Simultaneous delivery of multiple antibacterial agents from additively manufactured porous biomaterials to fully eradicate planktonic and adherent Staphylococcus aureus

Journal article (2017)

Authors

S. Bakhshandeh University Medical Center Utrecht, Biomaterials & Tissue Biomechanics - Mechanical, Maritime and Materials Engineering
Z. Gorgin Karaji University Medical Center Utrecht, Kermanshah University of Technology
S. Amin Yavari University Medical Center Utrecht, Biomaterials & Tissue Biomechanics - Mechanical, Maritime and Materials Engineering
K. Lietaert Katholieke Universiteit Leuven, 3D Systems
A. C. Fluit University Medical Center Utrecht
C. H.E. Boel University Medical Center Utrecht
H. C. Vogely University Medical Center Utrecht
T Vermonden Universiteit Utrecht
Wim E. Hennink Universiteit Utrecht
HH Weinans Biomaterials & Tissue Biomechanics - Mechanical, Maritime and Materials Engineering , University Medical Center Utrecht
H. Weinans Biomaterials & Tissue Biomechanics - Mechanical, Maritime and Materials Engineering , University Medical Center Utrecht
Harrie Weinans Biomaterials & Tissue Biomechanics - Mechanical, Maritime and Materials Engineering , University Medical Center Utrecht
A.A. Zadpoor Biomaterials & Tissue Biomechanics - Mechanical, Maritime and Materials Engineering
Amir Abbas Zadpoor Biomaterials & Tissue Biomechanics - Mechanical, Maritime and Materials Engineering
Amir A. Zadpoor Biomaterials & Tissue Biomechanics - Mechanical, Maritime and Materials Engineering
A. A. Zadpoor Biomaterials & Tissue Biomechanics - Mechanical, Maritime and Materials Engineering
Research Group
Biomaterials & Tissue Biomechanics (Mechanical, Maritime and Materials Engineering) (TU Delft)
Copyright: © 2017 S. Bakhshandeh, Z. Gorgin Karaji, K. Lietaert, A.C. Fluit, C.H.E. Boel, H.C. Vogely, T. Vermonden, W. E. Hennink, Harrie Weinans, A.A. Zadpoor, S. Amin Yavari
DOI: https://doi.org/10.1021/acsami.7b04950
More Info
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Published Date

2017

Language

English

Faculty

Mechanical, Maritime and Materials Engineering

Department

Biomechanical Engineering

Research Group

Biomaterials & Tissue Biomechanics

Abstract

Implant-associated infections are notoriously difficult to treat and may even result in amputation and death. The first few days after surgery are the most critical time to prevent those infections, preferably through full eradication of the micro-organisms entering the body perioperatively. That is particularly important for patients with a compromised immune system such as orthopedic oncology patients, as they are at higher risk for infection and complications. Full eradication of bacteria is, especially in a biofilm, extremely challenging due to the toxicity barrier that prevents delivery of high doses of antibacterial agents. This study aimed to use the potential synergistic effects of multiple antibacterial agents to prevent the use of toxic levels of these agents and achieve full eradication of planktonic and adherent bacteria. Silver ions and vancomycin were therefore simultaneously delivered from additively manufactured highly porous titanium implants with an extremely high surface area incorporating a bactericidal coating made from chitosan and gelatin applied by electrophoretic deposition (EPD). The presence of the chitosan/gelatin (Ch+Gel) coating, Ag, and vancomycin (Vanco) was confirmed by X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared spectroscopy (FTIR). The release of vancomycin and silver ions continued for at least 21 days as measured by inductively coupled plasma (ICP) and UV-spectroscopy. Antibacterial behavior against Staphylococcus aureus, both planktonic and in biofilm, was evaluated for up to 21 days. The Ch+Gel coating showed some bactericidal behavior on its own, while the loaded hydrogels (Ch+Gel+Ag and Ch+Gel+Vanco) achieved full eradication of both planktonic and adherent bacteria without causing significant levels of toxicity. Combining silver and vancomycin improved the release profiles of both agents and revealed a synergistic behavior that further increased the bactericidal effects.