BACKGROUND: Since device colonization is a prelude to infection, an antimicrobial-coated device that reduces bacterial colonization can potentially protect against infection. The objective of this animal study was to assess the efficacy of a coating with minocycline and rifampin to prevent colonization of a grit-blasted titanium implant and subsequent osteomyelitis. METHODS: Twenty-five rabbits underwent implantation of a titanium-alloy pin, either coated with minocycline and rifampin (thirteen rabbits) or uncoated (twelve rabbits), into the right femoral medullary canal. The implanted devices were inoculated with 500 CFU (colony-forming units) of Staphylococcus aureus prior to wound closure. The rabbits were killed one week later, and the removed device, femoral bone, a specimen obtained by swabbing the track surrounding the device, and blood were cultured. The rates of device colonization, osteomyelitis, and device-related osteomyelitis were compared between the two groups of rabbits. RESULTS: The antimicrobial-coated devices had a significantly lower rate of colonization than the uncoated devices (five of thirteen compared with twelve of twelve, p = 0.0016) and were associated with significantly lower rates of osteomyelitis (six of thirteen compared with twelve of twelve, p = 0.005) and device-related osteomyelitis (five of thirteen compared with twelve of twelve, p = 0.0016). Bacteremia did not develop in any rabbit. CONCLUSIONS: Orthopaedic devices coated with minocycline and rifampin significantly protected against device colonization and infection due to Staphylococcus aureus in this in vivo rabbit model. CLINICAL RELEVANCE: It is possible that orthopaedic devices coated with this unique combination of antimicrobial agents may protect against the development of clinical infection in humans.
BACKGROUND: Since device colonization is a prelude to infection, an antimicrobial-coated device that reduces bacterial colonization can potentially protect against infection. The objective of this animal study was to assess the efficacy of a coating with minocycline and rifampin to prevent colonization of a grit-blasted titanium implant and subsequent osteomyelitis. METHODS: Twenty-five rabbits underwent implantation of a titanium-alloy pin, either coated with minocycline and rifampin (thirteen rabbits) or uncoated (twelve rabbits), into the right femoral medullary canal. The implanted devices were inoculated with 500 CFU (colony-forming units) of Staphylococcus aureus prior to wound closure. The rabbits were killed one week later, and the removed device, femoral bone, a specimen obtained by swabbing the track surrounding the device, and blood were cultured. The rates of device colonization, osteomyelitis, and device-related osteomyelitis were compared between the two groups of rabbits. RESULTS: The antimicrobial-coated devices had a significantly lower rate of colonization than the uncoated devices (five of thirteen compared with twelve of twelve, p = 0.0016) and were associated with significantly lower rates of osteomyelitis (six of thirteen compared with twelve of twelve, p = 0.005) and device-related osteomyelitis (five of thirteen compared with twelve of twelve, p = 0.0016). Bacteremia did not develop in any rabbit. CONCLUSIONS: Orthopaedic devices coated with minocycline and rifampin significantly protected against device colonization and infection due to Staphylococcus aureus in this in vivo rabbit model. CLINICAL RELEVANCE: It is possible that orthopaedic devices coated with this unique combination of antimicrobial agents may protect against the development of clinical infection in humans.
Authors: Fabio Variola; John B Brunski; Giovanna Orsini; Paulo Tambasco de Oliveira; Rima Wazen; Antonio Nanci Journal: Nanoscale Date: 2010-10-26 Impact factor: 7.790
Authors: Jessica Amber Jennings; Daniel P Carpenter; Karen S Troxel; Karen E Beenken; Mark S Smeltzer; Harry S Courtney; Warren O Haggard Journal: Clin Orthop Relat Res Date: 2015-07 Impact factor: 4.176
Authors: H Yazici; H Fong; B Wilson; E E Oren; F A Amos; H Zhang; J S Evans; M L Snead; M Sarikaya; C Tamerler Journal: Acta Biomater Date: 2012-11-14 Impact factor: 8.947
Authors: Joshua S Moskowitz; Michael R Blaisse; Raymond E Samuel; Hu-Ping Hsu; Mitchel B Harris; Scott D Martin; Jean C Lee; Myron Spector; Paula T Hammond Journal: Biomaterials Date: 2010-05-21 Impact factor: 12.479
Authors: Nicholas M Bernthal; Alexandra I Stavrakis; Fabrizio Billi; John S Cho; Thomas J Kremen; Scott I Simon; Ambrose L Cheung; Gerald A Finerman; Jay R Lieberman; John S Adams; Lloyd S Miller Journal: PLoS One Date: 2010-09-07 Impact factor: 3.240