A1 Refereed original research article in a scientific journal

Efficacy of bioabsorbable antibiotic containing bone screw in the prevention of biomaterial-related infection due to Staphylococcus aureus




AuthorsMakinen TJ, Veiranto M, Knuuti J, Jalava J, Tormala P, Aro HT

PublisherELSEVIER SCIENCE INC

Publication year2005

JournalBONE

Journal name in sourceBONE

Journal acronymBONE

Volume36

Issue2

First page 292

Last page299

Number of pages8

ISSN8756-3282

DOIhttps://doi.org/10.1016/j.bone.2004.11.009


Abstract
Impregnation of antimicrobial agents within biodegradable orthopedic implants provides a possibility for local antimicrobial prophylaxis of biomaterial-related infections. The objective of this study was to evaluate the efficacy of a bioabsorbable ciprofloxacin containing bone screw (Ab-PLGA) in the prevention of biomaterial-related infection due to Staphylococcus aureus in a rabbit model. Animals in Group I (n = 8) received a Ab-PLGA screw contaminated with S. aureus, while animals in Group II (n = 8) received a stainless steel (SS) screw contaminated with S. aureus. In two negative control groups, the animals received a Ab-PLGA screw (Group III, n = 4) or a SS screw (Group IV, n = 4) without bacterial contamination. F-18-FDG-PET imaging, performed at 6 weeks, was applied as a novel quantitative in vivo imaging modality of implant-related infection. Infection was verified by swab cultures, direct cultures of the retrieved implant, and quantitative cultures of pulverized bone. The concentrations of ciprofloxacin in serum and local bone tissue were determined by a high performance liquid chromatographic (HPLC) method with fluorescence (FLD) detection. In the group of contaminated Ab-PLGA screws, all cultures were negative. In the group of contaminated SS screws, all cultures of retrieved implants and six cultures out of eight of pulverized bone were positive for inoculated S. aureus. In negative control groups, all cultures were negative except one contaminant (S. cohnii) found in a SS screw culture. Verified infection of contaminated SS screws was collaborated by the increased F-18-FDG-PET uptake (P = 0.004 compared with the group of contaminated Ab-PLGA screws). The mean bone tissue concentration of ciprofloxacin varied from 2.54 to 0.83 mu g/g bone as a function of distance from the implantation site. The serum concentration of ciprofloxacin remained undetectable and below the resolution of the analytic method (< 5.0 ng/ml). This study confirmed the in vivo efficacy of bioabsorbable antibiotic containing bone screw in the prevention of biomaterial-related infection due to S. aureus. (c) 2004 Elsevier Inc. All rights reserved.



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