title: Activity of bone cement loaded with daptomycin alone or in combination with gentamicin or PEG600 against Staphylococcus epidermidis biofilms.
abstract: Daptomycin is a promising candidate for local treatment of bone infection due to its activity against multi-resistant staphylococci. We investigated the activity of antibiotic-loaded PMMA against Staphylococcus epidermidis biofilms using an ultra-sensitive method bacterial heat detection method (microcalorimetry). PMMA cylinders loaded with daptomycin alone or in combination with gentamicin or PEG600, vancomycin and gentamicin were incubated with S. epidermidis-RP62A in tryptic soy broth (TSB) for 72 h. Cylinders were thereafter washed and transferred in microcalorimetry ampoules pre-filled with TSB. Bacterial heat production, proportional to the quantity of biofilm on the PMMA, was measured by isothermal microcalorimetry at 37 °C. Heat detection time was considered time to reach 20 μW. Experiments were performed in duplicate. The heat detection time was 5.7-7.0 h for PMMA without antibiotics. When loaded with 5% of daptomycin, vancomycin or gentamicin, detection times were 5.6-16.4 h, 16.8-35.7 h and 4.7-6.2 h, respectively. No heat was detected when 5% gentamicin or 0.5% PEG600 was added to the daptomycin-loaded PMMA. The study showed that vancomycin was superior to daptomycin and gentamicin in inhbiting staphylococcal adherence in vitro. However, PMMA loaded with daptomycin combined with gentamicin or PEG600 completely inhibited S. epidermidis-biofilm formation. PMMA loaded with these combinations may represent effective strategies for local treatment in the presence of multi-resistant staphylococci.
authors.affiliation: Service of Orthopaedics and Traumatology, Lausanne University Hospital, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland. Electronic address: patriciopenalbaarias@gmail.com.
authors.forename: Patricio
authors.initials: P
authors.lastname: Peñalba Arias
authors.affiliation: Septic Surgical Unit, Lausanne University Hospital, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland. Electronic address: hanna.furustrand@chuv.ch.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Furustrand Tafin
authors.affiliation: Service of Infectious Diseases, Lausanne University Hospital, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland. Electronic address: bertrand.betrisey@chuv.ch.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Bétrisey
authors.affiliation: Research and Development, Heraeus Medical GmbH, Philipp-Reis-Straße 13, 61273 Wehrheim, Germany. Electronic address: sebastian.vogt@heraeus.com.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Vogt
authors.affiliation: Center for Musculoskeletal Surgery, Charité-University Medicine, Free and Humboldt-University of Berlin, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: andrej.trampuz@gmail.com.
authors.forename: Andrej
authors.initials: A
authors.lastname: Trampuz
authors.affiliation: Service of Orthopaedics and Traumatology, Lausanne University Hospital, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland; Septic Surgical Unit, Lausanne University Hospital, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland. Electronic address: olivier.borens@chuv.ch.
authors.forename: Olivier
authors.initials: O
authors.lastname: Borens
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001422:Bacterial Adhesion / Q000187:drug effects*; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development; D001843:Bone Cements / Q000737:chemistry / Q000494:pharmacology*; D001842:Bone and Bones / Q000382:microbiology* / Q000473:pathology; D017576:Daptomycin / Q000494:pharmacology*; D005839:Gentamicins / Q000494:pharmacology*; D006801:Humans; D066298:In Vitro Techniques; D008826:Microbial Sensitivity Tests; D011092:Polyethylene Glycols / Q000494:pharmacology*; D019904:Polymethyl Methacrylate / Q000737:chemistry; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000254:growth & development
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D005839:Gentamicins; D011092:Polyethylene Glycols; D019904:Polymethyl Methacrylate; D017576:Daptomycin
keywords: Arthroplasty; Biofilm; Bone cement; Daptomycin; Gentamicin; Infection; Microcalorimetry; S. epidermidis; Two-stage exchange; Vancomycin