1
|
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.
Collapse
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.)
| |
Collapse
|
2
|
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.
Collapse
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
| | | | | | | | | | | |
Collapse
|
3
|
Sharma C, Verma M, Abidi SMS, Shukla AK, Acharya A. Functional fluorescent nanomaterials for the detection, diagnosis and control of bacterial infection and biofilm formation: Insight towards mechanistic aspects and advanced applications. Colloids Surf B Biointerfaces 2023; 232:113583. [PMID: 37844474 DOI: 10.1016/j.colsurfb.2023.113583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/20/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023]
Abstract
Infectious diseases resulting from the high pathogenic potential of several bacteria possesses a major threat to human health and safety. Traditional methods used for screening of these microorganisms face major issues with respect to detection time, selectivity and specificity which may delay treatment for critically ill patients past the optimal time. Thus, a convincing and essential need exists to upgrade the existing methodologies for the fast detection of bacteria. In this context, increasing number of newly emerging nanomaterials (NMs) have been discovered for their effective use and applications in the area of diagnosis in bacterial infections. Recently, functional fluorescent nanomaterials (FNMs) are extensively explored in the field of biomedical research, particularly in developing new diagnostic tools, nanosensors, specific imaging modalities and targeted drug delivery systems for bacterial infection. It is interesting to note that organic fluorophores and fluorescent proteins have played vital role for imaging and sensing technologies for long, however, off lately fluorescent nanomaterials are increasingly replacing these due to the latter's unprecedented fluorescence brightness, stability in the biological environment, high quantum yield along with high sensitivity due to enhanced surface property etc. Again, taking advantage of their photo-excitation property, these can also be used for either photothermal and photodynamic therapy to eradicate bacterial infection and biofilm formation. Here, in this review, we have paid particular attention on summarizing literature reports on FNMs which includes studies detailing fluorescence-based bacterial detection methodologies, antibacterial and antibiofilm applications of the same. It is expected that the present review will attract the attention of the researchers working in this field to develop new engineered FNMs for the comprehensive diagnosis and treatment of bacterial infection and biofilm formation.
Collapse
Affiliation(s)
- Chandni Sharma
- Biotechnology Division, CSIR-Institute of Himalayan Bioresource Technology, Palampur, H.P. 176061, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
| | - Mohini Verma
- Biotechnology Division, CSIR-Institute of Himalayan Bioresource Technology, Palampur, H.P. 176061, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
| | - Syed M S Abidi
- Biotechnology Division, CSIR-Institute of Himalayan Bioresource Technology, Palampur, H.P. 176061, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
| | - Ashish K Shukla
- Biotechnology Division, CSIR-Institute of Himalayan Bioresource Technology, Palampur, H.P. 176061, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
| | - Amitabha Acharya
- Biotechnology Division, CSIR-Institute of Himalayan Bioresource Technology, Palampur, H.P. 176061, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
| |
Collapse
|
4
|
Merlo A, González-Martínez E, Saad K, Gomez M, Grewal M, Deering J, DiCecco LA, Hosseinidoust Z, Sask KN, Moran-Mirabal JM, Grandfield K. Functionalization of 3D Printed Scaffolds Using Polydopamine and Silver Nanoparticles for Bone-Interfacing Applications. ACS APPLIED BIO MATERIALS 2023; 6:1161-1172. [PMID: 36881860 DOI: 10.1021/acsabm.2c00988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
The prevention of bacterial colonization and the stimulation of osseointegration are two major requirements for bone-interfacing materials to reduce the incidence of complications and promote the restoration of the patient's health. The present investigation developed an effective, two-step functionalization of 3D printed scaffolds intended for bone-interfacing applications using a simple polydopamine (PDA) dip-coating method followed by the formation of silver nanoparticles (AgNPs) after a second coating step in silver nitrate. 3D printed polymeric substrates coated with a ∼20 nm PDA layer and 70 nm diameter AgNPs proved effective in hindering Staphylococcus aureus biofilm formation, with a 3000-8000-fold reduction in the number of bacterial colonies formed. The implementation of porous geometries significantly accelerated osteoblast-like cell growth. Microscopy characterization further elucidated homogeneity, features, and penetration of the coating inside the scaffold. A proof-of-concept coating on titanium substrates attests to the transferability of the method to other materials, broadening the range of applications both in and outside the medical sector. The antibacterial efficiency of the coating is likely to lead to a decrease in the number of bacterial infections developed after surgery in the presence of these coatings on prosthetics, thus translating to a reduction in revision surgeries and improved health outcomes.
Collapse
Affiliation(s)
- Alessandra Merlo
- Department of Materials Science and Engineering, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Eduardo González-Martínez
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Kamal Saad
- School of Interdisciplinary Science, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Mellissa Gomez
- Department of Chemical Engineering, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Manjot Grewal
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Joseph Deering
- Department of Materials Science and Engineering, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Liza-Anastasia DiCecco
- Department of Materials Science and Engineering, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Zeinab Hosseinidoust
- School of Biomedical Engineering, McMaster University, Hamilton, Ontario L8S 4L8, Canada
- Brockhouse Institute for Materials Research, McMaster University, Hamilton, Ontario L8S 4L8, Canada
- Department of Chemical Engineering, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Kyla N Sask
- Department of Materials Science and Engineering, McMaster University, Hamilton, Ontario L8S 4L8, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, Ontario L8S 4L8, Canada
- Brockhouse Institute for Materials Research, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Jose M Moran-Mirabal
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Ontario L8S 4L8, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, Ontario L8S 4L8, Canada
- Brockhouse Institute for Materials Research, McMaster University, Hamilton, Ontario L8S 4L8, Canada
- Centre for Advanced Light Microscopy, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| | - Kathryn Grandfield
- Department of Materials Science and Engineering, McMaster University, Hamilton, Ontario L8S 4L8, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, Ontario L8S 4L8, Canada
- Brockhouse Institute for Materials Research, McMaster University, Hamilton, Ontario L8S 4L8, Canada
| |
Collapse
|
5
|
Sun L, Chen X, Chen R, Ji Z, Mu H, Liu C, Yu J, Wang J, Xia R, Zhang S, Xu Y, Ma K, Xia L. Balancing the antibacterial and osteogenic effects of double-layer TiO 2 nanotubes loaded with silver nanoparticles for the osseointegration of implants. NANOSCALE 2023; 15:2911-2923. [PMID: 36692007 DOI: 10.1039/d2nr06154f] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The improvement of Ag nanoparticles (AgNPs), in particular, loaded titania nanotubes, includes not only the antibacterial effect but also balancing the side effects from the antibacterial effect and osteogenesis properties, which can lead to an increased success rate of implants. Herein, based on the various needs of the graft to inhibit bacteria at different stages in vivo, we used a special osteogenic honeycomb-like "large tube over small tube" double-layered nanotube structure and created ultra-small-sized silver nanoparticles uniformly loaded on the surface and the interior of double-layer nanotubes by an optimized sputter coating method to ensure the time-dependent controllable release of antibacterial Ag ions from grafts and achieve the balance of the antibacterial effect and osteogenesis properties. The release of Ag+ from DNT-Ag8 was determined by inductively coupled plasma spectrometry. The release rate of Ag was slow; it was 30% on the first day and plateaued by the 19th day. Porphyromonas gingivalis adhesion and live bacteria were less abundant on the surface of DNT-Ag8, reaching an antibacterial efficiency of 55.6% in vitro. DNT-Ag8 shows a significantly higher antibacterial effect in a rat model infected with Staphylococcus aureus. An in vitro study demonstrated that DNT-Ag8 had no adverse effects on the adhesion, viability, proliferation, ALP staining, or activity assays of rat BMSCs. In contrast, it increased the expression of osteogenic genes. In vivo, DNT-Ag8 promoted bone-implant osseointegration in a beagle mandibular tooth loss model. This study demonstrated that the uniform loading of small-diameter silver nanoparticles using a honeycomb bilayer nanotube template structure is a promising method for modifying titanium surfaces to improve both bacteriostasis and osseointegration.
Collapse
Affiliation(s)
- Lei Sun
- Department of Stomatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Xuzhuo Chen
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Ruiguo Chen
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China.
| | - Zhibo Ji
- Department of Stomatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Haizhang Mu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Chun Liu
- Department of Stomatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jinlan Yu
- Department of Stomatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jiarong Wang
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China.
| | - Rong Xia
- Department of Stomatology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Shanyong Zhang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Yin Xu
- Laboratory of Molecular Neuropsychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China.
| | - Kun Ma
- High Magnetic Field Laboratory, CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China.
| | - Lunguo Xia
- Department of Orthodontics, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
6
|
Recent Advancements in Metallic Drug-Eluting Implants. Pharmaceutics 2023; 15:pharmaceutics15010223. [PMID: 36678852 PMCID: PMC9862589 DOI: 10.3390/pharmaceutics15010223] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Over the past decade, metallic drug-eluting implants have gained significance in orthopedic and dental applications for controlled drug release, specifically for preventing infection associated with implants. Recent studies showed that metallic implants loaded with drugs were substituted for conventional bare metal implants to achieve sustained and controlled drug release, resulting in a desired local therapeutic concentration. A number of secondary features can be provided by the incorporated active molecules, including the promotion of osteoconduction and angiogenesis, the inhibition of bacterial invasion, and the modulation of host body reaction. This paper reviews recent trends in the development of the metallic drug-eluting implants with various drug delivery systems in the past three years. There are various types of drug-eluting implants that have been developed to meet this purpose, depending on the drug or agents that have been loaded on them. These include anti-inflammatory drugs, antibiotics agents, growth factors, and anti-resorptive drugs.
Collapse
|
7
|
Agarwalla SV, Ellepola K, Sorokin V, Ihsan M, Silikas N, Neto AHC, Seneviratne CJ, Rosa V. Antimicrobial-free graphene nanocoating decreases fungal yeast-to-hyphal switching and maturation of cross-kingdom biofilms containing clinical and antibiotic-resistant bacteria. BIOMATERIALS AND BIOSYSTEMS 2022; 8:100069. [PMID: 36824379 PMCID: PMC9934433 DOI: 10.1016/j.bbiosy.2022.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 10/23/2022] [Accepted: 10/23/2022] [Indexed: 12/05/2022] Open
Abstract
Candida albicans and methicillin-resistant Staphylococcus aureus (MRSA) synergize in cross-kingdom biofilms to increase the risk of mortality and morbidity due to high resistance to immune and antimicrobial defenses. Biomedical devices and implants made with titanium are vulnerable to infections that may demand their surgical removal from the infected sites. Graphene nanocoating (GN) has promising anti-adhesive properties against C. albicans. Thus, we hypothesized that GN could prevent fungal yeast-to-hyphal switching and the development of cross-kingdom biofilms. Herein, titanium (Control) was coated with high-quality GN (coverage > 99%). Thereafter, mixed-species biofilms (C. albicans combined with S. aureus or MRSA) were allowed to develop on GN and Control. There were significant reductions in the number of viable cells, metabolic activity, and biofilm biomass on GN compared with the Control (CFU counting, XTT reduction, and crystal violet assays). Also, biofilms on GN were sparse and fragmented, whereas the Control presented several bacterial cells co-aggregating with intertwined hyphal elements (confocal and scanning electronic microscopy). Finally, GN did not induce hemolysis, an essential characteristic for blood-contacting biomaterials and devices. Thus, GN significantly inhibited the formation and maturation of deadly cross-kingdom biofilms, which can be advantageous to avoid infection and surgical removal of infected devices.
Collapse
Affiliation(s)
| | - Kassapa Ellepola
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, USA
| | - Vitaly Sorokin
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, National University Health System, Singapore
| | - Mario Ihsan
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nikolaos Silikas
- Dentistry, The University of Manchester, Manchester, United Kingdom
| | - AH Castro Neto
- Centre for Advanced 2D Materials, National University of Singapore, Singapore
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Australia,Co-corresponding author at: School of Dentistry, The University of Queensland, 288 Herston Road, Cnr Bramston Terrace & Herston Road Herston QLD 4006, Australia.
| | - Vinicius Rosa
- Faculty of Dentistry, National University of Singapore, Singapore,Centre for Advanced 2D Materials, National University of Singapore, Singapore,ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore,Corresponding author at: Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore.
| |
Collapse
|
8
|
Functionalized Self-Assembled Monolayers: Versatile Strategies to Combat Bacterial Biofilm Formation. Pharmaceutics 2022; 14:pharmaceutics14081613. [PMID: 36015238 PMCID: PMC9415113 DOI: 10.3390/pharmaceutics14081613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 11/16/2022] Open
Abstract
Bacterial infections due to biofilms account for up to 80% of bacterial infections in humans. With the increased use of antibiotic treatments, indwelling medical devices, disinfectants, and longer hospital stays, antibiotic resistant infections are sharply increasing. Annual deaths are predicted to outpace cancer and diabetes combined by 2050. In the past two decades, both chemical and physical strategies have arisen to combat biofilm formation on surfaces. One such promising chemical strategy is the formation of a self-assembled monolayer (SAM), due to its small layer thickness, strong covalent bonds, typically facile synthesis, and versatility. With the goal of combating biofilm formation, the SAM could be used to tether an antibacterial agent such as a small-molecule antibiotic, nanoparticle, peptide, or polymer to the surface, and limit the agent’s release into its environment. This review focuses on the use of SAMs to inhibit biofilm formation, both on their own and by covalent grafting of a biocidal agent, with the potential to be used in indwelling medical devices. We conclude with our perspectives on ongoing challenges and future directions for this field.
Collapse
|
9
|
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.
Collapse
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.
| |
Collapse
|
10
|
Sandhu AK, Yang Y, Li WW. In Vivo Antibacterial Efficacy of Antimicrobial Peptides Modified Metallic Implants─Systematic Review and Meta-Analysis. ACS Biomater Sci Eng 2022; 8:1749-1762. [PMID: 35412810 PMCID: PMC9171719 DOI: 10.1021/acsbiomaterials.1c01307] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Biomaterial-associated infection is difficult to detect and brings consequences that can lead to morbidity and mortality. Bacteria can adhere to the implant surface, grow, and form biofilms. Antimicrobial peptides (AMPs) can target and kill bacterial cells using a plethora of mechanisms of action such as rupturing the cell membrane by creating pores via depolarization with their cationic and amphipathic nature. AMPs can thus be coated onto metal implants to prevent microbial cell adhesion and growth. The aim of this systematic review was to determine the potential clinical applications of AMP-modified implants through in vivo induced infection models. Following a database search recently up to 22 January 2022 using PubMed, Web of Science and Cochrane databases, and abstract/title screening using the PRISMA framework, 24 studies remained, of which 18 were used in the random effects meta-analysis of standardized mean differences (SMD) to get effect sizes. Quality of studies was assessed using SYRCLE's risk of bias tool. The data from these 18 studies showed that AMPs carry antibacterial effects, and the meta-analysis confirmed the favorited antibacterial efficacy of AMP-coated groups over controls (SMD -1.74, 95%CI [-2.26, -1.26], p < 0.00001). Subgroup analysis showed that the differences in effect size are random, and high heterogeneity values suggested the same. HHC36 and vancomycin were the most common AMPs for surface modification and Staphylococcus aureus, the most tested bacterium in vivo. Covalent binding with polymer brush coating and physical layer-by-layer incorporation of AMPs were recognized as key methods of incorporation to achieve desired densities. The use of fusion peptides seemed admirable to incorporate additional benefits such as osteointegration and wound healing and possibly targeting more microbe strains. Further investigation into the incorporation methods, AMP activity against different bacterial strains, and the number of AMPs used for metal implant surface modification is needed to progress toward potential clinical application.
Collapse
Affiliation(s)
- Amrit Kaur Sandhu
- School of Pharmacy and Bioengineering, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, United Kingdom
| | - Ying Yang
- School of Pharmacy and Bioengineering, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, United Kingdom
| | - Wen-Wu Li
- School of Pharmacy and Bioengineering, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, United Kingdom
| |
Collapse
|
11
|
Ghosh S, Nag M, Lahiri D, Sarkar T, Pati S, Joshi S, Ray RR. New holistic approach for the management of biofilm‐associated infections by myco‐metabolites. J Basic Microbiol 2022; 62:1291-1306. [PMID: 35373364 DOI: 10.1002/jobm.202200047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/23/2022] [Accepted: 03/05/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Sreejita Ghosh
- Department of Biotechnology Maulana Abul Kalam Azad University of Technology Haringhata West Bengal India
| | - Moupriya Nag
- Department of Biotechnology University of Engineering & Management Kolkata West Bengal India
| | - Dibyajit Lahiri
- Department of Biotechnology University of Engineering & Management Kolkata West Bengal India
| | - Tanmay Sarkar
- Department of Food Processing Technology Malda Polytechnic, West Bengal State Council of Technical Education, Government of West Bengal Malda India
| | - Siddhartha Pati
- Skills innovation & Academic network (SIAN) Institute‐ABC Balasore Odisha India
- NatNov Bioscience Private Limited Balasore Odisha India
| | - Sanket Joshi
- Oil & Gas Research Center, Central Analytical and Applied Research Unit Sultan Qaboos University Maskat Oman
| | - Rina R. Ray
- Department of Biotechnology Maulana Abul Kalam Azad University of Technology Haringhata West Bengal India
| |
Collapse
|
12
|
Souza JG, Costa RC, Sampaio AA, Abdo VL, Nagay BE, Castro N, Retamal-Valdes B, Shibli JA, Feres M, Barão VA, Bertolini M. Cross-kingdom microbial interactions in dental implant-related infections: is Candida albicans a new villain? iScience 2022; 25:103994. [PMID: 35313695 PMCID: PMC8933675 DOI: 10.1016/j.isci.2022.103994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Candida albicans, an oral fungal opportunistic pathogen, has shown the ability to colonize implant surfaces and has been frequently isolated from biofilms associated with dental implant-related infections, possibly due to its synergistic interactions with certain oral bacteria. Moreover, evidence suggests that this cross-kingdom interaction on implant can encourage bacterial growth, leading to increased fungal virulence and mucosal damage. However, the role of Candida in implant-related infections has been overlooked and not widely explored or even considered by most microbiological analyses and therapeutic approaches. Thus, we summarized the scientific evidence regarding the ability of C. albicans to colonize implant surfaces, interact in implant-related polymicrobial biofilms, and its possible role in peri-implant infections as far as biologic plausibility. Next, a systematic review of preclinical and clinical studies was conducted to identify the relevance and the gap in the existing literature regarding the role of C. albicans in the pathogenesis of peri-implant infections.
Collapse
Affiliation(s)
- João G.S. Souza
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Sāo Paulo 07023-070, Brazil
- Dental Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Minas Gerais 39401-303, Brazil
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
- Corresponding author
| | - Raphael C. Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Aline A. Sampaio
- Department of Clinic, Pathology and Dental Surgery, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Victória L. Abdo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Sāo Paulo 07023-070, Brazil
| | - Bruna E. Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Nidia Castro
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Sāo Paulo 07023-070, Brazil
| | - Belén Retamal-Valdes
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Sāo Paulo 07023-070, Brazil
| | - Jamil A. Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Sāo Paulo 07023-070, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Sāo Paulo 07023-070, Brazil
| | - Valentim A.R. Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
- Corresponding author
| | - Martinna Bertolini
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pennsylvania 15260, USA
| |
Collapse
|
13
|
Sánchez-Bodón J, Andrade del Olmo J, Alonso JM, Moreno-Benítez I, Vilas-Vilela JL, Pérez-Álvarez L. Bioactive Coatings on Titanium: A Review on Hydroxylation, Self-Assembled Monolayers (SAMs) and Surface Modification Strategies. Polymers (Basel) 2021; 14:165. [PMID: 35012187 PMCID: PMC8747097 DOI: 10.3390/polym14010165] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 12/15/2022] Open
Abstract
Titanium (Ti) and its alloys have been demonstrated over the last decades to play an important role as inert materials in the field of orthopedic and dental implants. Nevertheless, with the widespread use of Ti, implant-associated rejection issues have arisen. To overcome these problems, antibacterial properties, fast and adequate osseointegration and long-term stability are essential features. Indeed, surface modification is currently presented as a versatile strategy for developing Ti coatings with all these challenging requirements and achieve a successful performance of the implant. Numerous approaches have been investigated to obtain stable and well-organized Ti coatings that promote the tailoring of surface chemical functionalization regardless of the geometry and shape of the implant. However, among all the approaches available in the literature to functionalize the Ti surface, a promising strategy is the combination of surface pre-activation treatments typically followed by the development of intermediate anchoring layers (self-assembled monolayers, SAMs) that serve as the supporting linkage of a final active layer. Therefore, this paper aims to review the latest approaches in the biomedical area to obtain bioactive coatings onto Ti surfaces with a special focus on (i) the most employed methods for Ti surface hydroxylation, (ii) SAMs-mediated active coatings development, and (iii) the latest advances in active agent immobilization and polymeric coatings for controlled release on Ti surfaces.
Collapse
Affiliation(s)
- Julia Sánchez-Bodón
- Grupo de Química Macromolecular (LABQUIMAC), Departamento de Química Física, Facultad de Ciencia y Tecnología, Universidad del País Vasco UPV/EHU, 48940 Leioa, Spain; (J.S.-B.); (J.A.d.O.); (I.M.-B.); (J.L.V.-V.)
| | - Jon Andrade del Olmo
- Grupo de Química Macromolecular (LABQUIMAC), Departamento de Química Física, Facultad de Ciencia y Tecnología, Universidad del País Vasco UPV/EHU, 48940 Leioa, Spain; (J.S.-B.); (J.A.d.O.); (I.M.-B.); (J.L.V.-V.)
- i+Med S. Coop, Parque Tecnológico de Alava, Albert Einstein 15, Nave 15, 01510 Vitoria-Gasteiz, Spain;
| | - Jose María Alonso
- i+Med S. Coop, Parque Tecnológico de Alava, Albert Einstein 15, Nave 15, 01510 Vitoria-Gasteiz, Spain;
| | - Isabel Moreno-Benítez
- Grupo de Química Macromolecular (LABQUIMAC), Departamento de Química Física, Facultad de Ciencia y Tecnología, Universidad del País Vasco UPV/EHU, 48940 Leioa, Spain; (J.S.-B.); (J.A.d.O.); (I.M.-B.); (J.L.V.-V.)
| | - José Luis Vilas-Vilela
- Grupo de Química Macromolecular (LABQUIMAC), Departamento de Química Física, Facultad de Ciencia y Tecnología, Universidad del País Vasco UPV/EHU, 48940 Leioa, Spain; (J.S.-B.); (J.A.d.O.); (I.M.-B.); (J.L.V.-V.)
- BCMaterials, Basque Center for Materials, Applications and Nanostructures, UPV/EHU Science Park, 48940 Leioa, Spain
| | - Leyre Pérez-Álvarez
- Grupo de Química Macromolecular (LABQUIMAC), Departamento de Química Física, Facultad de Ciencia y Tecnología, Universidad del País Vasco UPV/EHU, 48940 Leioa, Spain; (J.S.-B.); (J.A.d.O.); (I.M.-B.); (J.L.V.-V.)
- BCMaterials, Basque Center for Materials, Applications and Nanostructures, UPV/EHU Science Park, 48940 Leioa, Spain
| |
Collapse
|
14
|
Lu X, Wu Z, Xu K, Wang X, Wang S, Qiu H, Li X, Chen J. Multifunctional Coatings of Titanium Implants Toward Promoting Osseointegration and Preventing Infection: Recent Developments. Front Bioeng Biotechnol 2021; 9:783816. [PMID: 34950645 PMCID: PMC8691702 DOI: 10.3389/fbioe.2021.783816] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 10/25/2021] [Indexed: 01/27/2023] Open
Abstract
Titanium and its alloys are dominant material for orthopedic/dental implants due to their stable chemical properties and good biocompatibility. However, aseptic loosening and peri-implant infection remain problems that may lead to implant removal eventually. The ideal orthopedic implant should possess both osteogenic and antibacterial properties and do proper assistance to in situ inflammatory cells for anti-microbe and tissue repair. Recent advances in surface modification have provided various strategies to procure the harmonious relationship between implant and its microenvironment. In this review, we provide an overview of the latest strategies to endow titanium implants with bio-function and anti-infection properties. We state the methods they use to preparing these efficient surfaces and offer further insight into the interaction between these devices and the local biological environment. Finally, we discuss the unmet needs and current challenges in the development of ideal materials for bone implantation.
Collapse
Affiliation(s)
- Xiaoxuan Lu
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital and College, Anhui Medical University, Hefei, China
| | - Zichen Wu
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital and College, Anhui Medical University, Hefei, China
| | - Kehui Xu
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital and College, Anhui Medical University, Hefei, China
| | - Xiaowei Wang
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital and College, Anhui Medical University, Hefei, China
| | - Shuang Wang
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital and College, Anhui Medical University, Hefei, China
| | - Hua Qiu
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital and College, Anhui Medical University, Hefei, China
| | - Xiangyang Li
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital and College, Anhui Medical University, Hefei, China
| | - Jialong Chen
- Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital and College, Anhui Medical University, Hefei, China
| |
Collapse
|
15
|
Lamont-Friedrich SJ, Kidd SE, Giles C, Griesser HJ, Coad BR. Candida auris susceptibility on surfaces coated with the antifungal drug caspofungin. Med Mycol 2021; 60:6440162. [PMID: 34850067 DOI: 10.1093/mmy/myab075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/10/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Candida auris is known to survive for weeks on solid material surfaces. Its longevity contributes to medical device contamination and spread through healthcare facilities. We fabricated antifungal surface coatings by coating plastic and glass surfaces with a thin polymer layer to which the antifungal drug caspofungin was covalently conjugated. Caspofungin-susceptible and -resistant C. auris strains were inhibited on these surfaces by 98.7 and 81.1%, respectively. Cell viability studies showed that this inhibition was fungicidal. Our findings indicate that C. auris strains can be killed on contact when exposed to caspofungin that is reformulated as a covalently-bound surface layer. LAY SUMMARY Candida auris is pathogenic, multidrug resistant yeast with the ability to survive on surfaces and remain transmissible for long periods of time in healthcare settings. In this study, we have prepared an antifungal surface coating and demonstrated its ability to kill adhering C. auris cells on contact.
Collapse
Affiliation(s)
| | - Sarah E Kidd
- National Mycology Reference Centre, SA Pathology, Adelaide, South Australia 5000, Australia
| | - Carla Giles
- Centre for Aquatic Animal Health & Vaccines. Department of Primary Industries Parks Water & Environment Tasmania, Tasmania 7249, Australia
| | - Hans J Griesser
- Future Industries Institute, University of South Australia, Adelaide, South Australia 5095, Australia
| | - Bryan R Coad
- Future Industries Institute, University of South Australia, Adelaide, South Australia 5095, Australia.,School of Agriculture, Food & Wine, The University of Adelaide, Adelaide, South Australia 5064, Australia
| |
Collapse
|
16
|
Assessment of nonreleasing antifungal surface coatings bearing covalently attached pharmaceuticals. Biointerphases 2021; 16:061001. [PMID: 34794317 DOI: 10.1116/6.0001099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There are many reports of antimicrobial coatings bearing immobilized active agents on surfaces; however, strong analytical evidence is required to verify that the agents are indeed covalently attached to the surface. In the absence of such evidence, antimicrobial activity could result from a release of active agents. We report a detailed assessment of antifungal surface coatings prepared using covalent attachment chemistries, with the aim of establishing a set of instrumental and biological evidence required to convincingly demonstrate antimicrobial activity due to nonreleasing, surface active compounds and to exclude the alternate possibility of activity due to release. The strongest biological evidence initially supporting permanent antifungal activity was the demonstration of the ability to reuse samples in multiple, sequential pathogen challenges. However, additional supporting evidence from washing studies and instrumental analysis is also required to probe the possibility of gradual desorption of strongly physisorbed compounds versus covalently attached compounds. Potent antifungal surface coatings were prepared from approved pharmaceutical compounds from the echinocandin drug class (caspofungin, anidulafungin, and micafungin) and assessed by microbiological tests and instrumental methods. Carbonyl diimidazole linking chemistry enabled covalent attachment of caspofungin, anidulafungin, and micafungin to plasma polymer surfaces, with antifungal surface activity likely caused by molecular orientations that present the lipophilic tail toward interfacing fungal cells. This study demonstrates the instrumental and biological evidence required to convincingly ascertain activity due to nonreleasing, surface active compounds and summarize these as three criteria for assessing other reports on surface-immobilized antimicrobial compounds.
Collapse
|
17
|
Li Y, Wang S, Li S, Fei J. Clindamycin-loaded titanium prevents implant-related infection through blocking biofilm formation. J Biomater Appl 2021; 36:1231-1242. [PMID: 34723682 DOI: 10.1177/08853282211051183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Implant-related infection is a disastrous complication. Surface modification of titanium is considered as an important strategy to prevent implant-related infection. However, there is no recognized surface modification strategy that can be applied in clinic so far. We explored a new strategy of coating. The clindamycin-loaded titanium was constructed by layer-by-layer self-assembly. The release of clindamycin from titanium was detected through high performance liquid chromatography. Different titanium was co-cultured with Staphylococcus aureus for 24 h in vitro, then the effect of different titanium on bacterial colonization and biofilm formation was determined by spread plate method and scanning electron microscopy. Cytotoxicity and cytocompatibility of clindamycin-loaded titanium on MC3T3-E1 cells were measured by CCK8. The antibacterial ability of clindamycin-loaded titanium in vivo was also evaluated using a rat model of osteomyelitis. The number of osteoclasts in bone defect was observed by tartrate-resistant acid phosphatase staining. Bacterial burden of surrounding tissues around the site of infection was calculated by tissue homogenate and colony count. Clindamycin-loaded titanium could release clindamycin slowly within 160 h. It reduced bacterial colonization by three orders of magnitude compare to control (p < .05) and inhibits biofilm formation in vitro. Cells proliferation and adhesion were similar on three titanium surfaces (p > .05). In vivo, clindamycin-loaded titanium improved bone healing, reduced microbial burden, and decreased the number of osteoclasts compared control titanium in the rat model of osteomyelitis. This study demonstrated that clindamycin-loaded titanium exhibited good biocompatibility, and showed antibacterial activity both in vivo and in vitro. It is promising and might have potential for clinical application.
Collapse
Affiliation(s)
- Youbin Li
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China
| | - Shaochuan Wang
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China
| | - Shidan Li
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China
| | - Jun Fei
- 12525Department of Emergency Medicine of Army Medical Center, Army Medical University, Chongqing, China.,12525State Key Laboratory of Trauma, Burns and Combined Injury, Army Medical University, Chongqing, China
| |
Collapse
|
18
|
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.
Collapse
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
| |
Collapse
|
19
|
Varied-shaped gold nanoparticles with nanogram killing efficiency as potential antimicrobial surface coatings for the medical devices. Sci Rep 2021; 11:12546. [PMID: 34131207 PMCID: PMC8206335 DOI: 10.1038/s41598-021-91847-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/19/2021] [Indexed: 11/22/2022] Open
Abstract
Medical device-associated infections are a serious medical threat, particularly for patients with impaired mobility and/or advanced age. Despite a variety of antimicrobial coatings for medical devices being explored to date, only a limited number have been introduced for clinical use. Research into new bactericidal agents with the ability to eradicate pathogens, limit biofilm formation, and exhibit satisfactory biocompatibility, is therefore necessary and urgent. In this study, a series of varied-morphology gold nanoparticles in shapes of rods, peanuts, stars and spherical-like, porous ones with potent antibacterial activity were synthesized and thoroughly tested against spectrum of Candida albicans, Pseudomonas aeruginosa, Staphylococcus aureus clinical strains, as well as spectrum of uropathogenic Escherichia coli isolates. The optimization of gold nanoparticles synthesis allowed to develop nanomaterials, which are proved to be significantly more potent against tested microbes compared with the gold nanoformulations reported to date. Notably, their antimicrobial spectrum includes strains with different drug resistance mechanisms. Facile and cost-efficient synthesis of gold nanoparticles, remarkable bactericidal efficiency at nanogram doses, and low toxicity, underline their potential for development as a new coatings, as indicated by the example of urological catheters. The presented research fills a gap in microbial studies of non-spherical gold nanoparticles for the development of antimicrobial coatings targeting multidrug-resistant pathogens responsible for device-associated nosocomial infections.
Collapse
|
20
|
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.
Collapse
|
21
|
Huang X, Ge Y, Yang B, Han Q, Zhou W, Liang J, Li M, Peng X, Ren B, Yang B, Weir MD, Guo Q, Wang H, Zhou X, Lu X, Oates TW, Xu HHK, Deng D, Zhou X, Cheng L. Novel dental implant modifications with two-staged double benefits for preventing infection and promoting osseointegration in vivo and in vitro. Bioact Mater 2021; 6:4568-4579. [PMID: 34095616 PMCID: PMC8141509 DOI: 10.1016/j.bioactmat.2021.04.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/24/2021] [Accepted: 04/24/2021] [Indexed: 02/05/2023] Open
Abstract
Peri-implantitis are a major problem causing implant failure these days. Accordingly, anti-infection during the early stage and subsequent promotion of osseointegration are two main key factors to solve this issue. Micro-arc oxidation (MAO) treatment is a way to form an oxidation film on the surface of metallic materials. The method shows good osteogenic properties but weak antibacterial effect. Therefore, we developed combined strategies to combat severe peri-implantitis, which included the use of a novel compound, PD, comprising dendrimers poly(amidoamine) (PAMAM) loading dimethylaminododecyl methacrylate (DMADDM) as well as MAO treatment. Here, we explored the chemical properties of the novel compound PD, and proved that this compound was successfully synthesized, with the loading efficiency and encapsulation efficiency of 23.91% and 31.42%, respectively. We further report the two-stage double benefits capability of PD + MAO: (1) in the first stage, PD + MAO could decrease the adherence and development of biofilms by releasing DMADDM in the highly infected first stage after implant surgery both in vitro and in vivo; (2) in the second stage, PD + MAO indicated mighty anti-infection and osteoconductive characteristics in a rat model of peri-implantitis in vivo. This study first reports the two-staged, double benefits of PD + MAO, and demonstrates its potential in clinical applications for inhibiting peri-implantitis, especially in patients with severe infection risk.
Collapse
Affiliation(s)
- Xiaoyu Huang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.,Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Yang Ge
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.,Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, China.,Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China.,Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Bina Yang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.,Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Qi Han
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.,Department of Pathology, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Wen Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.,Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Jingou Liang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.,Department of Pediatrics, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Mingyun Li
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.,Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Xian Peng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Biao Ren
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Bangcheng Yang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610041, China
| | - Michael D Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, 21201, USA
| | - Qiang Guo
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Haohao Wang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.,Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Xinxuan Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Xugang Lu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610041, China
| | - Thomas W Oates
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, 21201, USA
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, 21201, USA
| | - Dongmei Deng
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.,Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.,Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| |
Collapse
|
22
|
Devine R, Douglass M, Ashcraft M, Tayag N, Handa H. Development of Novel Amphotericin B-Immobilized Nitric Oxide-Releasing Platform for the Prevention of Broad-Spectrum Infections and Thrombosis. ACS APPLIED MATERIALS & INTERFACES 2021; 13:19613-19624. [PMID: 33904311 PMCID: PMC9683085 DOI: 10.1021/acsami.1c01330] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Indwelling medical devices currently used to diagnose, monitor, and treat patients invariably suffer from two common clinical complications: broad-spectrum infections and device-induced thrombosis. Currently, infections are managed through antibiotic or antifungal treatment, but the emergence of antibiotic resistance, the formation of recalcitrant biofilms, and difficulty identifying culprit pathogens have made treatment increasingly challenging. Additionally, systemic anticoagulation has been used to manage device-induced thrombosis, but subsequent life-threatening bleeding events associated with all available therapies necessitates alternative solutions. In this study, a broad-spectrum antimicrobial, antithrombotic surface combining the incorporation of the nitric oxide (NO) donor S-nitroso-N-acetylpenicillamine (SNAP) with the immobilization of the antifungal Amphotericin B (AmB) on polydimethylsiloxane (PDMS) was developed in a two-step process. This novel strategy combines the key advantages of NO, a bactericidal agent and platelet inhibitor, with AmB, a potent antifungal agent. We demonstrated that SNAP-AmB surfaces significantly reduced the viability of adhered Staphylococcus aureus (99.0 ± 0.2%), Escherichia coli (89.7 ± 1.0%), and Candida albicans (93.5 ± 4.2%) compared to controls after 24 h of in vitro exposure. Moreover, SNAP-AmB surfaces reduced the number of platelets adhered by 74.6 ± 3.9% compared to controls after 2 h of in vitro porcine plasma exposure. Finally, a cytotoxicity assay validated that the materials did not present any cytotoxic side effects toward human fibroblast cells. This novel approach is the first to combine antifungal surface functionalization with NO-releasing technology, providing a promising step toward reducing the rate of broad-spectrum infection and thrombosis associated with indwelling medical devices.
Collapse
Affiliation(s)
- Ryan Devine
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Megan Douglass
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Morgan Ashcraft
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
- Pharmaceutical and Biomedical Sciences Department, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| | - Nicole Tayag
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| | - Hitesh Handa
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, Georgia 30602, United States
| |
Collapse
|
23
|
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.
Collapse
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
| |
Collapse
|
24
|
The Disinfectant Effect of Modified Hydrothermal Nanotitania Extract on Candida albicans. BIOMED RESEARCH INTERNATIONAL 2021. [DOI: 10.1155/2021/6617645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Candida albicans is a pathogenic yeast typically associated with diseases such as HIV, AIDS, and other immunocompromised conditions. It is rarely the cause of fatalities and is commonly treated with drugs administered orally or intravenously. In this experiment, Candida albicans was tested with an extract of modified hydrothermal nanotitania to identify whether the material is capable of inhibiting the organism’s growth. The extract was mixed with the Candida albicans in a culture media preparation to determine whether the organisms were able to grow. The test showed that modified hydrothermal nanotitania inhibits the growth of this organism.
Collapse
|
25
|
Souza JGS, Bertolini MM, Costa RC, Nagay BE, Dongari-Bagtzoglou A, Barão VAR. Targeting implant-associated infections: titanium surface loaded with antimicrobial. iScience 2021; 24:102008. [PMID: 33490916 PMCID: PMC7811145 DOI: 10.1016/j.isci.2020.102008] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Implant devices have = proven a successful treatment modality in reconstructive surgeries. However, increasing rates of peri-implant diseases demand further examination of their pathogenesis. Polymicrobial biofilm formation on titanium surfaces has been considered the main risk factor for inflammatory processes on tissues surrounding implant devices, which often lead to implant failure. To overcome microbial accumulation on titanium surfaces biofilm targeting strategies have been developed to modify the surface and incorporate antimicrobial coatings. Because antibiotics are widely used to treat polymicrobial infections, these agents have recently started to be incorporated on titanium surface. This review discusses the biofilm formation on titanium dental implants and key factors to be considered in therapeutic and preventative strategies. Moreover, a systematic review was conducted on coatings developed for titanium surfaces using different antibiotics. This review will also shed light on potential alternative strategies aiming to reduce microbial loads and control polymicrobial infection on implanted devices.
Collapse
Affiliation(s)
- João Gabriel Silva Souza
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
- Dental Research Division, Guarulhos University, Guarulhos, SP 07023-070, Brazil
- Dentistry Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Minas Gerais, 39401-303, Brazil
| | - Martinna Mendonça Bertolini
- Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Bruna Egumi Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Anna Dongari-Bagtzoglou
- Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| |
Collapse
|
26
|
Extracellular matrix scaffold crosslinked with vancomycin for multifunctional antibacterial bone infection therapy. Biomaterials 2020; 268:120603. [PMID: 33378735 DOI: 10.1016/j.biomaterials.2020.120603] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/22/2022]
Abstract
The treatment of acute and chronic bone infections remains a major clinical challenge. The various factors released by the bacteria, acidic environment, and bacterial colonies in the bone grooves and implanted synthetic materials collectively promote the formation of biofilms. Dormant bacteria and biofilms cause infections that are difficult to cure and that can develop chronically. Therefore, a new antibacterial material was synthesized in the present study for multifunctional bone infection therapy and consists of specific demineralized extracellular cancellous bone (SDECM) crosslinked with vancomycin (Van) by means of electrostatic interactions and chemical bonds. It was verified in vitro that the new material (Van-SDECM) not only has pH-sensitive release and biofilm inhibition properties, but also maintains sustained bactericidal ability accompanied by the degradation of the scaffold, which does not affect its favorable osteogenic performance. The infectious bone defect in vivo model further confirms the comprehensive anti-infective and osteogenic ability of the Van-SDECM. Further, these favorable properties are due to the pH-sensitive sustained release sterilization and scaffold contact antibacterial properties, accompanied by osteoclast activity inhibition, osteogenesis promotion and immunoregulation effects. This study provides a new drug-scaffold composite preparation method based on a native-derived extracellular matrix scaffold.
Collapse
|
27
|
Yang Z, Xi Y, Bai J, Jiang Z, Wang S, Zhang H, Dai W, Chen C, Gou Z, Yang G, Gao C. Covalent grafting of hyperbranched poly-L-lysine on Ti-based implants achieves dual functions of antibacteria and promoted osteointegration in vivo. Biomaterials 2020; 269:120534. [PMID: 33243425 DOI: 10.1016/j.biomaterials.2020.120534] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/29/2020] [Accepted: 11/03/2020] [Indexed: 12/25/2022]
Abstract
The dual functional implants of antibacteria and osteointegration are highly demanded in orthopedic and dentistry, especially for patients who suffer from diabetes or osteoporosis simultaneously. However, there is lack of the facile and robust method to produce clinically applicable implants with this dual function although coatings possessing single function have been extensively developed. Herein, hyperbranched poly-L-lysine (HBPL) polymers were covalently immobilized onto the alkali-heat treated titanium (Ti) substrates and implants by using 3-glycidyloxypropyltrimethoxysilane (GPTMS) as the coupling agent, which displayed excellent antibacterial activity against S. aureus and E. coli with an efficiency as high as 89.4% and 92.2% in vitro, respectively. The HBPL coating also significantly promoted the adhesion, spreading, proliferation and osteogenic differentiation of MC3T3-E1 cells in vitro. Furthermore, the results of a S. aureus infection rat model in vivo ulteriorly verified that the HBPL-modified screws had good antibacterial and anti-inflammatory abilities at an early stage of implantation and better osteointegration compared with the control Ti screws.
Collapse
Affiliation(s)
- Zhijian Yang
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Yue Xi
- Department of Implantology, Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Jun Bai
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Zhiwei Jiang
- Department of Implantology, Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Shuqin Wang
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Haolan Zhang
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Wei Dai
- Department of Implantology, Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Chaozhen Chen
- Department of Implantology, Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Zhongru Gou
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou, 310058, China
| | - Guoli Yang
- Department of Implantology, Stomatology Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China.
| | - Changyou Gao
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China; Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University, Hangzhou, 310058, China.
| |
Collapse
|
28
|
Vera-González N, Shukla A. Advances in Biomaterials for the Prevention and Disruption of Candida Biofilms. Front Microbiol 2020; 11:538602. [PMID: 33042051 PMCID: PMC7527432 DOI: 10.3389/fmicb.2020.538602] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/24/2020] [Indexed: 12/16/2022] Open
Abstract
Candida species can readily colonize a multitude of indwelling devices, leading to biofilm formation. These three-dimensional, surface-associated Candida communities employ a multitude of sophisticated mechanisms to evade treatment, leading to persistent and recurrent infections with high mortality rates. Further complicating matters, the current arsenal of antifungal therapeutics that are effective against biofilms is extremely limited. Antifungal biomaterials are gaining interest as an effective strategy for combating Candida biofilm infections. In this review, we explore biomaterials developed to prevent Candida biofilm formation and those that treat existing biofilms. Surface functionalization of devices employing clinically utilized antifungals, other antifungal molecules, and antifungal polymers has been extremely effective at preventing fungi attachment, which is the first step of biofilm formation. Several mechanisms can lead to this attachment inhibition, including contact killing and release-based killing of surrounding planktonic cells. Eliminating mature biofilms is arguably much more difficult than prevention. Nanoparticles have shown the most promise in disrupting existing biofilms, with the potential to penetrate the dense fungal biofilm matrix and locally target fungal cells. We will describe recent advances in both surface functionalization and nanoparticle therapeutics for the treatment of Candida biofilms.
Collapse
Affiliation(s)
- Noel Vera-González
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI, United States
| | - Anita Shukla
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI, United States
- Institute for Molecular and Nanoscale Innovation, Brown University, Providence, RI, United States
| |
Collapse
|
29
|
Ricciardi BF, Muthukrishnan G, Masters EA, Kaplan N, Daiss JL, Schwarz EM. New developments and future challenges in prevention, diagnosis, and treatment of prosthetic joint infection. J Orthop Res 2020; 38:1423-1435. [PMID: 31965585 PMCID: PMC7304545 DOI: 10.1002/jor.24595] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/03/2020] [Indexed: 02/04/2023]
Abstract
Prosthetic joint infection (PJI) is a devastating complication that results in substantial costs to society and patient morbidity. Advancements in our knowledge of this condition have focused on prevention, diagnosis, and treatment, in order to reduce rates of PJI and improve patient outcomes. Preventive measures such as optimization of patient comorbidities, and perioperative antibiotic usage are intensive areas of current clinical research to reduce the rate of PJI. Improved diagnostic tests such as synovial fluid (SF) α-defensin enzyme-linked immunosorbent assay, and nucleic acid-based tests for serum, SF, and tissue cultures, have improved diagnostic accuracy and organism identification. Increasing the diversity of available antibiotic therapy, immunotherapy, and alternative implant coatings remain promising treatments to improve infection eradication in the setting of PJI.
Collapse
Affiliation(s)
- Benjamin F Ricciardi
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine,Corresponding author: Benjamin Ricciardi, MD, Center for Musculoskeletal Research, University of Rochester School of Medicine, 601 Elmwood Avenue, Box 665, Rochester, NY 14642, Telephone: 585-341-9763 / Fax: 585-341-9865,
| | - Gowrishankar Muthukrishnan
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine
| | - Elysia A Masters
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine
| | - Nathan Kaplan
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine
| | - John L Daiss
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine
| | - Edward M Schwarz
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine
| |
Collapse
|
30
|
Pestrak MJ, Gupta TT, Dusane DH, Guzior DV, Staats A, Harro J, Horswill AR, Stoodley P. Investigation of synovial fluid induced Staphylococcus aureus aggregate development and its impact on surface attachment and biofilm formation. PLoS One 2020; 15:e0231791. [PMID: 32302361 PMCID: PMC7164621 DOI: 10.1371/journal.pone.0231791] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/31/2020] [Indexed: 12/01/2022] Open
Abstract
Periprosthetic joint infections (PJIs) are a devastating complication that occurs in 2% of patients following joint replacement. These infections are costly and difficult to treat, often requiring multiple corrective surgeries and prolonged antimicrobial treatments. The Gram-positive bacterium Staphylococcus aureus is one of the most common causes of PJIs, and it is often resistant to a number of commonly used antimicrobials. This tolerance can be partially attributed to the ability of S. aureus to form biofilms. Biofilms associated with the surface of indwelling medical devices have been observed on components removed during chronic infection, however, the development and localization of biofilms during PJIs remains unclear. Prior studies have demonstrated that synovial fluid, in the joint cavity, promotes the development of bacterial aggregates with many biofilm-like properties, including antibiotic resistance. We anticipate these aggregates have an important role in biofilm formation and antibiotic tolerance during PJIs. Therefore, we sought to determine specifically how synovial fluid promotes aggregate formation and the impact of this process on surface attachment. Using flow cytometry and microscopy, we quantified the aggregation of various clinical S. aureus strains following exposure to purified synovial fluid components. We determined that fibrinogen and fibronectin promoted bacterial aggregation, while cell free DNA, serum albumin, and hyaluronic acid had minimal effect. To determine how synovial fluid mediated aggregation affects surface attachment, we utilized microscopy to measure bacterial attachment. Surprisingly, we found that synovial fluid significantly impeded bacterial surface attachment to a variety of materials. We conclude from this study that fibrinogen and fibronectin in synovial fluid have a crucial role in promoting bacterial aggregation and inhibiting surface adhesion during PJI. Collectively, we propose that synovial fluid may have conflicting protective roles for the host by preventing adhesion to surfaces, but by promoting bacterial aggregation is also contributing to the development of antibiotic tolerance.
Collapse
Affiliation(s)
- Matthew J. Pestrak
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, United States of America
| | - Tripti Thapa Gupta
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, United States of America
| | - Devendra H. Dusane
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, United States of America
| | - Doug V. Guzior
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, United States of America
| | - Amelia Staats
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, United States of America
| | - Jan Harro
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, Maryland, United States of America
| | - Alexander R. Horswill
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Paul Stoodley
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, Ohio, United States of America
- Department of Orthopedics, The Ohio State University, Columbus, Ohio, United States of America
- National Centre for Advanced Tribology at Southampton (nCATS) and National Biofilm Innovation Centre (NBIC), Mechanical Engineering, University of Southampton, Southampton, United Kingdom
- * E-mail:
| |
Collapse
|
31
|
Hornschuh M, Zwicker P, Schmidt T, Kramer A, Müller G. In vitro evaluation of contact-active antibacterial efficacy of Ti-Al-V alloys coated with the antimicrobial agent PHMB. Acta Biomater 2020; 106:376-386. [PMID: 32068136 DOI: 10.1016/j.actbio.2020.02.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/03/2020] [Accepted: 02/11/2020] [Indexed: 12/31/2022]
Abstract
Immobilized polycationic substances on biomaterial surfaces kill adhering bacteria upon contact and are considered a promising non-antibiotic alternative. Unfortunately, there is no generally accepted in vitro method for quantitatively evaluating the antibacterial efficacy of contact-active non-leachable antimicrobial surfaces. Moreover, guidelines of generally accepted international industrial standards do not reflect the basic principle of bacterial contamination and/or are performed in the presence of a solid covering material. Therefore, in the present study, six bacterial adherence tests on non-porous surfaces with no covering material were compared with respect to their efficacy and reproducibility, as well as to evaluate the bactericidal contact-killing of relevant device-associated slime-producing bacteria using antimicrobially coated Ti6Al4V surfaces with positively-charged poly(hexamethylene biguanide) hydrochloride (PHMB). After direct bacterial inoculation to simulate a perioperative infection, non-leaching PHMB reacts bactericidally against the slime-producing bacteria Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa after surface contact. The 6-h drop technique was found to be a suitable method to quantitatively evaluate contact-active antibacterial surfaces. Adjunctively, however, damage of bacterial membrane integrity should be confirmed by LIVE/DEAD staining and the presence of non-leaching agents. STATEMENT OF SIGNIFICANCE: Unintentional perioperative bacterial adhesion to implant surfaces can generate biomaterial-associated infections. Adhered bacteria produce biofilms that protect them from antibiotic attack, which may be complicated by possible antibiotic resistance. Polycationic surfaces can prevent such unwanted biofilm formation by killing bacteria upon initial contact. Unfortunately, no reliable in vitro methods exist to evaluate the efficacy of contact-active antimicrobial surfaces. In this study, we show that the 6-h drop technique may be a suitable method to evaluate positively-charged contact-killing surfaces. Identification of suitable screening assays for evaluating the bactericidal efficacy of non-leachable antimicrobial agents will greatly improve this newly developing field as a prophylactic alternative to postoperative treatment of implant-associated infections by antibiotics.
Collapse
|
32
|
Rigo S, Hürlimann D, Marot L, Malmsten M, Meier W, Palivan CG. Decorating Nanostructured Surfaces with Antimicrobial Peptides to Efficiently Fight Bacteria. ACS APPLIED BIO MATERIALS 2020; 3:1533-1543. [DOI: 10.1021/acsabm.9b01154] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Serena Rigo
- Department of Chemistry, University of Basel, Mattenstrasse 24a, BPR 1096, CH-4002 Basel, Switzerland
| | - Dimitri Hürlimann
- Department of Chemistry, University of Basel, Mattenstrasse 24a, BPR 1096, CH-4002 Basel, Switzerland
| | - Laurent Marot
- Department of Physics, University of Basel, Klingelbergstrasse 82, CH-4056 Basel, Switzerland
| | - Martin Malmsten
- Department of Pharmacy, University of Copenhagen, DK-2100 Copenhagen, Denmark
- Department of Physical Chemistry 1, Lund University, SE-221 00 Lund, Sweden
| | - Wolfgang Meier
- Department of Chemistry, University of Basel, Mattenstrasse 24a, BPR 1096, CH-4002 Basel, Switzerland
| | - Cornelia G. Palivan
- Department of Chemistry, University of Basel, Mattenstrasse 24a, BPR 1096, CH-4002 Basel, Switzerland
| |
Collapse
|
33
|
Chuang PJ, Swaminathan V, Pavlovsky L, Marquez-Catral L, Jones DL, Song L. Negative influence of biofilm on CoCrMo corrosion. J Biomed Mater Res A 2019; 107:2556-2566. [PMID: 31355999 DOI: 10.1002/jbm.a.36761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 11/08/2022]
Abstract
Minimal studies exist investigating biofilm-induced corrosion of orthopaedic implants. This study investigates potential contributions of Pseudomonas aeruginosa and Staphylococcus aureus biofilms on corrosion resistance of CoCrMo under static and fretting conditions. Biofilms were cultured on CoCrMo coupons for either 4 weeks (static culture) or 6 days (fretting culture; pin-on-disk with a Ti6Al4V hemispherical tip pin). Morphology of biofilms and corrosion of coupon surfaces were analyzed via SEM. Open circuit potential and electrochemical impedance spectroscopy measurements were collected for corrosion performance evaluation. Results showed no visible corrosion on coupon surfaces in static culture, which suggests these biofilms alone do not induce severe corrosion under the conditions of this study. However, electrochemical data showed biofilm presence lowered coupon electrochemical impedance in static and fretting cultures, suggesting resistive and capacitive characteristics of the metal oxide-biofilm-media interface were altered. Under fretting, the P. aeruginosa group exhibited a distinct damage morphology and Co:Cr:Mo ratio within the wear scar when compared with S. aureus and the bacteria-free control. These differences suggest the presence of P. aeruginosa biofilms may negatively impact corrosion resistance at the fretting interface. Taken together these results demonstrate biofilms can contribute to implant corrosion by influencing the electrochemical impedance of implant metal surfaces.
Collapse
|
34
|
Radtke A, Ehlert M, Jędrzejewski T, Sadowska B, Więckowska-Szakiel M, Holopainen J, Ritala M, Leskelä M, Bartmański M, Szkodo M, Piszczek P. Titania Nanotubes/Hydroxyapatite Nanocomposites Produced with the Use of the Atomic Layer Deposition Technique: Estimation of Bioactivity and Nanomechanical Properties. NANOMATERIALS 2019; 9:nano9010123. [PMID: 30669454 PMCID: PMC6359504 DOI: 10.3390/nano9010123] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/14/2019] [Accepted: 01/15/2019] [Indexed: 12/14/2022]
Abstract
Titanium dioxide nanotubes/hydroxyapatite nanocomposites were produced on a titanium alloy (Ti6Al4V/TNT/HA) and studied as a biocompatible coating for an implant surface modification. As a novel approach for this type of nanocomposite fabrication, the atomic layer deposition (ALD) method with an extremely low number of cycles was used to enrich titania nanotubes (TNT) with a very thin hydroxyapatite coating. X-ray diffraction (XRD) and scanning electron microscopy (SEM) were used for determination of the structure and the surface morphology of the fabricated nanocoatings. The biointegration activity of the layers was estimated based on fibroblasts’ proliferation on the TNT/HA surface. The antibacterial activity was determined by analyzing the ability of the layers to inhibit bacterial colonization and biofilm formation. Mechanical properties of the Ti6Al4V/TNT/HA samples were estimated by measuring the hardness, Young’s module, and susceptibility to scratching. The results revealed that the nanoporous titanium alloy coatings enriched with a very thin hydroxyapatite layer may be a promising way to achieve the desired balance between biofunctional and biomechanical properties of modern implants.
Collapse
Affiliation(s)
- Aleksandra Radtke
- Faculty of Chemistry, Nicolaus Copernicus University in Toruń, Gagarina 7, 87-100 Toruń, Poland.
- Nano-implant Ltd. Gagarina 5, 87-100 Toruń, Poland.
| | - Michalina Ehlert
- Faculty of Chemistry, Nicolaus Copernicus University in Toruń, Gagarina 7, 87-100 Toruń, Poland.
- Nano-implant Ltd. Gagarina 5, 87-100 Toruń, Poland.
| | - Tomasz Jędrzejewski
- Faculty of Biology and Environmental Protection, Nicolaus Copernicus University in Toruń, Lwowska 1, 87-100 Toruń, Poland.
| | - Beata Sadowska
- Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237 Łódź, Poland.
| | - Marzena Więckowska-Szakiel
- Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237 Łódź, Poland.
| | - Jani Holopainen
- Department of Chemistry, University of Helsinki, A.I. Virtasen aukio 1, 00014 Helsinki, Finland.
| | - Mikko Ritala
- Department of Chemistry, University of Helsinki, A.I. Virtasen aukio 1, 00014 Helsinki, Finland.
| | - Markku Leskelä
- Department of Chemistry, University of Helsinki, A.I. Virtasen aukio 1, 00014 Helsinki, Finland.
| | - Michał Bartmański
- Faculty of Mechanical Engineering, Gdańsk University of Technology, Gabriela Narutowicza 11/12, 80-233 Gdańsk, Poland.
| | - Marek Szkodo
- Faculty of Mechanical Engineering, Gdańsk University of Technology, Gabriela Narutowicza 11/12, 80-233 Gdańsk, Poland.
| | - Piotr Piszczek
- Faculty of Chemistry, Nicolaus Copernicus University in Toruń, Gagarina 7, 87-100 Toruń, Poland.
- Nano-implant Ltd. Gagarina 5, 87-100 Toruń, Poland.
| |
Collapse
|
35
|
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.
Collapse
|
36
|
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.
Collapse
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
| |
Collapse
|
37
|
Naderi J, Giles C, Saboohi S, Griesser HJ, Coad BR. Surface coatings with covalently attached anidulafungin and micafungin preventCandida albicansbiofilm formation. J Antimicrob Chemother 2018; 74:360-364. [DOI: 10.1093/jac/dky437] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/28/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Javad Naderi
- Future Industries Institute, University of South Australia, Adelaide, Australia
| | - Carla Giles
- Future Industries Institute, University of South Australia, Adelaide, Australia
- Centre for Aquatic Animal Health & Vaccines, Tasmania Department of Primary Industries, Parks Water & Environment, 165 Westbury Road, Prospect, Tasmania, Australia
| | - Solmaz Saboohi
- Future Industries Institute, University of South Australia, Adelaide, Australia
| | - Hans J Griesser
- Future Industries Institute, University of South Australia, Adelaide, Australia
| | - Bryan R Coad
- Future Industries Institute, University of South Australia, Adelaide, Australia
- School of Agriculture, Food & Wine, University of Adelaide, Adelaide, Australia
| |
Collapse
|
38
|
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.
Collapse
|
39
|
Ricciardi BF, Muthukrishnan G, Masters E, Ninomiya M, Lee CC, Schwarz EM. Staphylococcus aureus Evasion of Host Immunity in the Setting of Prosthetic Joint Infection: Biofilm and Beyond. Curr Rev Musculoskelet Med 2018; 11:389-400. [PMID: 29987645 DOI: 10.1007/s12178-018-9501-4] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW The incidence of complications from prosthetic joint infection (PJI) is increasing, and treatment failure remains high. We review the current literature with a focus on Staphylococcus aureus pathogenesis and biofilm, as well as treatment challenges, and novel therapeutic strategies. RECENT FINDINGS S. aureus biofilm creates a favorable environment that increases antibiotic resistance, impairs host immunity, and increases tolerance to nutritional deprivation. Secreted proteins from bacterial cells within the biofilm and the quorum-sensing agr system contribute to immune evasion. Additional immunoevasive properties of S. aureus include the formation of staphylococcal abscess communities (SACs) and canalicular invasion. Novel approaches to target biofilm and increase resistance to implant colonization include novel antibiotic therapy, immunotherapy, and local implant treatments. Challenges remain given the diverse mechanisms developed by S. aureus to alter the host immune responses. Further understanding of these processes should provide novel therapeutic mechanisms to enhance eradication after PJI.
Collapse
Affiliation(s)
- Benjamin F Ricciardi
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine, 601 Elmwood Avenue, Box 665, Rochester, NY, 14642, USA
| | - Gowrishankar Muthukrishnan
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine, 601 Elmwood Avenue, Box 665, Rochester, NY, 14642, USA
| | - Elysia Masters
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine, 601 Elmwood Avenue, Box 665, Rochester, NY, 14642, USA
| | - Mark Ninomiya
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine, 601 Elmwood Avenue, Box 665, Rochester, NY, 14642, USA
| | - Charles C Lee
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine, 601 Elmwood Avenue, Box 665, Rochester, NY, 14642, USA
| | - Edward M Schwarz
- Center for Musculoskeletal Research, Department of Orthopaedics, University of Rochester School of Medicine, 601 Elmwood Avenue, Box 665, Rochester, NY, 14642, USA.
| |
Collapse
|
40
|
Van Dijck P, Sjollema J, Cammue BPA, Lagrou K, Berman J, d’Enfert C, Andes DR, Arendrup MC, Brakhage AA, Calderone R, Cantón E, Coenye T, Cos P, Cowen LE, Edgerton M, Espinel-Ingroff A, Filler SG, Ghannoum M, Gow NA, Haas H, Jabra-Rizk MA, Johnson EM, Lockhart SR, Lopez-Ribot JL, Maertens J, Munro CA, Nett JE, Nobile CJ, Pfaller MA, Ramage G, Sanglard D, Sanguinetti M, Spriet I, Verweij PE, Warris A, Wauters J, Yeaman MR, Zaat SA, Thevissen K. Methodologies for in vitro and in vivo evaluation of efficacy of antifungal and antibiofilm agents and surface coatings against fungal biofilms. MICROBIAL CELL (GRAZ, AUSTRIA) 2018; 5:300-326. [PMID: 29992128 PMCID: PMC6035839 DOI: 10.15698/mic2018.07.638] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 05/24/2018] [Indexed: 12/13/2022]
Abstract
Unlike superficial fungal infections of the skin and nails, which are the most common fungal diseases in humans, invasive fungal infections carry high morbidity and mortality, particularly those associated with biofilm formation on indwelling medical devices. Therapeutic management of these complex diseases is often complicated by the rise in resistance to the commonly used antifungal agents. Therefore, the availability of accurate susceptibility testing methods for determining antifungal resistance, as well as discovery of novel antifungal and antibiofilm agents, are key priorities in medical mycology research. To direct advancements in this field, here we present an overview of the methods currently available for determining (i) the susceptibility or resistance of fungal isolates or biofilms to antifungal or antibiofilm compounds and compound combinations; (ii) the in vivo efficacy of antifungal and antibiofilm compounds and compound combinations; and (iii) the in vitro and in vivo performance of anti-infective coatings and materials to prevent fungal biofilm-based infections.
Collapse
Affiliation(s)
- Patrick Van Dijck
- VIB-KU Leuven Center for Microbiology, Leuven, Belgium
- KU Leuven Laboratory of Molecular Cell Biology, Leuven, Belgium
| | - Jelmer Sjollema
- University of Groningen, University Medical Center Groningen, Department of BioMedical Engineering, Groningen, The Netherlands
| | - Bruno P. A. Cammue
- Centre for Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
- Department of Plant Systems Biology, VIB, Ghent, Belgium
| | - Katrien Lagrou
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
- Clinical Department of Laboratory Medicine and National Reference Center for Mycosis, UZ Leuven, Belgium
| | - Judith Berman
- School of Molecular Cell Biology and Biotechnology, Faculty of Life Sciences, Tel Aviv University, Ramat Aviv, Israel
| | - Christophe d’Enfert
- Institut Pasteur, INRA, Unité Biologie et Pathogénicité Fongiques, Paris, France
| | - David R. Andes
- Department of Medical Microbiology and Immunology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Maiken C. Arendrup
- Unit of Mycology, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Axel A. Brakhage
- Leibniz Institute for Natural Product Research and Infection Biology - Hans Knoell Institute (HKI), Dept. Microbiology and Molecular Biology, Friedrich Schiller University Jena, Institute of Microbiology, Jena, Germany
| | - Richard Calderone
- Department of Microbiology & Immunology, Georgetown University Medical Center, Washington DC, USA
| | - Emilia Cantón
- Severe Infection Research Group: Medical Research Institute La Fe (IISLaFe), Valencia, Spain
| | - Tom Coenye
- Laboratory of Pharmaceutical Microbiology, Ghent University, Ghent, Belgium
- ESCMID Study Group for Biofilms, Switzerland
| | - Paul Cos
- Laboratory for Microbiology, Parasitology and Hygiene (LMPH), University of Antwerp, Belgium
| | - Leah E. Cowen
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Mira Edgerton
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, Buffalo, NY USA
| | | | - Scott G. Filler
- Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Mahmoud Ghannoum
- Center for Medical Mycology, Department of Dermatology, University Hospitals Cleveland Medical Center and Case Western Re-serve University, Cleveland, OH, USA
| | - Neil A.R. Gow
- MRC Centre for Medical Mycology, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Hubertus Haas
- Biocenter - Division of Molecular Biology, Medical University Innsbruck, Innsbruck, Austria
| | - Mary Ann Jabra-Rizk
- Department of Oncology and Diagnostic Sciences, School of Dentistry; Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, USA
| | - Elizabeth M. Johnson
- National Infection Service, Public Health England, Mycology Reference Laboratory, Bristol, UK
| | | | | | - Johan Maertens
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium and Clinical Department of Haematology, UZ Leuven, Leuven, Belgium
| | - Carol A. Munro
- MRC Centre for Medical Mycology, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Jeniel E. Nett
- University of Wisconsin-Madison, Departments of Medicine and Medical Microbiology & Immunology, Madison, WI, USA
| | - Clarissa J. Nobile
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, Merced, USA
| | - Michael A. Pfaller
- Departments of Pathology and Epidemiology, University of Iowa, Iowa, USA
- JMI Laboratories, North Liberty, Iowa, USA
| | - Gordon Ramage
- ESCMID Study Group for Biofilms, Switzerland
- College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Dominique Sanglard
- Institute of Microbiology, University of Lausanne and University Hospital, CH-1011 Lausanne
| | - Maurizio Sanguinetti
- Institute of Microbiology, Università Cattolica del Sacro Cuore, IRCCS-Fondazione Policlinico "Agostino Gemelli", Rome, Italy
| | - Isabel Spriet
- Pharmacy Dpt, University Hospitals Leuven and Clinical Pharmacology and Pharmacotherapy, Dpt. of Pharmaceutical and Pharma-cological Sciences, KU Leuven, Belgium
| | - Paul E. Verweij
- Center of Expertise in Mycology Radboudumc/CWZ, Radboud University Medical Center, Nijmegen, the Netherlands (omit "Nijmegen" in Radboud University Medical Center)
| | - Adilia Warris
- MRC Centre for Medical Mycology, Aberdeen Fungal Group, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - Joost Wauters
- KU Leuven-University of Leuven, University Hospitals Leuven, Department of General Internal Medicine, Herestraat 49, B-3000 Leuven, Belgium
| | - Michael R. Yeaman
- Geffen School of Medicine at the University of California, Los Angeles, Divisions of Molecular Medicine & Infectious Diseases, Har-bor-UCLA Medical Center, LABioMed at Harbor-UCLA Medical Center
| | - Sebastian A.J. Zaat
- Department of Medical Microbiology, Amsterdam Infection and Immunity Institute, Academic Medical Center, University of Am-sterdam, Netherlands
| | - Karin Thevissen
- Centre for Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| |
Collapse
|
41
|
Yeoh SF, Lee TJ, Chew KL, Lin S, Yeo D, Setia S. Echinocandins for management of invasive candidiasis in patients with liver disease and liver transplantation. Infect Drug Resist 2018; 11:805-819. [PMID: 29881298 PMCID: PMC5985852 DOI: 10.2147/idr.s165676] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Candida species remains one of the most important causes of opportunistic infections worldwide. Invasive candidiasis (IC) is associated with considerable morbidity and mortality in liver disease (LD) patients if not treated promptly. Echinocandins are often recommended as a first-line empirical treatment for managing IC and can especially play a critical role in managing IC in LD patients. However, advanced LD patients are often immunocompromised and critically ill. Hence altered pharmacokinetics, drug interactions as well as tolerance issues of antifungal treatments are a concern in these patients. This comprehensive review examines the epidemiology, risk factors and diagnosis of IC in patients with LD and evaluates differences between three available echinocandins for treating this group of patients.
Collapse
Affiliation(s)
- Siang Fei Yeoh
- Department of Pharmacy, National University Health System, Singapore, Singapore
| | - Tae Jin Lee
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Ka Lip Chew
- Department of Laboratory Medicine, National University Hospital, Singapore, Singapore
| | - Stephen Lin
- Global Medical Affairs, Asia-Pacific region, Pfizer, Hong Kong, People’s Republic of China
| | - Dennis Yeo
- Medical Affairs, Pfizer Pte. Ltd., Singapore, Singapore
| | - Sajita Setia
- Medical Affairs, Pfizer Pte. Ltd., Singapore, Singapore
| |
Collapse
|
42
|
Sjollema J, Zaat SAJ, Fontaine V, Ramstedt M, Luginbuehl R, Thevissen K, Li J, van der Mei HC, Busscher HJ. In vitro methods for the evaluation of antimicrobial surface designs. Acta Biomater 2018; 70:12-24. [PMID: 29432983 DOI: 10.1016/j.actbio.2018.02.001] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/12/2018] [Accepted: 02/01/2018] [Indexed: 11/16/2022]
Abstract
Bacterial adhesion and subsequent biofilm formation on biomedical implants and devices are a major cause of their failure. As systemic antibiotic treatment is often ineffective, there is an urgent need for antimicrobial biomaterials and coatings. The term "antimicrobial" can encompass different mechanisms of action (here termed "antimicrobial surface designs"), such as antimicrobial-releasing, contact-killing or non-adhesivity. Biomaterials equipped with antimicrobial surface designs based on different mechanisms of action require different in vitro evaluation methods. Available industrial standard evaluation tests do not address the specific mechanisms of different antimicrobial surface designs and have therefore been modified over the past years, adding to the myriad of methods available in the literature to evaluate antimicrobial surface designs. The aim of this review is to categorize fourteen presently available methods including industrial standard tests for the in vitro evaluation of antimicrobial surface designs according to their suitability with respect to their antimicrobial mechanism of action. There is no single method or industrial test that allows to distinguish antimicrobial designs according to all three mechanisms identified here. However, critical consideration of each method clearly relates the different methods to a specific mechanism of antimicrobial action. It is anticipated that use of the provided table with the fourteen methods will avoid the use of wrong methods for evaluating new antimicrobial designs and therewith facilitate translation of novel antimicrobial biomaterials and coatings to clinical use. The need for more and better updated industrial standard tests is emphasized. STATEMENT OF SIGNIFICANCE European COST-action TD1305, IPROMEDAI aims to provide better understanding of mechanisms of antimicrobial surface designs of biomaterial implants and devices. Current industrial evaluation standard tests do not sufficiently account for different, advanced antimicrobial surface designs, yet are urgently needed to obtain convincing in vitro data for approval of animal experiments and clinical trials. This review aims to provide an innovative and clear guide to choose appropriate evaluation methods for three distinctly different mechanisms of antimicrobial design: (1) antimicrobial-releasing, (2) contact-killing and (3) non-adhesivity. Use of antimicrobial evaluation methods and definition of industrial standard tests, tailored toward the antimicrobial mechanism of the design, as identified here, fulfill a missing link in the translation of novel antimicrobial surface designs to clinical use.
Collapse
Affiliation(s)
- Jelmer Sjollema
- University of Groningen, University Medical Center Groningen, Department of BioMedical Engineering, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Sebastian A J Zaat
- Department of Medical Microbiology, CINIMA (Center for Infection and Immunity Amsterdam), Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
| | - Veronique Fontaine
- Unit of Pharmaceutical Microbiology and Hygiene, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), Campus Plaine, Boulevard du Triomphe, 1050 Brussels, Belgium
| | | | - Reto Luginbuehl
- RMS Foundation, Bischmattstrasse 12, 2544 Bettlach, Switzerland
| | - Karin Thevissen
- Centre for Microbial and Plant Genetics, CMPG, University of Leuven, Kasteelpark Arenberg 20, 3001 Heverlee, Belgium
| | - Jiuyi Li
- School of Civil Engineering, Beijing Jiaotong University, 3 Shangyuancun, Xizhimenwai, Beijing 100044, China
| | - Henny C van der Mei
- University of Groningen, University Medical Center Groningen, Department of BioMedical Engineering, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Henk J Busscher
- University of Groningen, University Medical Center Groningen, Department of BioMedical Engineering, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| |
Collapse
|
43
|
Giles C, Lamont-Friedrich SJ, Michl TD, Griesser HJ, Coad BR. The importance of fungal pathogens and antifungal coatings in medical device infections. Biotechnol Adv 2017; 36:264-280. [PMID: 29199134 DOI: 10.1016/j.biotechadv.2017.11.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/15/2017] [Accepted: 11/28/2017] [Indexed: 12/23/2022]
Abstract
In recent years, increasing evidence has been collated on the contributions of fungal species, particularly Candida, to medical device infections. Fungal species can form biofilms by themselves or by participating in polymicrobial biofilms with bacteria. Thus, there is a clear need for effective preventative measures, such as thin coatings that can be applied onto medical devices to stop the attachment, proliferation, and formation of device-associated biofilms. However, fungi being eukaryotes, the challenge is greater than for bacterial infections because antifungal agents are often toxic towards eukaryotic host cells. Whilst there is extensive literature on antibacterial coatings, a far lesser body of literature exists on surfaces or coatings that prevent attachment and biofilm formation on medical devices by fungal pathogens. Here we review strategies for the design and fabrication of medical devices with antifungal surfaces. We also survey the microbiology literature on fundamental mechanisms by which fungi attach and spread on natural and synthetic surfaces. Research in this field requires close collaboration between biomaterials scientists, microbiologists and clinicians; we consider progress in the molecular understanding of fungal recognition of, and attachment to, suitable surfaces, and of ensuing metabolic changes, to be essential for designing rational approaches towards effective antifungal coatings, rather than empirical trial of coatings.
Collapse
Affiliation(s)
- Carla Giles
- Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia
| | - Stephanie J Lamont-Friedrich
- Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia
| | - Thomas D Michl
- Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia
| | - Hans J Griesser
- Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia
| | - Bryan R Coad
- Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia; School of Agriculture Food & Wine, The University of Adelaide, Waite Campus, Adelaide, SA 5000, Australia.
| |
Collapse
|
44
|
Caspofungin on ARGET-ATRP grafted PHEMA polymers: Enhancement and selectivity of prevention of attachment ofCandida albicans. Biointerphases 2017; 12:05G602. [DOI: 10.1116/1.4986054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
45
|
Abstract
Candida species are the most common infectious fungal species in humans; out of the approximately 150 known species, Candida albicans is the leading pathogenic species, largely affecting immunocompromised individuals. Apart from its role as the primary etiology for various types of candidiasis, C. albicans is known to contribute to polymicrobial infections. Polymicrobial interactions, particularly between C. albicans and bacterial species, have gained recent interest in which polymicrobial biofilm virulence mechanisms have been studied including adhesion, invasion, quorum sensing, and development of antimicrobial resistance. These trans-kingdom interactions, either synergistic or antagonistic, may help modulate the virulence and pathogenicity of both Candida and bacteria while uniquely impacting the pathogen-host immune response. As antibiotic and antifungal resistance increases, there is a great need to explore the intermicrobial cross-talk with a focus on the treatment of Candida-associated polymicrobial infections. This article explores the current literature on the interactions between Candida and clinically important bacteria and evaluates these interactions in the context of pathogenesis, diagnosis, and disease management.
Collapse
|
46
|
Vargas-Blanco D, Lynn A, Rosch J, Noreldin R, Salerni A, Lambert C, Rao RP. A pre-therapeutic coating for medical devices that prevents the attachment of Candida albicans. Ann Clin Microbiol Antimicrob 2017; 16:41. [PMID: 28526091 PMCID: PMC5438570 DOI: 10.1186/s12941-017-0215-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 05/12/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Hospital acquired fungal infections are defined as "never events"-medical errors that should never have happened. Systemic Candida albicans infections results in 30-50% mortality rates. Typically, adhesion to abiotic medical devices and implants initiates such infections. Efficient adhesion initiates formation of aggressive biofilms that are difficult to treat. Therefore, inhibitors of adhesion are important for drug development and likely to have a broad spectrum efficacy against many fungal pathogens. In this study we further the development of a small molecule, Filastatin, capable of preventing C. albicans adhesion. We explored the potential of Filastatin as a pre-therapeutic coating of a diverse range of biomaterials. METHODS Filastatin was applied on various biomaterials, specifically bioactive glass (cochlear implants, subcutaneous drug delivery devices and prosthetics); silicone (catheters and other implanted devices) and dental resin (dentures and dental implants). Adhesion to biomaterials was evaluated by direct visualization of wild type C. albicans or a non-adherent mutant edt1 -/- that were stained or fluorescently tagged. Strains grown overnight at 30 °C were harvested, allowed to attach to surfaces for 4 h and washed prior to visualization. The adhesion force of C. albicans cells attached to surfaces treated with Filastatin was measured using Atomic Force Microscopy. Effectiveness of Filastatin was also demonstrated under dynamic conditions using a flow cell bioreactor. The effect of Filastatin under microfluidic flow conditions was quantified using electrochemical impedance spectroscopy. Experiments were typically performed in triplicate. RESULTS Treatment with Filastatin significantly inhibited the ability of C. albicans to adhere to bioactive glass (by 99.06%), silicone (by 77.27%), and dental resin (by 60.43%). Atomic force microcopy indicated that treatment with Filastatin decreased the adhesion force of C. albicans from 0.23 to 0.017 nN. Electrochemical Impedance Spectroscopy in a microfluidic device that mimic physiological flow conditions in vivo showed lower impedance for C. albicans when treated with Filastatin as compared to untreated control cells, suggesting decreased attachment. The anti-adhesive properties were maintained when Filastatin was included in the preparation of silicone materials. CONCLUSION We demonstrate that Filastatin treated medical devices prevented adhesion of Candida, thereby reducing nosocomial infections.
Collapse
Affiliation(s)
- Diego Vargas-Blanco
- Life Science and Bioengineering Center, Worcester Polytechnic Institute, 60 Prescott Street, Worcester, MA 01609 USA
| | - Aung Lynn
- Life Science and Bioengineering Center, Worcester Polytechnic Institute, 60 Prescott Street, Worcester, MA 01609 USA
| | - Jonah Rosch
- Life Science and Bioengineering Center, Worcester Polytechnic Institute, 60 Prescott Street, Worcester, MA 01609 USA
| | - Rony Noreldin
- Life Science and Bioengineering Center, Worcester Polytechnic Institute, 60 Prescott Street, Worcester, MA 01609 USA
| | - Anthony Salerni
- Life Science and Bioengineering Center, Worcester Polytechnic Institute, 60 Prescott Street, Worcester, MA 01609 USA
| | - Christopher Lambert
- Life Science and Bioengineering Center, Worcester Polytechnic Institute, 60 Prescott Street, Worcester, MA 01609 USA
| | - Reeta P. Rao
- Life Science and Bioengineering Center, Worcester Polytechnic Institute, 60 Prescott Street, Worcester, MA 01609 USA
| |
Collapse
|
47
|
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.
Collapse
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
| |
Collapse
|
48
|
Chang CC, Slavin MA, Chen SCA. New developments and directions in the clinical application of the echinocandins. Arch Toxicol 2017; 91:1613-1621. [DOI: 10.1007/s00204-016-1916-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/13/2016] [Indexed: 01/05/2023]
|
49
|
Michl TD, Giles C, Cross AT, Griesser HJ, Coad BR. Facile single-step bioconjugation of the antifungal agent caspofungin onto material surfaces via an epoxide plasma polymer interlayer. RSC Adv 2017. [DOI: 10.1039/c7ra03897f] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We report a facile, one-step, aqueous surface bioconjugation approach for producing an antifungal surface coating that prevents the formation of fungal biofilms.
Collapse
Affiliation(s)
- Thomas D. Michl
- Future Industries Institute
- University of South Australia
- Mawson Lakes
- Australia
| | - Carla Giles
- Future Industries Institute
- University of South Australia
- Mawson Lakes
- Australia
| | | | - Hans J. Griesser
- Future Industries Institute
- University of South Australia
- Mawson Lakes
- Australia
| | - Bryan R. Coad
- Future Industries Institute
- University of South Australia
- Mawson Lakes
- Australia
- School of Agriculture, Food and Wine
| |
Collapse
|
50
|
Covalent Immobilization of Enoxacin onto Titanium Implant Surfaces for Inhibiting Multiple Bacterial Species Infection and In Vivo Methicillin-Resistant Staphylococcus aureus Infection Prophylaxis. Antimicrob Agents Chemother 2016; 61:AAC.01766-16. [PMID: 27799220 DOI: 10.1128/aac.01766-16] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/25/2016] [Indexed: 12/19/2022] Open
Abstract
Infection is one of the most important causes of titanium implant failure in vivo A developing prophylactic method involves the immobilization of antibiotics, especially vancomycin, onto the surface of the titanium implant. However, these methods have a limited effect in curbing multiple bacterial infections due to antibiotic specificity. In the current study, enoxacin was covalently bound to an amine-functionalized Ti surface by use of a polyethylene glycol (PEG) spacer, and the bactericidal effectiveness was investigated in vitro and in vivo The titanium surface was amine functionalized with 3-aminopropyltriethoxysilane (APTES), through which PEG spacer molecules were covalently immobilized onto the titanium, and then the enoxacin was covalently bound to the PEG, which was confirmed by X-ray photoelectron spectrometry (XPS). A spread plate assay, confocal laser scanning microscopy (CLSM), and scanning electron microscopy (SEM) were used to characterize the antimicrobial activity. For the in vivo study, Ti implants were inoculated with methicillin-resistant Staphylococcus aureus (MRSA) and implanted into the femoral medullary cavity of rats. The degree of infection was assessed by radiography, micro-computed tomography, and determination of the counts of adherent bacteria 3 weeks after surgery. Our data demonstrate that the enoxacin-modified PEGylated Ti surface effectively prevented bacterial colonization without compromising cell viability, adhesion, or proliferation in vitro Furthermore, it prevented MRSA infection of the Ti implants in vivo Taken together, our results demonstrate that the use of enoxacin-modified Ti is a potential approach to the alleviation of infections of Ti implants by multiple bacterial species.
Collapse
|