Bacteriostatic properties of biomatrices against common orthopaedic pathogens.

Tissue-engineered grafts for tissue regeneration include either mature or progenitor cells seeded onto biomatrices that provide shape and support for developing tissue. Popular biomaterials used in orthopaedic surgery include collagen type I, hyaluronic acid, hydroxyapatite, and polylactic polyglycolic acid (PLGA). Biomatrices with bacteriostatic properties may be beneficial in promoting tissue-engineered graft survival in patients susceptible to infection. We evaluated the bacteriostatic effects of these biomaterials on the growth of the four most common orthopaedic bacterial pathogens: Staphylococcus aureus, Staphylococcus epidermidis, beta-hemolytic Streptococcus, and Pseudomonas aeruginosa. Hyaluronic acid demonstrated the largest bacteriostatic effect on these pathogens by inhibiting bacterial growth by an average of 76.8% (p = 0.0005). Hydroxyapatite and collagen inhibited growth on average by 49.7% (p = 0.011) and 37.5% (p = 0.102), respectively. PLGA exhibited the least bacteriostasis with an average inhibition of 9.8% (NS) and actually accelerated the growth of beta-hemolytic Streptococcus and P. aeruginosa.

[1]  J. Schierholz,et al.  Implant infections: a haven for opportunistic bacteria. , 2001, The Journal of hospital infection.

[2]  L. Montanaro,et al.  Presence and expression of collagen adhesin gene (cna) and slime production in Staphylococcus aureus strains from orthopaedic prosthesis infections. , 1999, Biomaterials.

[3]  J. Lane,et al.  Clinical applications of bone graft substitutes. , 2000, The Orthopedic clinics of North America.

[4]  Satoshi Tanaka,et al.  Manipulation of bacterial adhesion and proliferation by surface charges of electrically polarized hydroxyapatite. , 2002, Journal of biomedical materials research.

[5]  R Langer,et al.  In vitro and in vivo degradation of porous poly(DL-lactic-co-glycolic acid) foams. , 2000, Biomaterials.

[6]  Q. Myrvik,et al.  Cell Biology and Molecular Mechanisms in Artificial Device Infections , 1993, The International journal of artificial organs.

[7]  C. Court-Brown,et al.  Management Of Open Fractures , 1996 .

[8]  B. Brause,et al.  Clinical and microbial features of prosthetic joint infection. , 1984, The American journal of medicine.

[9]  G. Muschler,et al.  Bone cells and matrices in orthopedic tissue engineering. , 2000, The Orthopedic clinics of North America.

[10]  P. Nikkels,et al.  Effects of hydroxyapatite coating on Ti‐6 Al‐4V implant‐site infection in a rabbit tibial model , 2000, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[11]  A. Engström‐Làurent,et al.  Catabolism of hyaluronan in the knee joint of the rabbit. , 1992, Matrix.

[12]  E. J. Young,et al.  Infections associated with prosthetic devices: magnitude of the problem. , 1989, Infectious disease clinics of North America.

[13]  M. Höök,et al.  A collagen receptor on Staphylococcus aureus strains isolated from patients with septic arthritis mediates adhesion to cartilage , 1993, Molecular microbiology.

[14]  E. Söderling,et al.  Antibacterial effects of a bioactive glass paste on oral microorganisms. , 1998, Acta odontologica Scandinavica.

[15]  A. Tarkowski,et al.  The Staphylococcus aureus collagen adhesin is a virulence determinant in experimental septic arthritis , 1994, Infection and immunity.

[16]  P. Sanderson.  Infection in orthopaedic implants. , 1991, The Journal of hospital infection.

[17]  A. Gristina,et al.  Biomaterial-centered infection: microbial adhesion versus tissue integration. , 1987, Science.

[18]  Q. Myrvik,et al.  Surgical biomaterials and differential colonization by Staphylococcus epidermidis. , 1988, Biomaterials.

[19]  J. Baker,et al.  Characterization of the group B streptococcal hyaluronate lyase. , 1994, Archives of biochemistry and biophysics.

[20]  S. Haake,et al.  Bacteriostatic effects of hyaluronic acid. , 1999, Journal of periodontology.

[21]  T. Foster,et al.  Role of Staphylococcus aureus surface adhesins in orthopaedic device infections: are results model-dependent? , 1997, Journal of medical microbiology.

[22]  A. Gristina,et al.  Adherent bacterial colonization in the pathogenesis of osteomyelitis , 1985 .

[23]  Sang Ho Cho,et al.  Fabrication and characterization of hydrophilic poly(lactic-co-glycolic acid)/poly(vinyl alcohol) blend cell scaffolds by melt-molding particulate-leaching method. , 2003, Biomaterials.

[24]  M. Höök,et al.  Identification of a Staphylococcus aureus extracellular matrix-binding protein with broad specificity , 1993, Infection and immunity.

[25]  A. Mikos,et al.  Osteoblast migration on poly(α‐hydroxy esters) , 2000 .

[26]  R. Linhardt,et al.  Exploration of the action pattern of Streptomyces hyaluronate lyase using high-resolution capillary electrophoresis. , 1997, Biochimica et biophysica acta.

[27]  J. Vacanti,et al.  A polymer foam conduit seeded with Schwann cells promotes guided peripheral nerve regeneration. , 2000, Tissue engineering.

[28]  K. Shakesheff,et al.  A comparison of the adhesion of mammalian cells and Staphylococcus epidermidis on fibronectin-modified polymer surfaces. , 2001, Journal of biomedical materials research.

[29]  D. Wise,et al.  Expression of liver-specific functions by rat hepatocytes seeded in treated poly(lactic-co-glycolic) acid biodegradable foams. , 2001, Tissue engineering.

[30]  Michael Ladisch,et al.  Antimicrobial activity associated with extracellular matrices. , 2002, Tissue engineering.