51
|
Sanchez CJ, Shiels SM, Tennent DJ, Hardy SK, Murray CK, Wenke JC. Rifamycin Derivatives Are Effective Against Staphylococcal Biofilms In Vitro and Elutable From PMMA. Clin Orthop Relat Res 2015; 473:2874-84. [PMID: 25896136 PMCID: PMC4523531 DOI: 10.1007/s11999-015-4300-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Local antimicrobial delivery through polymethylmethacrylate beads (PMMA), commonly vancomycin, is used for the treatment of contaminated open fractures but has limited activity against Staphylococcus aureus biofilms, which occur commonly in such fractures. Rifamycins have activity against biofilms and are an effective treatment for osteoarticular infections involving staphylococcal biofilms, but there are limited studies evaluating the activity of rifamycin derivatives, other than rifampin, against biofilms of S. aureus and evaluating incorporation of these drugs into PMMA for treatment of contaminated open fractures. QUESTIONS/PURPOSES (1) Are rifamycin derivatives effective against established biofilms of clinical isolates of S. aureus? (2) Can PMMA be used as a carrier for rifamycin derivatives? METHODS Biofilms were developed and evaluated for susceptibility to a panel of antimicrobials in vitro using the minimum biofilm eradication concentration high-throughput model. Susceptibility was assessed by measuring bacterial recovery at 6 and 24 hours after antimicrobial treatment. Activity of rifamycin derivatives against intracellular bacteria was also evaluated using a gentamicin protection assay. Evaluation of PMMA as a carrier for rifampin and rifamycin derivatives was determined by assessing the curing time subsequent to loading of rifamycins and characterizing the release kinetics of rifamycins at daily intervals for 14 days from PMMA by performing bioassays. RESULTS Rifamycin derivatives between 1 and 8 µg/mL reduced bacteria within biofilms 5- to 9-logs and prevented bacterial recovery up to 24 hours post-treatment, indicating near to complete eradication of biofilms. Rifamycin derivatives at 32 µg/mL had activity against intracellular staphylococci, significantly reducing the number of internalized bacteria with limited effects on osteoblast viability. Rifampin was the only rifamycin observed to have a suitable release profile from PMMA, releasing 49% of the total antibiotic and maintaining a sustained released profile up to 14 days at a mean 28 ± 6 μg/mL. CONCLUSIONS Rifampin can be incorporated into PMMA and eluted at concentrations effective against biofilms and intracellular staphylococci. CLINICAL RELEVANCE Our in vitro findings suggest that local delivery of rifampin may be an effective strategy for the prevention and/or treatment of open fractures where S. aureus biofilms might develop. Clinical studies are needed to characterize what role this approach might have in the prevention and treatment of infections involving biofilms.
Collapse
Affiliation(s)
- Carlos J. Sanchez
- />Extremity Trauma & Regenerative Medicine Task Area, US Army Institute of Surgical Research, 3698 Chambers Pass, JBSA, Fort Sam Houston, TX 78234 USA
| | - Stefanie M. Shiels
- />Extremity Trauma & Regenerative Medicine Task Area, US Army Institute of Surgical Research, 3698 Chambers Pass, JBSA, Fort Sam Houston, TX 78234 USA
| | - David J. Tennent
- />Extremity Trauma & Regenerative Medicine Task Area, US Army Institute of Surgical Research, 3698 Chambers Pass, JBSA, Fort Sam Houston, TX 78234 USA
| | - Sharanda K. Hardy
- />Extremity Trauma & Regenerative Medicine Task Area, US Army Institute of Surgical Research, 3698 Chambers Pass, JBSA, Fort Sam Houston, TX 78234 USA
| | - Clinton K. Murray
- />Department of Medicine, Infectious Disease Service, San Antonio Military Medical Center, Fort Sam Houston, TX USA
| | - Joseph C. Wenke
- />Extremity Trauma & Regenerative Medicine Task Area, US Army Institute of Surgical Research, 3698 Chambers Pass, JBSA, Fort Sam Houston, TX 78234 USA
| |
Collapse
|
52
|
Ferreira IS, Bettencourt AF, Gonçalves LMD, Kasper S, Bétrisey B, Kikhney J, Moter A, Trampuz A, Almeida AJ. Activity of daptomycin- and vancomycin-loaded poly-epsilon-caprolactone microparticles against mature staphylococcal biofilms. Int J Nanomedicine 2015; 10:4351-66. [PMID: 26185439 PMCID: PMC4500610 DOI: 10.2147/ijn.s84108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The aim of the present study was to develop novel daptomycin-loaded poly-epsilon-caprolactone (PCL) microparticles with enhanced antibiofilm activity against mature biofilms of clinically relevant bacteria, methicillin-resistant Staphylococcus aureus (MRSA) and polysaccharide intercellular adhesin-positive Staphylococcus epidermidis. Daptomycin was encapsulated into PCL microparticles by a double emulsion-solvent evaporation method. For comparison purposes, formulations containing vancomycin were also prepared. Particle morphology, size distribution, encapsulation efficiency, surface charge, thermal behavior, and in vitro release were assessed. All formulations exhibited a spherical morphology, micrometer size, and negative surface charge. From a very early time stage, the released concentrations of daptomycin and vancomycin were higher than the minimal inhibitory concentration and continued so up to 72 hours. Daptomycin presented a sustained release profile with increasing concentrations of the drug being released up to 72 hours, whereas the release of vancomycin stabilized at 24 hours. The antibacterial activity of the microparticles was assessed by isothermal microcalorimetry against planktonic and sessile MRSA and S. epidermidis. Regarding planktonic bacteria, daptomycin-loaded PCL microparticles presented the highest antibacterial activity against both strains. Isothermal microcalorimetry also revealed that lower concentrations of daptomycin-loaded microparticles were required to completely inhibit the recovery of mature MRSA and S. epidermidis biofilms. Further characterization of the effect of daptomycin-loaded PCL microparticles on mature biofilms was performed by fluorescence in situ hybridization. Fluorescence in situ hybridization showed an important reduction in MRSA biofilm, whereas S. epidermidis biofilms, although inhibited, were not eradicated. In addition, an important attachment of the microparticles to MRSA and S. epidermidis biofilms was observed. Finally, all formulations proved to be biocompatible with both ISO compliant L929 fibroblasts and human MG63 osteoblast-like cells.
Collapse
Affiliation(s)
- Inês Santos Ferreira
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| | - Ana F Bettencourt
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| | - Lídia M D Gonçalves
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| | - Stefanie Kasper
- Biofilmcenter, German Heart Institute Berlin, Berlin, Germany
| | - Bertrand Bétrisey
- Infectious Diseases Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Judith Kikhney
- Biofilmcenter, German Heart Institute Berlin, Berlin, Germany
| | - Annette Moter
- Biofilmcenter, German Heart Institute Berlin, Berlin, Germany
| | - Andrej Trampuz
- Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Berlin, Germany
| | - António J Almeida
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| |
Collapse
|
53
|
Wafa H, Grimer RJ, Reddy K, Jeys L, Abudu A, Carter SR, Tillman RM. Retrospective evaluation of the incidence of early periprosthetic infection with silver-treated endoprostheses in high-risk patients: case-control study. Bone Joint J 2015; 97-B:252-7. [PMID: 25628291 DOI: 10.1302/0301-620x.97b2.34554] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We conducted a case-control study to examine the merit of silver-coated tumour prostheses. We reviewed 85 patients with Agluna-treated (silver-coated) tumour implants treated between 2006 and 2011 and matched them with 85 control patients treated between 2001 and 2011 with identical, but uncoated, tumour prostheses. In all, 106 men and 64 women with a mean age of 42.2 years (18.4 to 90.4) were included in the study. There were 50 primary reconstructions (29.4%); 79 one-stage revisions (46.5%) and 41 two-stage revisions for infection (24.1%). The overall post-operative infection rate of the silver-coated group was 11.8% compared with 22.4% for the control group (p = 0.033, chi-square test). A total of seven of the ten infected prostheses in the silver-coated group were treated successfully with debridement, antibiotics, and implant retention compared with only six of the 19 patients (31.6%) in the control group (p = 0.048, chi-square test). Three patients in the silver-coated group (3.5%) and 13 controls (15.3%) had chronic periprosthetic infection (p = 0.009, chi-square test). The overall success rates in controlling infection by two-stage revision in the silver-coated group was 85% (17/20) compared with 57.1% (12/21) in the control group (p = 0.05, chi-square test). The Agluna-treated endoprostheses were associated with a lower rate of early periprosthetic infection. These silver-treated implants were particularly useful in two-stage revisions for infection and in those patients with incidental positive cultures at the time of implantation of the prosthesis. Debridement with antibiotic treatment and retention of the implant appeared to be more successful with silver-coated implants.
Collapse
Affiliation(s)
- H Wafa
- Glasgow Royal Infirmary, 84, Castle Street, Glasgow, G4 0SF, UK
| | - R J Grimer
- Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham, B31 2AP, UK
| | - K Reddy
- Vanderbilt Orthopaedic Institute, 1215 21st Avenue South, Medical Center East, S Tower, Suite 4200, Nashville, Tennessee, 37232-8774, USA
| | - L Jeys
- Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham, B31 2AP, UK
| | - A Abudu
- Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham, B31 2AP, UK
| | - S R Carter
- Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham, B31 2AP, UK
| | - R M Tillman
- Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham, B31 2AP, UK
| |
Collapse
|
54
|
Valour F, Rasigade JP, Trouillet-Assant S, Gagnaire J, Bouaziz A, Karsenty J, Lacour C, Bes M, Lustig S, Bénet T, Chidiac C, Etienne J, Vandenesch F, Ferry T, Laurent F. Delta-toxin production deficiency in Staphylococcus aureus: a diagnostic marker of bone and joint infection chronicity linked with osteoblast invasion and biofilm formation. Clin Microbiol Infect 2015; 21:568.e1-11. [PMID: 25677632 DOI: 10.1016/j.cmi.2015.01.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 01/21/2015] [Accepted: 01/24/2015] [Indexed: 11/29/2022]
Abstract
Biofilm formation, intra-osteoblastic persistence, small-colony variants (SCVs) and the dysregulation of agr, the major virulence regulon, are possibly involved in staphylococcal bone and joint infection (BJI) pathogenesis. We aimed to investigate the contributions of these mechanisms among a collection of 95 Staphylococcus aureus clinical isolates from 64 acute (67.4%) and 31 chronic (32.6%) first episodes of BJI. The included isolates were compared for internalization rate, cell damage and SCV intracellular emergence using an ex vivo model of human osteoblast infection. Biofilm formation was assessed in a microbead immobilization assay (BioFilm Ring test). Virulence gene profiles were assessed by DNA microarray. Seventeen different clonal complexes were identified among the screened collection. The staphylococcal internalization rate in osteoblasts was significantly higher for chronic than acute BJI isolates, regardless of the genetic background. Conversely, no differences regarding cytotoxicity, SCV emergence, biofilm formation and virulence gene distribution were observed. Additionally, agr dysfunction, detected by the lack of delta-toxin production using whole-cell matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) analysis (n = 15; 15.8%), was significantly associated with BJI chronicity, osteoblast invasion and biofilm formation. These findings provide new insights into MSSA BJI pathogenesis, suggesting the correlation between chronicity and staphylococcal osteoblast invasion. This adaptive mechanism, along with biofilm formation, is associated with agr dysfunction, which can be routinely assessed by delta-toxin detection using MALDI-TOF spectrum analysis, possibly providing clinicians with a diagnostic marker of BJI chronicity at the time of diagnosis.
Collapse
Affiliation(s)
- F Valour
- Department of Infectious Diseases, Hospices Civils de Lyon, France; Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France.
| | - J-P Rasigade
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | | | - J Gagnaire
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France
| | - A Bouaziz
- Department of Infectious Diseases, Hospices Civils de Lyon, France
| | - J Karsenty
- Department of Infectious Diseases, Hospices Civils de Lyon, France
| | - C Lacour
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France
| | - M Bes
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France
| | - S Lustig
- INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France; Orthopaedic Surgery department, Hospices Civils de Lyon, France
| | - T Bénet
- Department of Infection Control and Epidemiology, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France
| | - C Chidiac
- Department of Infectious Diseases, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | - J Etienne
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | - F Vandenesch
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | - T Ferry
- Department of Infectious Diseases, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | - F Laurent
- Department of Microbiology, French National Reference Centre for Staphylococci, Hospices Civils de Lyon, France; INSERM U1111, International Centre for Infectiology Research, France; Claude Bernard Lyon 1 University, France
| | | |
Collapse
|
55
|
Abstract
The definition of the heterogeneous group of coagulase-negative staphylococci (CoNS) is still based on diagnostic procedures that fulfill the clinical need to differentiate between Staphylococcus aureus and those staphylococci classified historically as being less or nonpathogenic. Due to patient- and procedure-related changes, CoNS now represent one of the major nosocomial pathogens, with S. epidermidis and S. haemolyticus being the most significant species. They account substantially for foreign body-related infections and infections in preterm newborns. While S. saprophyticus has been associated with acute urethritis, S. lugdunensis has a unique status, in some aspects resembling S. aureus in causing infectious endocarditis. In addition to CoNS found as food-associated saprophytes, many other CoNS species colonize the skin and mucous membranes of humans and animals and are less frequently involved in clinically manifested infections. This blurred gradation in terms of pathogenicity is reflected by species- and strain-specific virulence factors and the development of different host-defending strategies. Clearly, CoNS possess fewer virulence properties than S. aureus, with a respectively different disease spectrum. In this regard, host susceptibility is much more important. Therapeutically, CoNS are challenging due to the large proportion of methicillin-resistant strains and increasing numbers of isolates with less susceptibility to glycopeptides.
Collapse
Affiliation(s)
- Karsten Becker
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Christine Heilmann
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Georg Peters
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| |
Collapse
|
56
|
Giormezis N, Kolonitsiou F, Foka A, Drougka E, Liakopoulos A, Makri A, Papanastasiou AD, Vogiatzi A, Dimitriou G, Marangos M, Christofidou M, Anastassiou ED, Petinaki E, Spiliopoulou I. Coagulase-negative staphylococcal bloodstream and prosthetic-device-associated infections: the role of biofilm formation and distribution of adhesin and toxin genes. J Med Microbiol 2014; 63:1500-1508. [PMID: 25082946 DOI: 10.1099/jmm.0.075259-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Coagulase-negative staphylococci (CNS), especially Staphylococcus epidermidis and Staphylococcus haemolyticus, have emerged as opportunistic pathogens in immunocompromised patients and those with indwelling medical devices. In this study, CNS recovered from patients with bloodstream infections (BSIs) or prosthetic-device-associated infections (PDAIs) were compared in terms of biofilm formation, antimicrobial resistance, clonal distribution, and carriage of adhesin and toxin genes. A total of 226 CNS isolates (168 S. epidermidis and 58 S. haemolyticus) recovered from hospital inpatients with BSIs (100 isolates) or PDAIs (126 isolates) were tested for biofilm formation, antimicrobial susceptibility, and mecA, ica operon, adhesin (aap, bap, fnbA, atlE, fbe) and toxin (tst, sea, sec) genes. The selected CNS were classified into pulsotypes by PFGE and assigned to sequence types by multilocus sequence typing. In total, 106/226 isolates (46.9%) produced biofilm, whereas 150 (66.4%) carried the ica operon. Most isolates carried mecA and were multidrug resistant (90.7%). CNS recovered from BSIs were significantly more likely to produce biofilm (P=0.003), be resistant to antimicrobials and carry mecA (P<0.001), as compared with isolates derived from PDAIs. CNS from PDAIs were more likely to carry the aap and bap genes (P=0.006 and P=0.045, respectively). No significant differences in the carriage of toxin genes were identified (P>0.05). Although PFGE revealed genetic diversity, especially among S. epidermidis, analysis of representative strains from the main PFGE types by multilocus sequence typing revealed three major clones (ST2, ST5 and ST16). A clonal relationship was found with respect to antimicrobial susceptibility and ica and aap gene carriage, reinforcing the premise of clonal expansion in hospital settings. The results of this study suggest that the pathogenesis of BSIs is associated with biofilm formation and high-level antimicrobial resistance, whereas PDAIs are related to the adhesion capabilities of S. epidermidis and S. haemolyticus strains.
Collapse
Affiliation(s)
- Nikolaos Giormezis
- National Reference Laboratory for Staphylococci, Patras, Greece.,Department of Microbiology, School of Medicine, University of Patras, Greece
| | - Fevronia Kolonitsiou
- National Reference Laboratory for Staphylococci, Patras, Greece.,Department of Microbiology, School of Medicine, University of Patras, Greece
| | - Antigoni Foka
- National Reference Laboratory for Staphylococci, Patras, Greece.,Department of Microbiology, School of Medicine, University of Patras, Greece
| | - Eleanna Drougka
- National Reference Laboratory for Staphylococci, Patras, Greece.,Department of Microbiology, School of Medicine, University of Patras, Greece
| | - Apostolos Liakopoulos
- Department of Microbiology, School of Medicine, University of Thessaly, Larissa, Greece
| | - Antonia Makri
- Laboratory of Microbiology, General Children Hospital Pentelis, Athens, Greece
| | | | - Aliki Vogiatzi
- Laboratory of Microbiology, General Children Hospital Pentelis, Athens, Greece
| | - Gabriel Dimitriou
- Neonatal Intensive Care Unit, Department of Paediatrics, School of Medicine, University of Patras, Greece
| | - Markos Marangos
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, University of Patras, Greece
| | - Myrto Christofidou
- Department of Microbiology, School of Medicine, University of Patras, Greece
| | - Evangelos D Anastassiou
- National Reference Laboratory for Staphylococci, Patras, Greece.,Department of Microbiology, School of Medicine, University of Patras, Greece
| | - Efthimia Petinaki
- Department of Microbiology, School of Medicine, University of Thessaly, Larissa, Greece
| | - Iris Spiliopoulou
- National Reference Laboratory for Staphylococci, Patras, Greece.,Department of Microbiology, School of Medicine, University of Patras, Greece
| |
Collapse
|
57
|
Rochford ETJ, Subbiahdoss G, Moriarty TF, Poulsson AHC, van der Mei HC, Busscher HJ, Richards RG. Anin vitroinvestigation of bacteria-osteoblast competition on oxygen plasma-modified PEEK. J Biomed Mater Res A 2014; 102:4427-34. [DOI: 10.1002/jbm.a.35130] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 02/05/2014] [Accepted: 02/11/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Edward T. J. Rochford
- AO Research Institute Davos, 7270 Davos; Switzerland
- Institute of Biological, Environmental and Rural sciences, Aberystwyth University; Wales, United Kingdom
| | - Guruprakash Subbiahdoss
- Department of BioMedical Engineering; University of Groningen and University Medical Center Groningen; Groningen The Netherlands
| | | | | | - Henny C. van der Mei
- Department of BioMedical Engineering; University of Groningen and University Medical Center Groningen; Groningen The Netherlands
| | - Henk J. Busscher
- Department of BioMedical Engineering; University of Groningen and University Medical Center Groningen; Groningen The Netherlands
| | - R. Geoff Richards
- AO Research Institute Davos, 7270 Davos; Switzerland
- Institute of Biological, Environmental and Rural sciences, Aberystwyth University; Wales, United Kingdom
| |
Collapse
|
58
|
Szász M, Hajdú M, Pesti N, Domahidy M, Kristóf K, Zahár A, Nagy K, Szabó D. In vitro efficiency of vancomycin containing experimental drug delivery systems. Acta Microbiol Immunol Hung 2013; 60:461-8. [PMID: 24292089 DOI: 10.1556/amicr.60.2013.4.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Biofilm-forming Staphylococcus epidermidis strains are common cause of the periprosthetic infection. The treatment of the periprosthetic infection is very problematic, so the prevention of these infections by an antibiotic containing prothesis could be an option for prevention.The purpose of the present study was to examine the in vitro effects of drug delivery systems (DDSs), namely Wax 1 and Wax 2 with different vancomycin content: 0.5, 1, 2 and 4 mg. In order to control the antibacterial activity of DDSs killing curve study was performed and in order to determine the antibiotic release and the antibiotic peak concentration from the DDSs biological assay was carried out.The time kill curve studies showed, that both DDSs with all vancomycin concentration decreased significantly the bacterial counts, however, Wax 2 with 4 mg vancomycin significantly decreased the bacterial count than all the other groups.The vancomycin release was the best with the highest peak concentration from DDSs with 4 mg vancomycin contain; it was significantly better than in the other groups, however, no significant difference was observed between Wax 1 and Wax 2 in this respect.These findings suggest that Wax 2 with 4 mg vancomycin content could be a potential agent for clinical use.
Collapse
Affiliation(s)
- Máté Szász
- Semmelweis University Institute of Medical Microbiology Budapest Hungary
| | | | | | | | | | | | | | | |
Collapse
|