title: An in vitro assessment of the antibacterial properties and cytotoxicity of nanoparticulate silver bone cement.
abstract: Infections with multiresistant bacteria have become a serious problem in joint arthroplasty. This study reports about in vitro antibacterial activity against multiresistant bacteria and in vitro cytotoxicity of polymethylmetacrylate bone cement loaded with metallic silver particles with a size of 5-50 nm called NanoSilver. In vitro antibacterial activity against S. epidermidis, methicillin-resistant S. epidermidis (MRSE), and methicillin-resistant S. aureus (MRSA) was studied by microplate proliferation tests. Quantitative elution testing and qualitative ongrowth of human osteoblasts was done to study in vitro cytotoxicity. Only NanoSilver cement showed high-antibacterial activity against all strains, including MRSE and MRSA. Gentamicin cement was not effective against MRSA and MRSE due to the high-level gentamicin resistance of the tested strains. Plain cement did not inhibit proliferation of any strains. There was no significant difference regarding in vitro cytotoxicity between NanoSilver and the non-toxic control. Cytotoxicity of cement loaded with silver salts made this kind of silver unsuitable for all day clinical use in the past. This new form of silver called NanoSilver was free of in vitro cytotoxicity and showed high effectiveness against multiresistant bacteria. If the results can be confirmed in vivo NanoSilver may have a high interest in joint arthroplasty.
authors.affiliation: Department of Trauma Surgery, Justus-Liebig-University Giessen, Rudolf-Buchheim-Str. 7, 35385 Giessen, Germany. volker.alt@chiru.med.uni-giessen.de
authors.forename: Volker
authors.initials: V
authors.lastname: Alt
authors.forename: Thorsten
authors.initials: T
authors.lastname: Bechert
authors.forename: Peter
authors.initials: P
authors.lastname: Steinrücke
authors.forename: Michael
authors.initials: M
authors.lastname: Wagener
authors.forename: Peter
authors.initials: P
authors.lastname: Seidel
authors.forename: Elvira
authors.initials: E
authors.lastname: Dingeldein
authors.forename: Eugen
authors.initials: E
authors.lastname: Domann
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schnettler
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000633:toxicity; D018441:Biofilms / Q000187:drug effects; D001843:Bone Cements / Q000494:pharmacology / Q000633:toxicity; D002460:Cell Line; D016503:Drug Delivery Systems / Q000379:methods; D005347:Fibroblasts / Q000187:drug effects*; D006801:Humans; D051379:Mice; D043942:Nanotubes / Q000737:chemistry / Q000633:toxicity; D010006:Osteoblasts / Q000187:drug effects*; D019904:Polymethyl Methacrylate / Q000008:administration & dosage* / Q000633:toxicity*; D012834:Silver / Q000008:administration & dosage* / Q000633:toxicity*; D013210:Staphylococcus / Q000166:cytology / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D012834:Silver; D019904:Polymethyl Methacrylate