BACKGROUND: Induction of osteomyelitis can be caused by gram-negative microflora, most often P.aeruginosa, Acinetobacterspp., Klebsiellaspp., Enterobacterspp. Two-stage treatment using the Masculet method is recognized as effective, but technologies for one-stage surgical treatment are being sought. The use of submersible metal structures with a bioactive calcium phosphate coating in combination with an antibacterial component can prevent the development of infectious complications, reduce the number of relapses of osteomyelitis and at the same time accelerate the processes of osteogenesis.
AIM: Assessment of the bactericidal properties of experimental samples of titanium alloy implants with a calcium phosphate coating and an antibacterial component against gram-negative pathogens.
MATERIALS AND METHODS: Carried out a single-center, continuous, prospective, unblinded experimental in vitro study. The disk diffusion method was used. We tested discs made of titanium alloy VT6 with a calcium phosphate coating, impregnated with the antibiotics amikacin, cefepime and cefotaxime at concentrations of 2.5/5.0/7.5μg. Test cultures: museum strains of bacteria Pseudomonas aeruginosa ATCC27853, Acinetobacter baumannii ATCC19606, Klebsiella pneumoniae ATCC700603. The results were assessed by the diameter of the zone of growth inhibition of microorganisms around the disk.
RESULTS: determined that bactericidal properties against Klebsiella pneumoniae appear when amikacin and cefatoxime are impregnated onto a metal bioactive substrate at a concentration of 2.5μg; cefepime— at a concentration of 7.5mcg. Against Pseudomonas aeruginosa, the bactericidal effect is expressed when amikacin is impregnated at a concentration of 5μg and cefepime at a concentration of 7.5μg. In relation to Acinetobacter baumannii, the tested concentrations of antibacterial drugs did not show bactericidal properties. Limitations of the study: The bactericidal effect was studied only against gram-negative museum strains of bacteria. There may be differences when clinical strains are used.
CONCLUSIONS: It is possible to ensure the bactericidal properties of the surface of submersible metal structures intended for traumatology and orthopedics, in particular against gram-negative bacteria, using known antibacterial drugs. However, their effectiveness depends on the antibiotic used and its concentration.
