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Controlled Release of Vancomycin and Tigecycline from an Orthopaedic Implant Coating Prevents Staphylococcus aureus Infection in an Open Fracture Animal Model.

Publication ,  Journal Article
Stavrakis, AI; Zhu, S; Loftin, AH; Weixian, X; Niska, J; Hegde, V; Segura, T; Bernthal, NM
Published in: BioMed research international
January 2019

Treatment of open fractures routinely involves multiple surgeries and delayed definitive fracture fixation because of concern for infection. If implants were made less susceptible to infection, a one-stage procedure with intramedullary nailing would be more feasible, which would reduce morbidity and improve outcomes.In this study, a novel open fracture mouse model was developed using Staphylococcus aureus (S. aureus) and single-stage intramedullary fixation. The model was used to evaluate whether implants coated with a novel "smart" polymer coating containing vancomycin or tigecycline would be colonized by bacteria in an open fracture model infected with S. aureus. In vivo bioluminescence, ex vivo CFUs, and X-ray images were evaluated over a 42-day postoperative period.We found evidence of a markedly decreased bacterial burden with the local release of vancomycin and tigecycline from the PEG-PPS polymer compared to polymer alone. Vancomycin was released in a controlled fashion and maintained local drug concentrations above the minimum inhibition concentration for S. aureus for greater than 7 days postoperatively. Bacteria were reduced 139-fold from implants containing vancomycin and undetected from the bone and soft tissue. Tigecycline coatings led to a 5991-fold reduction in bacteria isolated from bone and soft tissue and 15-fold reduction on the implants compared to polymer alone. Antibiotic coatings also prevented osteomyelitis and implant loosening as observed on X-ray.Vancomycin and tigecycline can be encapsulated in a polymer coating and released over time to maintain therapeutic levels during the perioperative period. Our results suggest that antibiotic coatings can be used to prevent implant infection and osteomyelitis in the setting of open fracture. This novel open fracture mouse model can be used as a powerful in vivo preclinical tool to evaluate and optimize the treatment of open fractures before further studies in humans.

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Published In

BioMed research international

DOI

EISSN

2314-6141

ISSN

2314-6133

Publication Date

January 2019

Volume

2019

Start / End Page

1638508

Related Subject Headings

  • Vancomycin
  • Tigecycline
  • Staphylococcus aureus
  • Staphylococcal Infections
  • Prostheses and Implants
  • Osteomyelitis
  • Orthopedics
  • Mice, Inbred C57BL
  • Mice
  • Male
 

Citation

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Chicago
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Stavrakis, A. I., Zhu, S., Loftin, A. H., Weixian, X., Niska, J., Hegde, V., … Bernthal, N. M. (2019). Controlled Release of Vancomycin and Tigecycline from an Orthopaedic Implant Coating Prevents Staphylococcus aureus Infection in an Open Fracture Animal Model. BioMed Research International, 2019, 1638508. https://doi.org/10.1155/2019/1638508
Stavrakis, A. I., S. Zhu, A. H. Loftin, X. Weixian, J. Niska, V. Hegde, T. Segura, and N. M. Bernthal. “Controlled Release of Vancomycin and Tigecycline from an Orthopaedic Implant Coating Prevents Staphylococcus aureus Infection in an Open Fracture Animal Model.BioMed Research International 2019 (January 2019): 1638508. https://doi.org/10.1155/2019/1638508.
Stavrakis AI, Zhu S, Loftin AH, Weixian X, Niska J, Hegde V, et al. Controlled Release of Vancomycin and Tigecycline from an Orthopaedic Implant Coating Prevents Staphylococcus aureus Infection in an Open Fracture Animal Model. BioMed research international. 2019 Jan;2019:1638508.
Stavrakis, A. I., et al. “Controlled Release of Vancomycin and Tigecycline from an Orthopaedic Implant Coating Prevents Staphylococcus aureus Infection in an Open Fracture Animal Model.BioMed Research International, vol. 2019, Jan. 2019, p. 1638508. Epmc, doi:10.1155/2019/1638508.
Stavrakis AI, Zhu S, Loftin AH, Weixian X, Niska J, Hegde V, Segura T, Bernthal NM. Controlled Release of Vancomycin and Tigecycline from an Orthopaedic Implant Coating Prevents Staphylococcus aureus Infection in an Open Fracture Animal Model. BioMed research international. 2019 Jan;2019:1638508.

Published In

BioMed research international

DOI

EISSN

2314-6141

ISSN

2314-6133

Publication Date

January 2019

Volume

2019

Start / End Page

1638508

Related Subject Headings

  • Vancomycin
  • Tigecycline
  • Staphylococcus aureus
  • Staphylococcal Infections
  • Prostheses and Implants
  • Osteomyelitis
  • Orthopedics
  • Mice, Inbred C57BL
  • Mice
  • Male