Staphylococcus Antimicrobial properties of antibiotic-loaded
ESSKA Academy. Ollivier m. May 12, 2018; 218109; FP41-1723
Assoc. Prof. matthieu Ollivier
Assoc. Prof. matthieu Ollivier
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Objectives: Infection remains one of the top causes for failure and revision in hip and knee arthroplasties. As an increasing number of arthroplasties are completed with uncemented constructs if local antibiotics could be effectively and reliably be delivered through tantalum vehicles, there would be an opportunity to drastically reduce, prevent, and treat periprosthetic infections. It was our hypothesis that local antibiotics could be effectively and reliably be delivered through tantalum vehicles.

Methods: To perform this experimental ex-vivo study, Porous tantalum (TM) cylinders (1 cm3) were specifically designed. Eleven study groups were defined according to the type of bacteria Staphilococcus Aureus Methy-S (SAMS) or Methy-R (SAMR), and Staphylococcus Epidermidi (SE) and according to the tested antiobiotic: Vancomycine (Vanco), Tobramycine (Tobra) or Gentamycine (Genta). A controls groups was created using a phosphate buffered saline (PBS) serum. In each group, 5 samples were tested. The cylinders were bathed in an antiobiotic solution (50mg/mL for Vanco and Tobra and 40mg/mL) or PBS during one hour. The cylinders were then placed on an Agar Plate renewed every 24h and inoculated with the different bacteria and placed 37.2 degrees humid atmosphere. Zones of inhibition (ZOI) were measured each day (in mm) (including photographs) until no antibiotic activity (ZOI<20mm) is left based upon previously validated protocols.

Results: For the 3 bacteria, the TM cylinder with the PBS showed no antimicrobial properties (ZOI= 0 mm). For the SAMS, mean ZOI for TM+ Vanco were 38.6 mm at day 1 and progressively decrased to 17 mm at day 9, for TM+Genta: 50 mm at day1 and decreased to 23 at day10, for TM+Tobra: 51mm at day1 and decreased to 24 at day 7. For the SAMR, mean ZOI for TM+ Vanco were 34 mm at day1 and progressively decreased to 14.5 mm at day 5, for TM+Genta : 45 mm at day1 and decreased to 11 at day5, for TM+Tobra: 41mm at day1and decreased to 22.5 at day 3. For the SE, mean ZOI for TM+Vanco were 43 mm at day1 and progressively decreased to 23 mm at day 9, for TM+Genta : 56 mm at day1 and decreased to 24.5 at day10, for TM+Tobra: 57 mm at day1and decreased to 25.5 at day 7.

The results of our study confirmed our hypothesis. Elution experiment should performed to find the optimal loading protocol and then evaluate in vivo antimicrobial properties of loaded Tantalum.

total knee arthroplasty, tantalum, antimicrobial properties , antibiotic.
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