Antimicrobial effect of anesthetic‐eluting ultra‐high molecular weight polyethylene for post‐arthroplasty antibacterial prophylaxis

Abstract

Despite being a relatively safe surgery, total joint replacement is often associated with two major complications—severe post‐operative pain and periprosthetic joint infection. Local sustained delivery of therapeutics to the surgical site has a potential to address these complications more effectively than current clinical approaches. Given that several analgesics were shown to possess antibacterial activity, we propose here to use analgesic‐loaded ultra‐high molecular weight polyethylene (UHMWPE) as a delivery vehicle to provide antimicrobial effect after an arthroplasty. Three commonly used anesthetics, lidocaine, bupivacaine, and ropivacaine, were analyzed in order to reveal the drug with the highest antibacterial activity against methicillin‐sensitive Staphylococcus aureus. Having shown highest antibacterial activity in the bacterial susceptibility tests, bupivacaine was chosen to be incorporated into UHMWPE to provide antibacterial properties. Bupivacaine‐loaded UHMWPE possessed moderate dose‐dependent antimicrobial properties, decreasing the S. aureus proliferation rate by up to 70%. Biofilm formation was also substanitally inhibited during the first 9 h of culture as quantified by bacterial counts and SEM. This proof‐of‐concept study is first of its kind to demonstrate that analgesic‐loaded UHMWPE can be used as part of a multimodal antimicrobial therapy. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res

Efficacy of moist heat decontamination against various pathogens for the reuse of N95 respirators in the COVID-19 emergency

“…After decontamination, 5 mL of sterile phosphate buffered saline (PBS) was added, and the tubes were vortexed for 60 seconds to dislodge and resuspend bacterial inoculum. Bacterial concentration in the obtained suspension was determined using the spread-plate method outlined in reference [6]. The samples were serially diluted in PBS, and 100 μL of each dilution was spread-plated on agar plates using LB agar for S. aureus, P. aeruginosa isolation agar for P. aeruginosa , or LB Lenox medium for A .…”

A Ação Antimicrobiana E Imunomoduladorados Anestésicos Locais

“…A potência antimicrobiana dos anestésicos locais pode ser maior quando fatores como: concentração, temperatura e tempo de exposição são mais altos (JOHNSON et al, 2008). Além disso, o anestésico utilizado também é importante, visto que, alguns são mais eficientes que outros, como é o caso da Bupivacaína e Lidocaína (GIL et al, 2019). Collura e Letellier (1990), descreveram que o potencial hidrogeniônico (pH) também influenciou a ação da Dibucaína, uma vez que, em pH alcalino houve maior facilidade para a inibição da respiração celular da Escherichia coli.…”

“…Atualmente sabe-se que essa forma de administração pode contribuir para a resistência bacteriana. Gil et al (2019) avaliaram se ao incorporar Bupivacaína às próteses de Polietileno de Ultra Alto Peso Molecular (PEUAPM) poderia promover, além do alívio da dor, efeito profilático antimicrobiano adicional contra Staphylococcus aureus sensível à meticilina. Os autores optaram por utilizar a Bupivacaína, visto que, ela possui concentração mínima inibitória e concentração mínima bactericida menor que a Lidocaína e a Ropivacaína e também por ter mais estabilidade térmica, o que confere maior resistência as condições de moldagem da prótese.…”

New materials for hip and knee joint replacement: What's hip and what's in kneed?

“…These bone cement technologies, obviously require cemented implant applications and are not applicable to cementless implant designs. Antibiotic eluting UHMWPE is an example of technology innovation in PJI treatment 60 . Currently the regulatory pathway for anti‐infection technologies is costly, laborious, and uncertain, for all practical purposes limiting technology innovation in this space.…”

“…Antibiotic eluting UHMWPE is an example of technology innovation in PJI treatment. 60 Currently the regulatory pathway for anti-infection technologies is costly, laborious, and uncertain, for all practical purposes limiting technology innovation in this space.…”