Gentamicin coating of metallic implants reduces implant-related osteomyelitis in rats

Lücke, Martin; Schmidmaier, Gerhard; Sadoni, Sebastian; Wildemann, Britt; Schiller, R.; Haas, Norbert; Raschke, M.

doi:10.1016/s8756-3282(03)00050-4

Cited by 306 publications

(251 citation statements)

References 51 publications

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“…For local prophylaxis, application of gentamicin in the bone cement as well as coating of metallic implants with tobramycin or gentamicin appear to be effective, resulting in improved long-term implant survival [8]. For the treatment of skeletal infections, gentamicin-loaded bone cement beads, tobramycin impregnated beads and bone graft substitutes offer high concentrations of antibiotics at the site of infection [9].…”

Section: Discussionmentioning

confidence: 99%

Aminoglycoside-resistant staphylococci in Greece: prevalence and resistance mechanisms

Liakopoulos

Foka

Vourli

et al. 2011

Eur J Clin Microbiol Infect Dis

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To determine the prevalence of aminoglycoside-modifying enzymes (AMEs) genes and the rate of resistance to amikacin, gentamicin, kanamycin and tobramycin a total of 1228 gene. The rate of resistance as determined by disk diffusion method and Etest was 48.2% for kanamycin, 48.2% for amikacin, 12.9% for tobramycin and 6.3% for gentamicin. MRSA were more resistant than MSSA (92.7% resistant to amikacin and kanamycin, 25% to tobramycin and 12.3% to gentamicin versus 2.6% to amikacin and kanamycin and 0.3% to tobramycin respectively). Vitek 2 P549 card failed to characterize all S. aureus that carried the aph(3')-IIIa gene. Significant differences on the rate of resistance and distribution of AME genes were observed among S. aureus strains originating in different hospitals. On the other hand, 42.8% of S. epidermidis, all methicillin-resistant, carried any AMEs genes; 70% of the positive strains carried the aac(6')-Ie-aph(2") gene in combination with both ant(4')-Ia and aph(3')-IIIa genes, 18% carried the aac(6')-Ie-aph(2") gene with ant(4')-Ia, while, 12% carried the aac(6')-Ie-aph(2") gene with aph(3')-IIIa. The rate of resistance to all aminoglycosides tested was 42.8%; 100% concordance of susceptibility results was observed between those of disk diffusion method, Etest and Vitek 2 P549 card. No significant differences on the rate of resistance or the AME gene distribution among different geographic regions were observed among S. epidermidis strains. These results suggest an alarming rate of aminoglycoside-resistant staphylococciin Greece and the necessity for a continuous surveillance.

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Section: Discussionmentioning

confidence: 99%

Aminoglycoside-resistant staphylococci in Greece: prevalence and resistance mechanisms

Liakopoulos

Foka

Vourli

et al. 2011

Eur J Clin Microbiol Infect Dis

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“…So far, only intramedullary nails with a PDLLA coating containing gentamicin were placed on the market [14]. For example, metal implants such as plates and wires have been coated with a polymer matrix layer loaded with a microbial antibiotic, while others have studied different therapeutic agents including triclosan and chlorhexidine (CHX) [15,16,17]. In such studies, however, in vitro antibiotic release experiments showed that most of the drug was released within several hours after exposure to an aqueous environment.…”

Section: Introductionmentioning

confidence: 99%

Antibacterial PHAs coating for titanium implants

Rodríguez-Contreras

García

Manero

et al. 2017

European Polymer Journal

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Biomaterial-associated infection is a serious complication of modern implantation surgery.Thus, the improvement of implant surfaces is required to avoid the first stage for biofilm formation, bacterial adhesion. The current research addresses this issue by developing drug delivery systems (DDS) consisting of antibiotic-loaded polyhydroxyalkanoates (PHAs) coatings on titanium implants. Dip-coating technique was used to achieve optimal coatings with biodegradable biopolyesters, polyhydroxybutyrate (PHB) and its copolymer, polyhydroxybutyrate-co-hydroxyvalerate (PHBV). The coatings were completely characterized (wettability, topography, thickness and roughness), and studies of drug delivery, toxicity, antibacterial effect, and cell adhesion were performed. For both of biopolymers, surfaces were partially covered with 1 and 3 immersions, while with 6, they were completely covered. Although both antibiotic-loaded biopolymer coatings assure the protection against bacteria populations, PHBV coatings are closer to the desired release profile; its faster degradation provides for a greater and more stable drug release for a given period of time compared to PHB coatings. The use of coatings with different drug concentration per layer results in more controlled and homogeneous releases. The DDS designed not only assure toavoid the first stage of bacterial adhesion, but also their proliferation and biofilm formation, since the coatings degrade with time under physiological conditions, guaranteeing a prolonged drug release.

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“…Gentamicin-loaded nanotubes and polymer coatings have been shown in various studies to effectively inhibit bacterial adhesion while retaining good osteoinductivity. 13,29 Meanwhile, our in vitro research revealed that gentamicinloaded nanotubes (NT-G) and nanotubes with no drug loading (NT), especially those with diameters of 80 nm, significantly improved the antimicrobial effects and osteogenic activity of the implant surface. 16,26 However, there have also been several reports indicating that the nanotubular surfaces increased bacterial adhesion compared with conventional and nanorough surfaces due to the presence of fluorine and amorphous crystallinity.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, implant-related infection model in rats, which could be used to simulate the tibia or femur implant-related intramedullary infection in clinics, have been widely used to verify the treatment effect of implant with antibacterial properties in vivo. 29,32 This study was designed to further investigate the effects of gentamicin-loaded nanotubes on the surface of titanium implants on experimental infection in a rat femur implant-related infection model using a standard Staphylococcus aureus (ATCC 25923) strain inoculation.…”

Section: Introductionmentioning

confidence: 99%

In vivo evaluation of the anti-infection potential of gentamicin-loaded nanotubes on titania implants

Yang

et al. 2016

IJN

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Titanium-based implants have been widely used in orthopedic surgery; however, failures still occur. Our in vitro study has demonstrated that gentamicin-loaded, 80 nm-diameter nanotubes possessed both antibacterial and osteogenic activities. Thus, the aim of this study was to further investigate the in vivo anti-infection effect of the titanium implants with gentamicin-loaded nanotubes. Thirty-six male Sprague Dawley rats were used to establish an implant-associated infection model. A volume of 50 μL Staphylococcus aureus suspension (1×10 5 CFU/mL) was injected into the medullary cavity of the left femur, and then the titanium rods without modification (Ti), titanium nanotubes without drug loading (NT), and gentamicin-loaded titanium nanotubes (NT-G) were inserted with phosphate-buffered saline-inoculated Ti rods as a blank control. X-ray images were obtained 1 day, 21 days, and 42 days after surgery; micro-computed tomography, microbiological, and histopathological analyses were used to evaluate the infections at the time of sacrifice. Radiographic signs of bone infection, including osteolysis, periosteal reaction, osteosclerosis, and damaged articular surfaces, were demonstrated in the infected Ti group and were slightly alleviated in the NT group but not observed in the NT-G group. Meanwhile, the radiographic and gross bone pathological scores of the NT-G group were significantly lower than those of the infected Ti group ( P <0.01). Explant cultures revealed significantly less bacterial growth in the NT-G group than in the Ti and NT groups ( P <0.01), and the NT group showed decreased live bacterial growth compared with the Ti group ( P <0.01). Confocal laser scanning microscopy, scanning electron microscopy, and histopathological observations further confirmed decreased bacterial burden in the NT-G group compared with the Ti and NT groups. We concluded that the NT-G coatings can significantly prevent the development of implant-associated infections in a rat model; therefore, they may provide an effective drug-loading strategy to combat implant-associated infections in clinic.

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Gentamicin coating of metallic implants reduces implant-related osteomyelitis in rats

Cited by 306 publications

References 51 publications

Aminoglycoside-resistant staphylococci in Greece: prevalence and resistance mechanisms

Aminoglycoside-resistant staphylococci in Greece: prevalence and resistance mechanisms

Antibacterial PHAs coating for titanium implants

In vivo evaluation of the anti-infection potential of gentamicin-loaded nanotubes on titania implants

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