Preventing Implant-Associated Infections by Silver Coating
Preventing Implant-Associated Infections by Silver Coating
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DOI：
10.1128/aac.02934-15
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发表时间：
2016-04-01
影响因子：
4.9
通讯作者：
Khanna, Nina
中科院分区：
文献类型：
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作者：
Kuehl, Richard;Brunetto, Priscilla S.;Khanna, Nina
植入物相关感染（IAI）是一种可怕的并发症，主要由生物膜形成葡萄球菌引起。防止微生物定植的植入物表面将是期望的。我们研究了镀银钛铝铌（TiAlNb）合金的预防效果。在琼脂抑制试验中，该表面引起了对表皮葡萄球菌和金黄色葡萄球菌的强烈的接种依赖性活性。伽马灭菌和酒精消毒没有改变效果。在组织笼小鼠模型中，TiAlNb笼的银涂层以接种依赖性方式预防围手术期感染，并且在用2 x 10（6）CFU S.表皮细胞/笼。In S.金黄色葡萄球菌感染，银涂层仅具有有限的效果。同样，单独使用达托霉素或万古霉素预防也不能预防S。金黄色葡萄球菌感染然而，银涂层结合达托霉素或万古霉素预防性治疗可阻止耐甲氧西林S.金黄色葡萄球菌感染的预防率分别为100%或33%。此外，银从表面的释放是独立的感染和植入后迅速发生。在第2天，在笼液中达到82 μ g Ag/ml的峰值，相当于几乎6倍的葡萄球菌MIC。对笼中白细胞的细胞毒性较低且为暂时性。周围组织未显示银毒性的组织学体征。在体外，在几种临床葡萄球菌菌株中，在连续亚抑制银暴露后，未观察到银耐药性的出现。总之，我们的数据表明，镀银TiAlNb可有效预防IAI，因此可考虑用于临床应用。
Implant-associated infections (IAIs) are a dreaded complication mainly caused by biofilm-forming staphylococci. Implant surfaces preventing microbial colonization would be desirable. We examined the preventive effect of a silver-coated titanium-aluminum-niobium (TiAlNb) alloy. The surface elicited a strong, inoculum-dependent activity against Staphylococcus epidermidis and Staphylococcus aureus in an agar inhibition assay. Gamma sterilization and alcohol disinfection did not alter the effect. In a tissue cage mouse model, silver coating of TiAlNb cages prevented perioperative infections in an inoculum-dependent manner and led to a 100% prevention rate after challenge with 2 x 10(6) CFU of S. epidermidis per cage. In S. aureus infections, silver coating had only limited effect. Similarly, daptomycin or vancomycin prophylaxis alone did not prevent S. aureus infections. However, silver coating combined with daptomycin or vancomycin prophylaxis thwarted methicillin-resistant S. aureus infections at a prevention rate of 100% or 33%, respectively. Moreover, silver release from the surface was independent of infection and occurred rapidly after implantation. On day 2, a peak of 82 mu g Ag/ml was reached in the cage fluid, corresponding to almost 6x the MIC of the staphylococci. Cytotoxicity toward leukocytes in the cage was low and temporary. Surrounding tissue did not reveal histological signs of silver toxicity. In vitro, no emergence of silver resistance was observed in several clinical strains of staphylococci upon serial subinhibitory silver exposures. In conclusion, our data demonstrate that silver-coated TiAlNb is potent for prevention of IAIs and thus can be considered for clinical application.