title: Enhancing the antibacterial activity of biomimetic HA coatings by incorporation of norvancomycin.
abstract: BACKGROUND
  Bacterial infections associated with the use of biomaterials remain a great challenge for orthopedic surgery. The main purpose of the work discussed in this paper was to improve the antibacterial activity of a biomimetic calcium phosphate (CP) coating widely used in orthopedic biomaterials by incorporation of norvancomycin in the biomimetic process.
  
  
  METHODS
  CP coating and CP coating containing norvancomycin were produced on a titanium alloy (Ti6Al4V) surface by a biomimetic process. The morphology, surface crystal structure, and concentrations of elements in the coatings were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDX), respectively. The amount of norvancomycin and its release were investigated by UV-visible spectroscopy. MTT was used to investigate cell behavior. The morphology of adhered bacteria was observed by SEM. Antibacterial activity was expressed as inhibition zone by using Staphylococcus aureus (ATCC 25923) as model bacteria.
  
  
  RESULTS
  Results from SEM, EDX, and XRD revealed formation of a hydroxyapatite (HA) coating. The amount of antibiotic in the CP coating increased with increasing concentration of norvancomycin in the coating solution, followed by a plateau when the concentration of norvancomycin in the coating solution reached 600 mg/l. Approximately 2.16 μg norvancomycin per mg coating was co-precipitated with the CP layer onto titanium alloy discs when 600 mg/l norvancomycin coating solution was applied. The norvancomycin had a fast release profile followed by slow release. The MTT test of osteoblast cell cultures suggested that coatings containing norvancomycin did not cause any cytotoxicity compared with the CP coating and control titanium plate. The antibacterial activity test showed that the norvancomycin released from the coatings inhibited the growth of Staphylococcus aureus; more bacteria were found on the CP coating than on the norvancomycin-loaded coating.
  
  
  CONCLUSIONS
  A norvancomycin-loaded HA-like coating was successfully obtained on titanium surfaces. The norvancomycin incorporated had no negative effects on osteoblast cell behavior. The released norvancomycin results in excellent antibacterial activity of Ca-P coatings. Therefore, incorporation of norvancomycin can enhance antibacterial activity and the norvancomycin-loaded CP coating can be used to inhibit post-surgical infections in orthopaedics.
authors.affiliation: Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, China. swjtupcj@163.com
authors.forename: Chang-Jiang
authors.initials: CJ
authors.lastname: Pan
authors.forename: Yun-Xiao
authors.initials: YX
authors.lastname: Dong
authors.forename: Yao-Yao
authors.initials: YY
authors.lastname: Zhang
authors.forename: Yu-Dong
authors.initials: YD
authors.lastname: Nie
authors.forename: Chang-Hong
authors.initials: CH
authors.lastname: Zhao
authors.forename: Yuan-Liang
authors.initials: YL
authors.lastname: Wang
mesh_terms: D040761:Biomimetic Materials; D020099:Coated Materials, Biocompatible; D017886:Durapatite / Q000494:pharmacology*; D006801:Humans; D007595:Joint Prosthesis; D008422:Materials Testing; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects*; D013499:Surface Properties
chemical_list: D020099:Coated Materials, Biocompatible; D017886:Durapatite