In vitro testing of chitosan in gentamicin-loaded bone cement No antimicrobial effect and reduced mechanical performance

Abstract

Background and purpose Efforts to prevent infection of arthroplasties, including the use of antibiotic-loaded bone cement, are not always successful. We investigated whether the incorporation of chitosan in gentamicinloaded bone cement increases antibiotic release, and prevents bacterial adherence and biofilm formation by clinical isolates of Staphylococcus spp. In addition, we performed mechanical and degradation tests.Methods Different amounts of chitosan were added to the powder of the gentamicin-loaded bone cement. Gentamicin release was determined using high-performance liquid chromatography mass spectrometry. Bacterial adherence and bacterial biofilm formation were determined using clinical isolates cultured from implants retrieved at revision hip surgery. The mechanical properties were determined as a function of degradation in accordance with ISO and ASTM standards for PMMA bone cement.Results The addition of chitosan to bone cement loaded with gentamicin reduced gentamicin release and did not increase the efficacy of the bone cement in preventing bacterial colonization and biofilm formation. Moreover, the mechanical performance of cement containing chitosan was reduced after 28 days of degradation. The compressive and bending strengths were not in compliance with the minimum ISO and ASTM requirements.Interpretation Clinically, incorporation of chitosan into gentamicin-loaded bone cement for use in joint replacement surgery has no antimicrobial benefit and

Adjustment of the antibacterial activity and biocompatibility of hydroxypropyltrimethyl ammonium chloride chitosan by varying the degree of substitution of quaternary ammonium

“…Because of this, the implant surface needs to have low cytotoxicity and good biocompatibility with bone cells. Chitosan is structurally similar to glycosaminoglycan and has many desirable properties as a tissue engineering scaffold Cooney, Petermann, Lau, & Minteer, 2009;Kim et al, 2008;Shi et al, 2009;Twu, Chang, & Ping, 2005), but Dunne et al (2008) reported that it had no antimicrobial effect and reduced mechanical performance in gentamicin-loaded bone cement. There have not yet been any reports about the potential use of HACC in this field.…”

Evaluation of the Effect of Ciprofloxacin and Vancomycin on Mechanical Properties of PMMA Cement; a Preliminary Study on Molecular Weight

“…Comparison of the effect of ciprofloxacin and vancomycin showed that MW of antibiotics could significantly affect the mechanical properties of cement, at high concentration (10% w/w, P = 0.002). Dunne et al 22 used chitosan, an ultra-high molecular weight macromolecule, reported significant reduction in the compressive and bending strengths of cements containing chitosan, after period of 28 days (p = 0.003).…”

“…This phenomenon is exacerbated by the addition of antibiotics as a stress riser 29,36 . Elution of antibiotics from cement can www.nature.com/scientificreports www.nature.com/scientificreports/ also cause adverse effects on cement strength 17,22 . In the present study, density value of the control cement (1.18 g. cm −3 ) also declined over time (1.12 g.cm −3 ) due to interference with the liquid medium, which is in accordance with the other study 24 .…”

“…Briefly, 3 mm samples of a selected group of fractured samples were used. The surfaces of samples were coated with a gold layer using a sputter coater model SCD 005 (BAL-TEC, New York, USA) under vacuum 22,23 . The specimen surfaces were scanned with SEM at an accelerating voltage of 25 kV with different magnifications.…”

Antibacterial polyelectrolyte-coated Mg alloys for biomedical applications

“…The interaction between the polyelectrolytes and the antibacterial drugs used could be a reason for the weaker antibacterial function of the polyelectrolyte-coated samples loaded with combination drugs. From a different experiment, it was clearly shown that the incorporation of chitosan into gentamicin-loaded bone cement for use in joint replacement surgery had no antimicrobial benefit [21][22][23][24][25][26]. Here, the best result is with the UV-treated and gentamicin-loaded samples.…”