In vitro testing of vancomycin - gentamicin loaded bone cement to prevent prosthetic joint infection


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Year of publication 2005
Type Article in Periodical
Magazine / Source Biomedical Papers
MU Faculty or unit

Faculty of Science

Field Genetics and molecular biology
Keywords Prosthetic joint infection; Polymethylmethacrylate; Antibiotic loaded cement; Vancomycin;Gentamicin; Staphylococcus aureus; Staphylococcus epidermidis
Description Sepsis is a greatly feared complication of total joint arthroplasty. One key question is how to prevent periopera-tive bacterial adherence, and therefore the potential for infectious complications. The objective of our study was to appraise the emerging capacity of staphylococcal survival on prosthetic materials and to analyze the in vitro eects of gentamicin and vancomycin loaded polymethylmethacrylate (PMMA) cement on bacterial adherence and growth. Hospital acquired staphylococcal strains were systematically inoculated on four orthopedic materials (ultrahigh mo-lecular weight polyethylene, PMMA without antibiotic, commercially produced PMMA loaded with gentamicin, and manually mixed PMMA loaded with gentamicin and vancomycin). Staphylococci were identied using culture and biochemical tests. The inoculated material was allowed to incubate in a liquid broth growth media and subsequently prepared for scanning electron microscopy and bacterial growth quantication. Materials without antibiotics showed evidence of staphylococcal growth. PMMA loaded with only gentamicin grew methicillin-resistant Staphylococcus aureus. Gentamicin-vancomycin loaded PMMA completely inhibited any bacterial growth.Low-dose gentamicin-vancomycin loaded PMMA prevents staphylococcal colonization better than commercially manufactured PMMA loaded with gentamicin. We recommend this combination in high-risk procedures and revision surgeries requiring bone cement.
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