applying alternating current (AC) signals with an asymmetrical wave shape. We show that for the model molecule bovine serum albumin (BSA), as well as for the clinically relevant antifungal lipopeptide caspofungin (CASP), the deposition yield is drastically improved by superimposing a DC offset in the direction of the high-amplitude peak of the AC signal. Additionally, in order to produce immobilized CASP coatings, this experimental AC/DC-EPD method is combined with an established surface activation protocol. Principle component analysis (PCA) of time-of-flight secondary ion mass spectrometry (ToF-SIMS) data confirm the immobilization of CASP with higher yield as compared to a diffusion-controlled process, and higher purity than the clinical CASP starting suspensions. Scratch testing data indicate good coating adhesion. Importantly, the coatings remain active against the fungal pathogen C. albicans as shown by in vitro biofilm experiments. In summary, this paper delivers a proof-of-concept for the application of AC-EPD as a fast grafting tool for antimicrobial molecules without compromising their activities.
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Affiliation(s)
- Annabel Braem
- KU Leuven Department of Materials Engineering (MTM), Kasteelpark Arenberg 44, 3001 Heverlee, Belgium
| | - Katrijn De Brucker
- KU Leuven Centre of Microbial and Plant Genetics (CMPG), Kasteelpark Arenberg 20, 3001 Heverlee, Belgium
| | - Nicolas Delattin
- KU Leuven Centre of Microbial and Plant Genetics (CMPG), Kasteelpark Arenberg 20, 3001 Heverlee, Belgium
| | - Manuela S Killian
- Department of Materials Science and Engineering, Chair for Surface Science and Corrosion, Friedrich-Alexander-University of Erlangen-Nuremberg , Martensstrasse 7, 91058 Erlangen, Germany
| | - Maarten B J Roeffaers
- KU Leuven Center for Surface Chemistry and Catalysis (COK), Kasteelpark Arenberg 23, 3001 Leuven, Belgium
| | - Tomohiko Yoshioka
- Biomaterials Laboratory, Graduate School of Natural Science and Technology, Okayama University , 3-1-1, Tsushima, Kita-ku, Okayama 700-8530, Japan
| | - Satoshi Hayakawa
- Biomaterials Laboratory, Graduate School of Natural Science and Technology, Okayama University , 3-1-1, Tsushima, Kita-ku, Okayama 700-8530, Japan
| | - Patrik Schmuki
- Department of Materials Science and Engineering, Chair for Surface Science and Corrosion, Friedrich-Alexander-University of Erlangen-Nuremberg , Martensstrasse 7, 91058 Erlangen, Germany
| | - Bruno P A Cammue
- KU Leuven Centre of Microbial and Plant Genetics (CMPG), Kasteelpark Arenberg 20, 3001 Heverlee, Belgium
- Department of Plant Systems Biology, Vlaams Instituut voor Biotechnologie (VIB) , Technologiepark 927, 9052 Ghent, Belgium
| | - Sannakaisa Virtanen
- Department of Materials Science and Engineering, Chair for Surface Science and Corrosion, Friedrich-Alexander-University of Erlangen-Nuremberg , Martensstrasse 7, 91058 Erlangen, Germany
| | - Karin Thevissen
- KU Leuven Centre of Microbial and Plant Genetics (CMPG), Kasteelpark Arenberg 20, 3001 Heverlee, Belgium
| | - Bram Neirinck
- KU Leuven Department of Materials Engineering (MTM), Kasteelpark Arenberg 44, 3001 Heverlee, Belgium
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20
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Nie B, Ao H, Long T, Zhou J, Tang T, Yue B. Immobilizing bacitracin on titanium for prophylaxis of infections and for improving osteoinductivity: An in vivo study. Colloids Surf B Biointerfaces 2016; 150:183-191. [PMID: 27914255 DOI: 10.1016/j.colsurfb.2016.11.034] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 11/07/2016] [Accepted: 11/25/2016] [Indexed: 11/16/2022]
Abstract
Bacitracin immobilized on the titanium (Ti) surface significantly improves anti-bacterial activity and biocompatibility in vitro. In the current study, we investigated the biologic performance (bactericidal effect and bone-implant integration) of bacitracin-modified Ti in vivo. A rat osteomyelitis model with femoral medullary cavity placement of Ti rods was employed to analyze the prophylactic effect of bacitracin-modified Ti (Ti-BC). Thirty-six female Sprague Dawley (SD) rats were used to establish the Ti implant-associated infection. The Ti and Ti-BC rods were incubated with and without Staphylococcus aureus to mimic the contaminated Ti rod and were implanted into the medullary cavity of the left femur, and sterile Ti rods were used as the blank control. After 3 weeks, the bone pathology was evaluated using X-ray and micro-computed tomography (micro-CT) analysis. For the investigation of the Ti-BC implant osseointegration in vivo, fifteen SD rats were divided into three groups (N=5), namely Ti, Ti-dopamine immobilized (Ti-DOPA), and Ti-BC. Ti rods were implanted into the left femoral cavity and micro-CT and histological evaluation was conducted after 12 weeks. The in vivo study indicated that Ti-immobilized bacitracin owned the prophylaxis potential for the infection associated with the Ti implants and allowed for the osseointegration. Thus, the multiple biofunctionalized Ti implants could be realized via immobilization of bacitracin, making them promising candidates for preventing the Ti implant-associated infections while retaining the osseointegration effects.
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Affiliation(s)
- Bin'en Nie
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, PR China
| | - Haiyong Ao
- School of Materials Science and Engineering, East China Jiaotong University, Nanchang, PR China
| | - Teng Long
- Department of Joint Surgery and Sports Medicine, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, PR China
| | - Jianliang Zhou
- Department of Cardiothoracic Surgery, the Second Affiliated Hospital of Nanchang University, PR China
| | - Tingting Tang
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, PR China
| | - Bing Yue
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, PR China; Department of Joint Surgery and Sports Medicine, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, PR China.
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21
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Modulation of the Substitution Pattern of 5-Aryl-2-Aminoimidazoles Allows Fine-Tuning of Their Antibiofilm Activity Spectrum and Toxicity. Antimicrob Agents Chemother 2016; 60:6483-6497. [PMID: 27550355 PMCID: PMC5075052 DOI: 10.1128/aac.00035-16] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 08/01/2016] [Indexed: 12/17/2022] Open
Abstract
We previously synthesized several series of compounds, based on the 5-aryl-2-aminoimidazole scaffold, that showed activity preventing the formation of Salmonella enterica serovar Typhimurium and Pseudomonas aeruginosa biofilms. Here, we further studied the activity spectrum of a number of the most active N1- and 2N-substituted 5-aryl-2-aminoimidazoles against a broad panel of biofilms formed by monospecies and mixed species of bacteria and fungi. An N1-substituted compound showed very strong activity against the biofilms formed by Gram-negative and Gram-positive bacteria and the fungus Candida albicans but was previously shown to be toxic against various eukaryotic cell lines. In contrast, 2N-substituted compounds were nontoxic and active against biofilms formed by Gram-negative bacteria and C. albicans but had reduced activity against biofilms formed by Gram-positive bacteria. In an attempt to develop nontoxic compounds with potent activity against biofilms formed by Gram-positive bacteria for application in antibiofilm coatings for medical implants, we synthesized novel compounds with substituents at both the N1 and 2N positions and tested these compounds for antibiofilm activity and toxicity. Interestingly, most of these N1-,2N-disubstituted 5-aryl-2-aminoimidazoles showed very strong activity against biofilms formed by Gram-positive bacteria and C. albicans in various setups with biofilms formed by monospecies and mixed species but lost activity against biofilms formed by Gram-negative bacteria. In light of application of these compounds as anti-infective coatings on orthopedic implants, toxicity against two bone cell lines and the functionality of these cells were tested. The N1-,2N-disubstituted 5-aryl-2-aminoimidazoles in general did not affect the viability of bone cells and even induced calcium deposition. This indicates that modulating the substitution pattern on positions N1 and 2N of the 5-aryl-2-aminoimidazole scaffold allows fine-tuning of both the antibiofilm activity spectrum and toxicity.
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22
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Floroian L, Ristoscu C, Mihailescu N, Negut I, Badea M, Ursutiu D, Chifiriuc MC, Urzica I, Dyia HM, Bleotu C, Mihailescu IN. Functionalized Antimicrobial Composite Thin Films Printing for Stainless Steel Implant Coatings. Molecules 2016; 21:molecules21060740. [PMID: 27294895 PMCID: PMC6274373 DOI: 10.3390/molecules21060740] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/01/2016] [Accepted: 06/02/2016] [Indexed: 01/24/2023] Open
Abstract
In this work we try to address the large interest existing nowadays in the better understanding of the interaction between microbial biofilms and metallic implants. Our aimed was to identify a new preventive strategy to control drug release, biofilm formation and contamination of medical devices with microbes. The transfer and printing of novel bioactive glass-polymer-antibiotic composites by Matrix-Assisted Pulsed Laser Evaporation into uniform thin films onto 316 L stainless steel substrates of the type used in implants are reported. The targets were prepared by freezing in liquid nitrogen mixtures containing polymer and antibiotic reinforced with bioglass powder. The cryogenic targets were submitted to multipulse evaporation by irradiation with an UV KrF* (λ = 248 nm, τFWHM ≤ 25 ns) excimer laser source. The prepared structures were analyzed by infrared spectroscopy, scanning electron microscopy, energy dispersive X-ray spectroscopy and profilometry, before and after immersion in physiological fluids. The bioactivity and the release of the antibiotic have been evaluated. We showed that the incorporated antibiotic underwent a gradually dissolution in physiological fluids thus supporting a high local treatment efficiency. Electrochemical measurements including linear sweep voltammetry and impedance spectroscopy studies were carried out to investigate the corrosion resistance of the coatings in physiological environments. The in vitro biocompatibility assay using the MG63 mammalian cell line revealed that the obtained nanostructured composite films are non-cytotoxic. The antimicrobial effect of the coatings was tested against Staphylococcus aureus and Escherichia coli strains, usually present in implant-associated infections. An anti-biofilm activity was evidenced, stronger against E. coli than the S. aureus strain. The results proved that the applied method allows for the fabrication of implantable biomaterials which shield metal ion release and possess increased biocompatibility and resistance to microbial colonization and biofilm growth.
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Affiliation(s)
- Laura Floroian
- Faculty of Electrical Engineering and Computer Science, 1 Politehnicii Str., Transilvania University of Brasov, Brasov 500024, Romania.
| | - Carmen Ristoscu
- National Institute for Laser, Plasma and Radiation Physics, P.O. Box MG-36, Magurele, Ilfov RO-77125, Romania.
| | - Natalia Mihailescu
- National Institute for Laser, Plasma and Radiation Physics, P.O. Box MG-36, Magurele, Ilfov RO-77125, Romania.
| | - Irina Negut
- National Institute for Laser, Plasma and Radiation Physics, P.O. Box MG-36, Magurele, Ilfov RO-77125, Romania.
- Faculty of Physics, University of Bucharest, Magurele, Ilfov 077125, Romania.
| | - Mihaela Badea
- Faculty of Medicine, 56 N. Balcescu Str., Transilvania University of Brasov, Brasov 500019, Romania.
| | - Doru Ursutiu
- Faculty of Electrical Engineering and Computer Science, 1 Politehnicii Str., Transilvania University of Brasov, Brasov 500024, Romania.
| | - Mariana Carmen Chifiriuc
- Faculty of Biology, Research Institute of the University of Bucharest-ICUB, University of Bucharest, Spl. Independentei 91-95, Bucharest 050095, Romania.
| | - Iuliana Urzica
- National Institute for Laser, Plasma and Radiation Physics, P.O. Box MG-36, Magurele, Ilfov RO-77125, Romania.
| | - Hussien Mohammed Dyia
- Faculty of Biology, Research Institute of the University of Bucharest-ICUB, University of Bucharest, Spl. Independentei 91-95, Bucharest 050095, Romania.
| | - Coralia Bleotu
- "Stefan S. Nicolau" Institute of Virology, 285 Mihai Bravu Avenue, Bucharest 30304, Romania.
| | - Ion N Mihailescu
- National Institute for Laser, Plasma and Radiation Physics, P.O. Box MG-36, Magurele, Ilfov RO-77125, Romania.
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23
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Gerits E, Blommaert E, Lippell A, O’Neill AJ, Weytjens B, De Maeyer D, Fierro AC, Marchal K, Marchand A, Chaltin P, Spincemaille P, De Brucker K, Thevissen K, Cammue BPA, Swings T, Liebens V, Fauvart M, Verstraeten N, Michiels J. Elucidation of the Mode of Action of a New Antibacterial Compound Active against Staphylococcus aureus and Pseudomonas aeruginosa. PLoS One 2016; 11:e0155139. [PMID: 27167126 PMCID: PMC4864301 DOI: 10.1371/journal.pone.0155139] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 04/25/2016] [Indexed: 01/29/2023] Open
Abstract
Nosocomial and community-acquired infections caused by multidrug resistant bacteria represent a major human health problem. Thus, there is an urgent need for the development of antibiotics with new modes of action. In this study, we investigated the antibacterial characteristics and mode of action of a new antimicrobial compound, SPI031 (N-alkylated 3, 6-dihalogenocarbazol 1-(sec-butylamino)-3-(3,6-dichloro-9H-carbazol-9-yl)propan-2-ol), which was previously identified in our group. This compound exhibits broad-spectrum antibacterial activity, including activity against the human pathogens Staphylococcus aureus and Pseudomonas aeruginosa. We found that SPI031 has rapid bactericidal activity (7-log reduction within 30 min at 4x MIC) and that the frequency of resistance development against SPI031 is low. To elucidate the mode of action of SPI031, we performed a macromolecular synthesis assay, which showed that SPI031 causes non-specific inhibition of macromolecular biosynthesis pathways. Liposome leakage and membrane permeability studies revealed that SPI031 rapidly exerts membrane damage, which is likely the primary cause of its antibacterial activity. These findings were supported by a mutational analysis of SPI031-resistant mutants, a transcriptome analysis and the identification of transposon mutants with altered sensitivity to the compound. In conclusion, our results show that SPI031 exerts its antimicrobial activity by causing membrane damage, making it an interesting starting point for the development of new antibacterial therapies.
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Affiliation(s)
- Evelien Gerits
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| | - Eline Blommaert
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| | - Anna Lippell
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Alex J. O’Neill
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Bram Weytjens
- Department of Information Technology (INTEC, iMINDS), U.Ghent, Ghent, Belgium
| | - Dries De Maeyer
- Department of Information Technology (INTEC, iMINDS), U.Ghent, Ghent, Belgium
| | - Ana Carolina Fierro
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
- Department of Information Technology (INTEC, iMINDS), U.Ghent, Ghent, Belgium
| | - Kathleen Marchal
- Department of Information Technology (INTEC, iMINDS), U.Ghent, Ghent, Belgium
- Department of Plant Biotechnology and Bioinformatics, U.Ghent, Ghent, Belgium
| | - Arnaud Marchand
- CISTIM Leuven vzw, Bio-Incubator, KU Leuven, Leuven, Belgium
| | - Patrick Chaltin
- CISTIM Leuven vzw, Bio-Incubator, KU Leuven, Leuven, Belgium
- Centre for Drug Design and Discovery (CD3), Research and Development, KU Leuven, Leuven, Belgium
| | - Pieter Spincemaille
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Karin Thevissen
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| | - Bruno P. A. Cammue
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
- Department of Plant Systems Biology, VIB, Ghent, Belgium
| | - Toon Swings
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| | - Veerle Liebens
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| | - Maarten Fauvart
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
- imec, Smart Systems and Emerging Technologies Unit, Department of Life Science Technologies, Leuven, Belgium
| | | | - Jan Michiels
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
- * E-mail:
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