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Burke Ó, Zeden MS, O'Gara JP. The pathogenicity and virulence of the opportunistic pathogen Staphylococcus epidermidis. Virulence 2024; 15:2359483. [PMID: 38868991 DOI: 10.1080/21505594.2024.2359483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/19/2024] [Indexed: 06/14/2024] Open
Abstract
The pervasive presence of Staphylococcus epidermidis and other coagulase-negative staphylococci on the skin and mucous membranes has long underpinned a casual disregard for the infection risk that these organisms pose to vulnerable patients in healthcare settings. Prior to the recognition of biofilm as an important virulence determinant in S. epidermidis, isolation of this microorganism in diagnostic specimens was often overlooked as clinically insignificant with potential delays in diagnosis and onset of appropriate treatment, contributing to the establishment of chronic infection and increased morbidity or mortality. While impressive progress has been made in our understanding of biofilm mechanisms in this important opportunistic pathogen, research into other virulence determinants has lagged S. aureus. In this review, the broader virulence potential of S. epidermidis including biofilm, toxins, proteases, immune evasion strategies and antibiotic resistance mechanisms is surveyed, together with current and future approaches for improved therapeutic interventions.
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Affiliation(s)
- Órla Burke
- Microbiology, School of Biological and Chemical Sciences, University of Galway, Galway, Ireland
| | | | - James P O'Gara
- Microbiology, School of Biological and Chemical Sciences, University of Galway, Galway, Ireland
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Zarif ME, Bita B, Yehia-Alexe SA, Negut I, Gradisteanu Pircalabioru G, Andronescu E, Groza A. Biological and Physicochemical Analysis of Sr-Doped Hydroxyapatite/Chitosan Composite Layers. Polymers (Basel) 2024; 16:1922. [PMID: 39000777 PMCID: PMC11244040 DOI: 10.3390/polym16131922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/06/2024] [Accepted: 07/02/2024] [Indexed: 07/17/2024] Open
Abstract
In this work results are presented on the evaluation of HAp, HApSr, HAp_CS, and HApSr_CS layers deposited on Ti substrates regarding L929 cell viability and cytotoxicity as well as antimicrobial activity against Staphylococcus aureus, in connection with their physicochemical properties. The HAp and HApSr layers generated by radio-frequency magnetron sputtering technique were further covered with chitosan by a matrix-assisted pulsed laser evaporation technique. During the plasma depositions, the Ti substrates were heated externally by a home-made oven above 100 °C. The HApSr_CS layers generated on the unpolished Ti substrates at 100 °C and 400 °C showed the highest biocompatibility properties and antimicrobial activity against Staphylococcus aureus. The morphology of the layer surfaces, revealed by scanning electron microscopy, is dependent on substrate temperature and substrate surface roughness. The optically polished surfaces of Ti substrates revealed grain-like and microchannel structure morphologies of the layers deposited at 25 °C substrate temperature and 400 °C, respectively. Chitosan has no major influence on HAp and HApSr layer surface morphologies. X-ray photoelectron spectroscopy indicated the presence of Ca 2p3/2 peak characteristic of the HAp structure even in the case of the HApSr_CS samples generated at a 400 °C substrate temperature. Fourier transform infrared spectroscopy investigations showed shifts in the wavenumber positions of the P-O absorption bands as a function of Sr or chitosan presence in the HAp layers generated at 25, 100, and 400 °C substrate temperatures.
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Affiliation(s)
- Maria Elena Zarif
- National Institute for Lasers, Plasma and Radiation Physics, 077125 Măgurele, Romania; (M.E.Z.); (B.B.); (S.A.Y.-A.); (I.N.)
- Faculty of Chemical Engineering and Biotechnologies, University Politehnica of Bucharest, 011061 Bucharest, Romania;
| | - Bogdan Bita
- National Institute for Lasers, Plasma and Radiation Physics, 077125 Măgurele, Romania; (M.E.Z.); (B.B.); (S.A.Y.-A.); (I.N.)
- Faculty of Physics, University of Bucharest, 077125 Măgurele, Romania
| | - Sasa Alexandra Yehia-Alexe
- National Institute for Lasers, Plasma and Radiation Physics, 077125 Măgurele, Romania; (M.E.Z.); (B.B.); (S.A.Y.-A.); (I.N.)
- Faculty of Physics, University of Bucharest, 077125 Măgurele, Romania
| | - Irina Negut
- National Institute for Lasers, Plasma and Radiation Physics, 077125 Măgurele, Romania; (M.E.Z.); (B.B.); (S.A.Y.-A.); (I.N.)
| | - Gratiela Gradisteanu Pircalabioru
- eBio-Hub Research Center, University Politehnica of Bucharest-CAMPUS, 6 Iuliu Maniu Boulevard, 061344 Bucharest, Romania;
- Research Institute of the University of Bucharest (ICUB), University of Bucharest, 050657 Bucharest, Romania
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest, 050657 Bucharest, Romania
| | - Ecaterina Andronescu
- Faculty of Chemical Engineering and Biotechnologies, University Politehnica of Bucharest, 011061 Bucharest, Romania;
- Academy of Romanian Scientists, 3 Ilfov Str., District 5, 050044 Bucharest, Romania
- National Research Center for Micro and Nanomaterials, University Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Andreea Groza
- National Institute for Lasers, Plasma and Radiation Physics, 077125 Măgurele, Romania; (M.E.Z.); (B.B.); (S.A.Y.-A.); (I.N.)
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Kamphof R, Lima RN, Schoones JW, Arts JJ, Nelissen RG, Cama G, Pijls BG. Antimicrobial activity of ion-substituted calcium phosphates: A systematic review. Heliyon 2023; 9:e16568. [PMID: 37303579 PMCID: PMC10248076 DOI: 10.1016/j.heliyon.2023.e16568] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/13/2023] Open
Abstract
In this systematic review, the antimicrobial effect of ion-substituted calcium phosphate biomaterials was quantitatively assessed. The literature was systematically searched up to the 6th of December 2021. Study selection and data extraction was performed in duplo by two independent reviewers with a modified version of the OHAT tool for risk of bias assessment. Any differences were resolved by consensus or by a referee. A mixed effects model was used to investigate the relation between the degree of ionic substitution and bacterial reduction. Of 1016 identified studies, 108 were included in the analysis. The methodological quality of included studies ranged from 6 to 16 out of 18 (average 11.4). Selenite, copper, zinc, rubidium, gadolinium, silver and samarium had a clear antimicrobial effect, with a log reduction in bacteria count of 0.23, 1.8, 2.1, 3.6, 5.8, 7.4 and 10 per atomic% of substitution, respectively. There was considerable between-study variation, which could partially be explained by differences in material formulation, study quality and microbial strain. Future research should focus on clinically relevant scenarios in vitro and the translation to in vivo prevention of PJI.
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Affiliation(s)
- Robert Kamphof
- Leiden University Medical Center, Department of Orthopaedics, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - Rui N.O. Lima
- CAM Bioceramics B.V., Zernikedreef 6, 2333, CL, Leiden, the Netherlands
- Delft University of Technology, Mekelweg 5, 2628, CD, Delft, the Netherlands
| | - Jan W. Schoones
- Leiden University Medical Centre, Directorate of Research Policy, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - Jacobus J. Arts
- Maastricht University Medical Centre, Department of Orthopaedic SurgeryP., Debyelaan 25, 6229, HX, Maastricht, the Netherlands
| | - Rob G.H.H. Nelissen
- Leiden University Medical Center, Department of Orthopaedics, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - Giuseppe Cama
- CAM Bioceramics B.V., Zernikedreef 6, 2333, CL, Leiden, the Netherlands
| | - Bart G.C.W. Pijls
- Leiden University Medical Center, Department of Orthopaedics, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
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Wang X, Diwu W, Guo J, Yan M, Ma W, Yang M, Bi L, Han Y. Enhancement of antibacterial properties and biocompatibility of Ti 6Al 4V by graphene oxide/strontium nanocomposite electrodepositing. Biochem Biophys Res Commun 2023; 665:35-44. [PMID: 37156051 DOI: 10.1016/j.bbrc.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/19/2023] [Accepted: 05/01/2023] [Indexed: 05/10/2023]
Abstract
Ti6Al4V is a widely used orthopedic implant material in clinics. Due to its poor antibacterial properties, surface modification is required to prevent peri-implantation infection. However, chemical linkers used for surface modification have generally been reported to have detrimental effects on cell growth. In this work, by optimizing parameters related to electrodeposition, a composite structural coating with graphene oxide (GO) compact films in the inner layer and 35 nm diameter strontium (Sr) nanoparticles in the outer layer was constructed on the surface of Ti6Al4V without using substance harmful to bone marrow mesenchymal stem cells (BMSCs) growth. The antibacterial properties of Ti6Al4V are enhanced by the controlled release of Sr ions and incomplete masking of the GO surface, showing excellent antibacterial activity against Staphylococcus aureus in bacterial culture assays. The biomimetic GO/Sr coating has a reduced roughness of the implant surface and a water contact angle of 44.1°, improving the adhesion, proliferation and differentiation of BMSCs. Observations of synovial tissue and fluid in the joint in an implantation model of rabbit knee also point to the superior anti-infective properties of the novel GO/Sr coating. In summary, the novel GO/Sr nanocomposite coating on the surface of Ti6Al4V effectively prevents surface colonization of Staphylococcus aureus and eliminates local infections in vitro and in vivo.
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Affiliation(s)
- Xing Wang
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, People's Republic of China; Department of Medical Identification, The Air Force Medical Center, Beijing, People's Republic of China
| | - Weilong Diwu
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, People's Republic of China
| | - Jianbin Guo
- Department of Joint Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, People's Republic of China
| | - Ming Yan
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, People's Republic of China
| | - Wenrui Ma
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, People's Republic of China
| | - Min Yang
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, People's Republic of China
| | - Long Bi
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, People's Republic of China.
| | - Yisheng Han
- Department of Orthopedics, The First Affiliated Hospital of Air Force Military Medical University, People's Republic of China.
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Wang H, Zheng TX, Yang NY, Li Y, Sun H, Dong W, Feng LF, Deng JP, Qi MC. Osteogenic and long-term antibacterial properties of Sr/Ag-containing TiO 2 microporous coating in vitro and in vivo. J Mater Chem B 2023; 11:2972-2988. [PMID: 36919628 DOI: 10.1039/d2tb01658c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Bacterial infection and poor osseointegration are two critical issues that need to be solved for long-term use of titanium implants. As such, Sr/Ag-containing TiO2 microporous coatings were prepared on a Ti alloy surface in the current study via a single-step microarc oxidation technique. The coatings showed both good cytocompatibility in vitro and biosafety in vivo. Sr/Ag incorporation brought no significant change in the surface micromorphology and physicochemical properties, but endowed the coating with strong osteogenic activity and long-term antibacterial capability in vitro. Furthermore, the osteogenic and antibacterial capability of the coating was also confirmed in vivo. In a rat osseointegration model, new bone formation, implant-bone contact, removal torque and bone mineralization were all significantly increased in the M-Sr/Ag group when compared with those in group M, although they were slightly lower than those in group M-Sr. In a periimplantitis model, no rats suffered infection in the M-Sr/Ag group after 3 months of osseointegration and 5 weeks of bacterial inoculation period, when compared to 100% and 75% infection rates in M and M-Sr groups, respectively. In addition, active bone remodeling and many mesenchymal cells were observed in the M-Sr group, suggesting good bone regeneration potential in Sr-containing coatings in the case of controlled periimplantitis. Overall, the Sr/Ag-containing TiO2 microporous coating is valuable for preventing periimplantitis and improving implant reosseointegration, and is therefore promising for long-term and high quality use of titanium implants.
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Affiliation(s)
- Huan Wang
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Tian-Xia Zheng
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Nuo-Ya Yang
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Ying Li
- Department of Stomatology, First Hospital of Qinhuangdao, Qinhuangdao City, Hebei Province, China
| | - Hong Sun
- Department of Pathology, College of Basic Medicine, North China University of Science and Technology, Tangshan, Hebei Province, China
| | - Wei Dong
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Li-Fang Feng
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Jiu-Peng Deng
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
| | - Meng-Chun Qi
- Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, 21, Bohai Road, District of Caofeidian (063210), Tangshan City, Hebei Province, P. R. China.
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Strategies to Mitigate and Treat Orthopaedic Device-Associated Infections. Antibiotics (Basel) 2022; 11:antibiotics11121822. [PMID: 36551479 PMCID: PMC9774155 DOI: 10.3390/antibiotics11121822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/03/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022] Open
Abstract
Orthopaedic device implants play a crucial role in restoring functionality to patients suffering from debilitating musculoskeletal diseases or to those who have experienced traumatic injury. However, the surgical implantation of these devices carries a risk of infection, which represents a significant burden for patients and healthcare providers. This review delineates the pathogenesis of orthopaedic implant infections and the challenges that arise due to biofilm formation and the implications for treatment. It focuses on research advancements in the development of next-generation orthopaedic medical devices to mitigate against implant-related infections. Key considerations impacting the development of devices, which must often perform multiple biological and mechanical roles, are delineated. We review technologies designed to exert spatial and temporal control over antimicrobial presentation and the use of antimicrobial surfaces with intrinsic antibacterial activity. A range of measures to control bio-interfacial interactions including approaches that modify implant surface chemistry or topography to reduce the capacity of bacteria to colonise the surface, form biofilms and cause infections at the device interface and surrounding tissues are also reviewed.
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Antibacterial and Cytocompatible: Combining Silver Nitrate with Strontium Acetate Increases the Therapeutic Window. Int J Mol Sci 2022; 23:ijms23158058. [PMID: 35897634 PMCID: PMC9331456 DOI: 10.3390/ijms23158058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/16/2022] [Accepted: 07/19/2022] [Indexed: 02/01/2023] Open
Abstract
Microbial infection and insufficient tissue formation are considered to be the two main causes of dental implant failure. Novel studies have focused on designing dual-functional strategies to promote antibacterial properties and improve tissue cell response simultaneously. In this study, we investigated the antibacterial properties and cytocompatibility of silver nitrate (AgNO3) and strontium acetate (SrAc) in a mono-culture setup for dental application. Additionally, we defined the therapeutic window between the minimum inhibitory concentration against pathogenic bacteria and maximum cytocompatible dose in the case of combined applications in a co-culture setup. Antibacterial properties were screened using Aggregatibacter actinomycetemcomitans and cell response experiments were performed with osteoblastic cells (MC3T3) and fibroblastic cells (NIH3T3). The osteoinductive behavior was investigated separately on MC3T3 cells using alizarin red staining. A therapeutic window for AgNO3 as well as SrAc applications could be defined in the case of MC3T3 cells while the cytocompatibility of NIH3T3 cells was compromised for all concentrations with an antibacterial effect. However, the combined application of AgNO3/SrAc caused an enhanced antibacterial effect and opened a therapeutic window for both cell lines. Enhanced mineralization rates could be observed in cultures containing SrAc. In conclusion, we were able to demonstrate that adding SrAc to AgNO3 not only intensifies antibacterial properties but also exhibits bone inductive characteristics, thereby offering a promising strategy to combat peri-implantitis and at the same time improve osseointegration in implant therapy.
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Antibacterial Optimization of Highly Deformed Titanium Alloys for Spinal Implants. Molecules 2021; 26:molecules26113145. [PMID: 34074062 PMCID: PMC8197332 DOI: 10.3390/molecules26113145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 12/31/2022] Open
Abstract
The goal of the work was to develop materials dedicated to spine surgery that minimized the potential for infection originating from the transfer of bacteria during long surgeries. The bacteria form biofilms, causing implant loosening, pain and finally, a risk of paralysis for patients. Our strategy focused both on improvement of antibacterial properties against bacteria adhesion and on wear and corrosion resistance of tools for spine surgery. Further, a ~35% decrease in implant and tool dimensions was expected by introducing ultrahigh-strength titanium alloys for less-invasive surgeries. The tested materials, in the form of thin, multi-layered coatings, showed nanocrystalline microstructures. Performed direct-cytotoxicity studies (including lactate dehydrogenase activity measurement) showed that there was a low probability of adverse effects on surrounding SAOS-2 (Homo sapiens bone osteosarcoma) cells. The microbiological studies (e.g., ISO 22196 contact tests) showed that implanting Ag nanoparticles into Ti/TixN coatings inhibited the growth of E. coli and S. aureus cells and reduced their adhesion to the material surface. These findings suggest that Ag-nanoparticles present in implant coatings may potentially minimize infection risk and lower inherent stress.
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