title: An In Vitro Comparison of PMMA and Calcium Sulfate as Carriers for the Local Delivery of Gallium(III) Nitrate to Staphylococcal Infected Surgical Sites.
abstract: Antibiotic-loaded bone cements, including poly(methyl methacrylate) (PMMA) and calcium sulfate (CaSO4), are often used for treatment of orthopaedic infections involving Staphylococcus spp., although the effectiveness of this treatment modality may be limited due to the emergence of antimicrobial resistance and/or the development of biofilms within surgical sites. Gallium(III) is an iron analog capable of inhibiting essential iron-dependent pathways, exerting broad antimicrobial activity against multiple microorganisms, including Staphylococcus spp. Herein, we evaluated PMMA and CaSO4 as carriers for delivery of gallium(III) nitrate (Ga(NO3)3) to infected surgical sites by assessing the release kinetics subsequent to incorporation and antimicrobial activity against S. aureus and S. epidermidis. PMMA and to a lesser extent CaSO4 were observed to be compatible as carriers for Ga(NO3)3, eluting concentrations with antimicrobial activity against planktonic bacteria, inhibiting bacterial growth, and preventing bacterial colonization of beads, and effective against established bacterial biofilms of S. aureus and S. epidermidis. Collectively, our in vitro results indicate that PMMA is a more suitable carrier compared to CaSO4 for delivery of Ga(NO3)3; moreover they provide evidence for the potential use of Ga(NO3)3 with PMMA as a strategy for the prevention and/or treatment for orthopaedic infections.
authors.affiliation: Extremity Trauma and Regenerative Medicine, United States Army Institute of Surgical Research, JBSA Fort Sam, Houston, TX, USA.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Garcia
authors.affiliation: Extremity Trauma and Regenerative Medicine, United States Army Institute of Surgical Research, JBSA Fort Sam, Houston, TX, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Tennent
authors.affiliation: Extremity Trauma and Regenerative Medicine, United States Army Institute of Surgical Research, JBSA Fort Sam, Houston, TX, USA.
authors.forename: David
authors.initials: D
authors.lastname: Chang
authors.affiliation: Extremity Trauma and Regenerative Medicine, United States Army Institute of Surgical Research, JBSA Fort Sam, Houston, TX, USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Wenke
authors.affiliation: Extremity Trauma and Regenerative Medicine, United States Army Institute of Surgical Research, JBSA Fort Sam, Houston, TX, USA.
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Sanchez
mesh_terms: D018441:Biofilms / Q000187:drug effects; D001843:Bone Cements / Q000737:chemistry / Q000627:therapeutic use; D002133:Calcium Sulfate / Q000008:administration & dosage; D004337:Drug Carriers / Q000008:administration & dosage* / Q000737:chemistry; D005708:Gallium / Q000008:administration & dosage; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000472:pathogenicity; D019904:Polymethyl Methacrylate / Q000008:administration & dosage* / Q000737:chemistry; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
chemical_list: D001843:Bone Cements; D004337:Drug Carriers; D019904:Polymethyl Methacrylate; D005708:Gallium; D002133:Calcium Sulfate