Electrospun vancomycin-loaded coating on titanium implants for the prevention of implant-associated infections

Abstract

The objectives of this work were to develop an antibiotic coating on the surface of a titanium plate to determine its antibacterial properties in vitro and in vivo. To prepare vancomycin-coated titanium implants, we adopted the electrospinning nanotechnique. The surface structure of the coating implants was observed using a scanning electron microscope. An elution method and a high-pressure liquid chromatography assay were used to characterize the release behavior of vancomycin from the coating. The antibacterial efficacy and the cytotoxicity of the coated titanium implants on osteoblasts were investigated in vitro. In addition, X-ray, white blood cell count, C-reactive protein, erythrocyte sedimentation rate, and pathological examination were performed to validate its antimicrobial efficacy in vivo. The antibiotic coating released 82.7% (approximately 528.2 μg) of total vancomycin loading in the coating in vitro. The release behavior of vancomycin from nanofiber coatings exhibited a biphasic release pattern with an initial burst on day 1, followed by a slow and controlled release over 28 days. There was no cytotoxicity observed in vitro for the vancomycin-loaded coating. The vancomycin-coated titanium implants were active in treating implant-associated infection in vivo. Thus, vancomycin-coated titanium implants may be a promising approach to prevent and treat implant-associated infections.

Antimicrobial technology in orthopedic and spinal implants

“…Micrograph and apparatus perspective of electrospinning technology. Scanning electron microscopy micrographs of PLGA electrospun coatings containing (A) vancomycin and (B) no drug [74] ; C: Schematic of a charged electrospinning apparatus spinning a PLGA coating onto an implant device [71] . PLGA: Poly(lactic-co-glycolic acid).…”

“…In electrospinning, ultrafine fibers with nanometer diameters form a matrix with a very high surface-areato-volume ratio [72] . Produced by syringe-pumping various drug and polymer solutions in the presence of a high electrical field potential [73] , the resulting drug loaded, nonwoven PLGA membranes are flexible, porous, and enable controlled drug release ( Figure 9) [71,74] . Like coating, the matrices adhere directly to orthopedic implants.…”

Effect of the configuration of poly(lactic acid) and content of poly(oxyethylene) blocks to the structure and functional properties of poly(lactic acid)‐block‐poly(oxirane)‐based nanofibrous electrospun polyester–ether–urethanes used as potential drug‐delivery system

“…Accordingly, (i) might reflect the ability of PLA blocks to crystalize when in extended conformations (induced by electrospinning); (ii) may result from the dilution effect of the added VAC. Due to the lower concentration of the polymer in the drug-loaded and to the increased conductivity of the electrospun solution, the diameters of the fibers should decrease 19,20,26,30 ; (iii) and the fact that PEU6 forms no nanofibres indicate that the highly flexible POE blocks under the applied processing conditions show the characteristic feature of the electrospinning process: chaotic oscillations of the electrospinning jet preventing fiber formation. [31][32][33][34] The data on VAC encapsulation efficiency (E e ) was determined by HPLC using known mehod.…”

Fosfomycin Addition to Poly(D,L-Lactide) Coating Does Not Affect Prophylaxis Efficacy in Rat Implant-Related Infection Model, But That of Gentamicin Does

“…Direct application of potential antimicrobial agents to the tissue-implant interface may provide better infection prophylaxis. Coating the implant surface with antimicrobial peptides can reduce the adhesion of bacteria and biofilm formation, and therefore have a potential protective role in IRI [27]. As an alternative drug for gentamicin, fosfomycin shows antimicrobial activity against biofilms, particularly in combination with fluoroquinolones or aminoglycosides against gram-negative bacteria [28–31].…”