title: The inhibition of Staphylococcus epidermidis biofilm formation by vancomycin-modified titanium alloy and implications for the treatment of periprosthetic infection.
abstract: Peri-prosthetic infections are notoriously difficult to treat as the biomaterial implant is ideal for bacterial adhesion and biofilm formation, resulting in decreased antibiotic sensitivity. Previously, we reported that vancomycin covalently attached to a Ti alloy surface (Vanc-Ti) could prevent bacterial colonization. Herein we examine the effect of this Vanc-Ti surface on Staphylococci epidermidis, a Gram-positive organism prevalent in orthopaedic infections. By direct colony counting and fluorescent visualization of live bacteria, S. epidermidis colonization was significantly inhibited on Vanc-Ti implants. In contrast, the gram-negative organism Escherichia coli readily colonized the Vanc-Ti rod, suggesting retention of antibiotic specificity. By histochemical and SEM analysis, Vanc-Ti prevented S. epidermidis biofilm formation, even in the presence of serum. Furthermore, when challenged multiple times with S. epidermidis, Vanc-Ti rods resisted bacterial colonization. Finally, when S. epidermidis was continuously cultured in the presence of Vanc-Ti, the bacteria maintained a Vanc sensitivity equivalent to the parent strain. These findings indicate that antibiotic derivatization of implants can result in a surface that can resist bacterial colonization. This technology holds great promise for the prevention and treatment of periprosthetic infections.
authors.affiliation: Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: Valentin
authors.initials: V
authors.lastname: Antoci
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Adams
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
authors.forename: Helen M
authors.initials: HM
authors.lastname: Davidson
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Composto
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Freeman
authors.forename: Eric
authors.initials: E
authors.lastname: Wickstrom
authors.forename: Paul
authors.initials: P
authors.lastname: Ducheyne
authors.forename: Donald
authors.initials: D
authors.lastname: Jungkind
authors.forename: Irving M
authors.initials: IM
authors.lastname: Shapiro
authors.forename: Noreen J
authors.initials: NJ
authors.lastname: Hickok
mesh_terms: D000497:Alloys / Q000737:chemistry; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects*; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000254:growth & development*; D014025:Titanium / Q000737:chemistry; D014640:Vancomycin / Q000737:chemistry / Q000494:pharmacology*
chemical_list: D000497:Alloys; D000900:Anti-Bacterial Agents; D014640:Vancomycin; D014025:Titanium