Is Implant Coating With Tyrosol- and Antibiotic-loaded Hydrogel Effective in Reducing Cutibacterium (Propionibacterium) acnes Biofilm Formation? A Preliminary In Vitro Study

Abstract

Background Studies have suggested that Cutibacterium acnes (formerly known as Propionibacterium) is the most frequently isolated pathogen after shoulder arthroplasty. To address the burden of periprosthetic joint infections associated with this pathogen, new prevention methods are needed. Tyrosol has a promising record of effectiveness in the field of biofilm-associated infections; however, to our knowledge, it has not been tested against C. acnes thus far. Questions/purposes In this in vitro study, we asked: (1) Is tyrosol effective in inhibiting and eradicating C. acnes Each author certifies that neither he or she, nor any member of his or her immediate family, has funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Clinical Orthopaedics and Related Research® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

CORR Insights®: Is Implant Coating With Tyrosol- and Antibiotic-loaded Hydrogel Effective in Reducing Cutibacterium (Propionibacterium) acnes Biofilm Formation? A Preliminary In Vitro Study

“…The titles of the current study [9] and of Drago and colleagues [3] ask similar questions regarding the efficacy of implant coated antimicrobial loaded DAC hydrogels to control biofilms, but come to opposite conclusions. The most obvious difference is in the choice of challenge organisms, although it is difficult to see why C. acnes would be so much harder to kill than the other pathogens, when MICs, MBCs, and minimum biofilm eliminating concentration values were similar, or less, than many of the strains tested.…”

“…The study by Tsikopoulos and colleagues [9] assessed the ability of hydrogels impregnated with tyrosol, as well as conventional antibiotics coated on the surface of titanium (Ti) coupons, simulating an orthopaedic implant surface, to prevent biofilms formed by Cutibacterium (Propionibacterium) acnes (C. acnes). Tsikopoulos and colleagues [9] speculated that tyrosol could potentially protect shoulder implants from C. acnes. Although C. acnes strains generally are susceptible to antibiotics like vancomycin, they become highly tolerant when they form biofilms [2,5].…”

Local Antibiotic Delivery Options in Prosthetic Joint Infection

“…They can also carry a wide variety of antimicrobial substances as, in contrast to PMMA, hydrogel can be mixed at room temperature, without thermal damage to the contained antimicrobial. They have been combined in experimental studies or case reports with a variety of antibiotics, antifungals, chitosan, and tyrosol [ 122 , 123 , 124 ]. The high water content inside the hydrogel matrix is also an appropriate environment for containing and releasing bacteriophages [ 125 ].…”

Is nanomaterial- and vancomycin-loaded polymer coating effective at preventing methicillin-resistant Staphylococcus aureus growth on titanium disks? An in vitro study

“…The samples were mounted on bronze substrates with adhesive double-sided carbon tape, and were then subjected to coating with carbon featuring an average thickness of 200 Å using a vacuum evaporator JEOL 4X. For this study, the minimum biofilm inhibitory concentration (MBIC) was determined using a similar technique to that used for planktonic bacteria [9]. The following coating combinations were considered:…”