title: Biofilm formation on pyrolytic carbon heart valves: influence of surface free energy, roughness, and bacterial species.
abstract: OBJECTIVE
  The aim of this study was to analyze the interaction of surface free energy and roughness characteristics of different pyrolytic carbon heart valves with three bacterial species on biofilm formation.
  
  
  METHODS
  Three pyrolytic carbon heart valves (St Jude Medical [St Jude Medical Inc, Minneapolis, Minn], Sulzer Carbomedics [CarboMedics Inc, Austin, Tex], and MedicalCV [Medical Incorporated, Inver Grove Heights, Minn]) were tested. Roughness was measured by interferential microscopy and surface free energy by contact angle technique. To obtain a biofilm, prostheses were inserted into a bioreactor with Staphylococcus aureus P209, Staphylococcus epidermidis RP62A, or Pseudomonas aeruginosa PAO1. Adhesion was quantified by counting sessile bacteria. Morphologic characteristics of biofilms were evaluated with scanning electron microscopy.
  
  
  RESULTS
  Roughness analysis revealed significant differences between the MedicalCV (35.18 +/- 4.43 nm) valve and St Jude Medical (11.03 +/- 3.11 nm; P < .0001) and Sulzer Carbomedics (8.80 +/- 1.10 nm; P < .0001) valves. Analysis of surface free energy revealed a higher level for the MedicalCV valve (41.03 mJ x m(-2)) than for both the Sulzer Carbomedics (38.93 mJ x m(-2)) and St Jude Medical (31.51 mJ . m(-2)) models. These results showed a correlation between surface free energy and bacterial adhesion for S epidermidis and P aeruginosa species. Regardless of the support, we observed significant adhesion differences for the three bacterial species. S aureus was the most adherent species, S epidermidis was the least, and P aeruginosa was intermediate.
  
  
  CONCLUSIONS
  Our results suggest that adhesion of S epidermidis and P aeruginosa are dependent on pyrolytic carbon surface free energy and roughness, although S aureus adhesion appears to be independent of these factors. Improvement of pyrolytic carbon physicochemical properties thus could lead to a reduction in valvular prosthetic infections.
authors: Department of Thoracic and Cardiovascular Surgery, Rouen University Hospital Charles Nicolle, Rouen, France. pierre-yves.litzler@chu-rouen.fr
authors: Pierre-Yves
authors: PY
authors: Litzler
authors: Laetitia
authors: L
authors: Benard
authors: Noëlle
authors: N
authors: Barbier-Frebourg
authors: Sebastien
authors: S
authors: Vilain
authors: Thierry
authors: T
authors: Jouenne
authors: Eric
authors: E
authors: Beucher
authors: Claude
authors: C
authors: Bunel
authors: Jean-François
authors: JF
authors: Lemeland
authors: Jean-Paul
authors: JP
authors: Bessou
mesh_terms: D018441:Biofilms; D019149:Bioreactors; D002244:Carbon; D004867:Equipment Design; D006350:Heart Valve Prosthesis / Q000382:microbiology*; D008855:Microscopy, Electron, Scanning; D011550:Pseudomonas aeruginosa; D015203:Reproducibility of Results; D013211:Staphylococcus aureus; D013212:Staphylococcus epidermidis; D018709:Statistics, Nonparametric; D013499:Surface Properties
chemical_list: D002244:Carbon