Efficacy of a saline wash plus vancomycin/tobramycin-doped PVA composite (PVA-VAN/TOB-P) in a mouse pouch infection model implanted with 3D-printed porous titanium cylinders.

IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Bone & Joint Research Pub Date : 2024-11-01 DOI:10.1302/2046-3758.1311.BJR-2023-0334.R2
David C Markel, Therese Bou-Akl, Bin Wu, Paula Pawlitz, Weiping Ren
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Abstract

Aims: The efficacy of saline irrigation for treatment of implant-associated infections is limited in the presence of porous metallic implants. This study evaluated the therapeutic efficacy of antibiotic doped bioceramic (vancomycin/tobramycin-doped polyvinyl alcohol composite (PVA-VAN/TOB-P)) after saline wash in a mouse infection model implanted with titanium cylinders.

Methods: Air pouches created in female BalBc mice by subcutaneous injection of air. In the first of two independent studies, pouches were implanted with titanium cylinders (400, 700, and 100 µm pore sizes) and inoculated with Staphylococcus aureus (1 × 103 or 1 × 106 colony-forming units (CFU)/pouch) to establish infection and biofilm formation. Mice were killed after one week for microbiological analysis. In the second study, pouches were implanted with 400 µm titanium cylinders and inoculated with S. aureus (1 × 103 or 1 × 106 CFU/pouch). Four groups were tested: 1) no bacteria; 2) bacteria without saline wash; 3) saline wash only; and 4) saline wash plus PVA-VAN/TOB-P. After seven days, the pouches were opened and washed with saline alone, or had an additional injection of PVA-VAN/TOB-P. Mice were killed 14 days after pouch wash.

Results: The first part of the study showed that low-grade infection was more significant in 400 µm cylinders than cylinders with larger pore sizes (p < 0.05). The second part of the study showed that saline wash alone was ineffective in eradicating both low- and high-grade infections. Saline plus PVA-VAN/TOB-P eradicated the titanium cylinder-associated infections, as manifested by negative cultures of the washouts and supported by scanning electron microscopy and histology.

Conclusion: Porous titanium cylinders were vulnerable to bacterial infection and biofilm formation that could not be treated by saline irrigation alone. Application of PVA-VAN/TOB-P directly into the surgical site alone or after saline wash represents a feasible approach for prevention and/or treatment of porous implant-related infections.

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生理盐水冲洗加万古霉素/托布津掺杂的 PVA 复合材料(PVA-VAN/TOB-P)在植入 3D 打印多孔钛圆柱的小鼠小袋感染模型中的疗效。
目的:在多孔金属种植体存在的情况下,生理盐水冲洗治疗种植体相关感染的疗效有限。本研究评估了掺入抗生素的生物陶瓷(掺入万古霉素/托布津的聚乙烯醇复合材料(PVA-VAN/TOB-P))在生理盐水冲洗植入钛圆柱的小鼠感染模型后的疗效:通过皮下注射空气在雌性 BalBc 小鼠体内形成气囊。在两项独立研究中的第一项研究中,小鼠气囊内植入钛圆柱(孔径分别为 400、700 和 100 µm),并接种金黄色葡萄球菌(1 × 103 或 1 × 106 菌落总数形成单位 (CFU)/气囊)以形成感染和生物膜。一周后杀死小鼠,进行微生物分析。在第二项研究中,将 400 µm 的钛圆柱植入小袋,并接种金黄色葡萄球菌(1 × 103 或 1 × 106 CFU/袋)。测试分为四组:1)无细菌;2)无生理盐水清洗的细菌;3)仅生理盐水清洗;4)生理盐水清洗加 PVA-VAN/TOB-P。七天后,打开小袋,仅用生理盐水清洗,或额外注射 PVA-VAN/TOB-P。洗袋 14 天后处死小鼠:研究的第一部分显示,与孔径较大的圆筒相比,400 微米圆筒的低度感染更为严重(p < 0.05)。研究的第二部分显示,仅用生理盐水清洗无法有效消除低度和高度感染。生理盐水加 PVA-VAN/TOB-P 可根除与钛圆柱相关的感染,洗出液的阴性培养证明了这一点,扫描电子显微镜和组织学也证明了这一点:结论:多孔钛缸容易受到细菌感染并形成生物膜,仅靠生理盐水冲洗无法根治。在手术部位直接使用 PVA-VAN/TOB-P 或在生理盐水冲洗后使用 PVA-VAN/TOB-P 是预防和/或治疗多孔种植体相关感染的可行方法。
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来源期刊
Bone & Joint Research
Bone & Joint Research CELL & TISSUE ENGINEERING-ORTHOPEDICS
CiteScore
7.40
自引率
23.90%
发文量
156
审稿时长
12 weeks
期刊介绍: The gold open access journal for the musculoskeletal sciences. Included in PubMed and available in PubMed Central.
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