1
|
Conde A, Voces D, Medel-Plaza M, Perales C, de Ávila AI, Aguilera-Correa JJ, de Damborenea JJ, Esteban J, Domingo E, Arenas MA. Fluoride anodic films on stainless-steel fomites to reduce transmission infections. Appl Environ Microbiol 2024; 90:e0189223. [PMID: 38289132 PMCID: PMC10880592 DOI: 10.1128/aem.01892-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/05/2024] [Indexed: 02/22/2024] Open
Abstract
The growing concern arising from viruses with pandemic potential and multi-resistant bacteria responsible for hospital-acquired infections and outbreaks of food poisoning has led to an increased awareness of indirect contact transmission. This has resulted in a renewed interest to confer antimicrobial properties to commonly used metallic materials. The present work provides a full characterization of optimized fluoride anodic films grown in stainless steel 304L as well as their antimicrobial properties. Antibacterial tests show that the anodic film, composed mainly of chromium and iron fluorides, reduces the count and the percentage of the area covered by 50% and 87.7% for Pseudomonas aeruginosa and Stenotrophomonas maltophilia, respectively. Virologic tests show that the same treatment reduces the infectivity of the coronavirus HCoV-229E-GFP, in comparison with the non-anodized stainless steel 304L.IMPORTANCEThe importance of environmental surfaces as a source of infection is a topic of particular interest today, as many microorganisms can survive on these surfaces and infect humans through direct contact. Modification of these surfaces by anodizing has been shown to be useful for some alloys of medical interest. This work evaluates the effect of anodizing on stainless steel, a metal widely used in a variety of applications. According to the study, the fluoride anodic layers reduce the colonization of the surfaces by both bacteria and viruses, thus reducing the risk of acquiring infections from these sources.
Collapse
Affiliation(s)
- Ana Conde
- Centro Nacional de Investigaciones Metalúrgicas, CENIM-CSIC, Madrid, Spain
- CIBERINFEC, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Infecciosas, Madrid, Spain
| | - Daniel Voces
- Centro Nacional de Investigaciones Metalúrgicas, CENIM-CSIC, Madrid, Spain
| | | | - Celia Perales
- IIS-Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
- Centro Nacional de Biotecnología, CNB-CSIC, Madrid, Spain
- CIBEREHD, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Hepáticas y Digestivas, Madrid, Spain
| | - Ana Isabel de Ávila
- CIBEREHD, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Hepáticas y Digestivas, Madrid, Spain
- Centro de Biología Molecular Severo Ochoa (CBMSO) (CSIC-UAM), Madrid, Spain
| | - John Jairo Aguilera-Correa
- CIBERINFEC, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Infecciosas, Madrid, Spain
- Pathogénie mycobactérienne et nouvelles cibles thérapeutiques, Institut de Recherche en Infectiologie de Montpellier, Montpellier, France
| | - Juan Jose de Damborenea
- Centro Nacional de Investigaciones Metalúrgicas, CENIM-CSIC, Madrid, Spain
- CIBERINFEC, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Infecciosas, Madrid, Spain
| | - Jaime Esteban
- CIBERINFEC, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Infecciosas, Madrid, Spain
- IIS-Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Esteban Domingo
- CIBEREHD, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Hepáticas y Digestivas, Madrid, Spain
- Centro de Biología Molecular Severo Ochoa (CBMSO) (CSIC-UAM), Madrid, Spain
| | - Maria Angeles Arenas
- Centro Nacional de Investigaciones Metalúrgicas, CENIM-CSIC, Madrid, Spain
- CIBERINFEC, CENTRO DE INVESTIGACIÓN BIOMEDICA EN RED Enfermedades Infecciosas, Madrid, Spain
| |
Collapse
|
2
|
Yang X, Chen NF, Huang XL, Lin S, Chen QQ, Wang WM, Chen JS. Iodine-doped TiO 2 nanotube coatings: a technique for enhancing the antimicrobial properties of titanium surfaces against Staphylococcus aureus. J Orthop Surg Res 2023; 18:854. [PMID: 37950251 PMCID: PMC10636994 DOI: 10.1186/s13018-023-04354-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Implant-related infections are a challenging complication of orthopedic surgery, primarily due to the formation of bacterial biofilms on the implant surface. An antibacterial coating for titanium implants was developed to provide novel insights into the prevention and treatment of implant-related infections. METHODS Titanium plates were coated with TiO2 nanotubes by anodization, and iodine was doped onto the coating via electrophoretic deposition. The obtained plates were characterized using a range of analytical techniques. Subsequently, Staphylococcus aureus was inoculated onto the surfaces of untreated titanium plates (control group), TiO2-nanocoated titanium plates (TiO2 group), and iodine-doped TiO2-nanocoated titanium plates (I-TiO2 group) to compare their antibacterial properties. RESULTS Twenty-four hour in vitro antimicrobial activity test of the I-TiO2 group against Staphylococcus aureus was superior to those of the other groups, and this difference was statistically significant (P < 0.05). CONCLUSIONS This coating technology provides a new theoretical basis for the development of anti-infective implants against Staphylococcus aureus in orthopedics.
Collapse
Affiliation(s)
- Xiu Yang
- Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350000, China
- The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, 350000, China
| | | | | | - Shun Lin
- Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350000, China
| | - Qing-Quan Chen
- Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350000, China
| | - Wan-Ming Wang
- Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350000, China.
| | - Jin-Shui Chen
- Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350000, China.
- The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, 350000, China.
| |
Collapse
|
3
|
Martín-García M, Aguilera-Correa JJ, Arenas MÁ, García-Diego IM, Conde A, de Damborenea JJ, Esteban J. Differences in In Vitro Bacterial Adherence between Ti6Al4V and CoCrMo Alloys. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1505. [PMID: 36837133 PMCID: PMC9959577 DOI: 10.3390/ma16041505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/20/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Prosthetic joint infection is an uncommon entity, but it supposes high costs, both from the economic side to the health systems and from the emotional side of the patient. The evaluation of the bacterial adherence to different materials frequently involved in joint prostheses allows us to better understand the mechanisms underlying this and provide information for the future development of prevention strategies. This study evaluated the bacterial adherence of four different species (Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa) on Ti6Al4V and CoCrMo. The topography, surface contact angles, and linear average roughness were measured in the samples from both alloys. The interaction with the surface of both alloys was significantly different, with the CoCrMo showing an aggregating effect on all the species, with additional anti-adherent activity in the case of Pseudomonas aeruginosa. The viability also changes, with a significant decrease (p < 0.05) in the CoCrMo alloy. In the case of S. epidermidis, the viability in the supernatant from the samples was different, too, with a decrease in the colony-forming units in the Ti6Al4V, which could be related to cation release from the surface. Beyond adhesion is a multifactorial and complex process, and considering that topography and wettability were similar, the chemical composition could play a main role in the different properties observed.
Collapse
Affiliation(s)
- Marta Martín-García
- Department of Clinical Microbiology, University Hospital Fundación Jiménez Díaz, IIS-FJD, 28040 Madrid, Spain
| | - John Jairo Aguilera-Correa
- Department of Clinical Microbiology, University Hospital Fundación Jiménez Díaz, IIS-FJD, 28040 Madrid, Spain
- CIBERINFEC—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Ángeles Arenas
- CIBERINFEC—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Surface Engineering Corrosion and Durability, National Centre for Metallurgical Research (CENIM-CSIC), 28040 Madrid, Spain
| | - Ignacio M. García-Diego
- Department of Surface Engineering Corrosion and Durability, National Centre for Metallurgical Research (CENIM-CSIC), 28040 Madrid, Spain
| | - Ana Conde
- CIBERINFEC—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Surface Engineering Corrosion and Durability, National Centre for Metallurgical Research (CENIM-CSIC), 28040 Madrid, Spain
| | - Juan José de Damborenea
- CIBERINFEC—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Surface Engineering Corrosion and Durability, National Centre for Metallurgical Research (CENIM-CSIC), 28040 Madrid, Spain
| | - Jaime Esteban
- Department of Clinical Microbiology, University Hospital Fundación Jiménez Díaz, IIS-FJD, 28040 Madrid, Spain
- CIBERINFEC—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
| |
Collapse
|
4
|
Esteban J, Vallet-Regí M, Aguilera-Correa JJ. Antibiotics- and Heavy Metals-Based Titanium Alloy Surface Modifications for Local Prosthetic Joint Infections. Antibiotics (Basel) 2021; 10:1270. [PMID: 34680850 PMCID: PMC8532710 DOI: 10.3390/antibiotics10101270] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 01/04/2023] Open
Abstract
Prosthetic joint infection (PJI) is the second most common cause of arthroplasty failure. Though infrequent, it is one of the most devastating complications since it is associated with great personal cost for the patient and a high economic burden for health systems. Due to the high number of patients that will eventually receive a prosthesis, PJI incidence is increasing exponentially. As these infections are provoked by microorganisms, mainly bacteria, and as such can develop a biofilm, which is in turn resistant to both antibiotics and the immune system, prevention is the ideal approach. However, conventional preventative strategies seem to have reached their limit. Novel prevention strategies fall within two broad categories: (1) antibiotic- and (2) heavy metal-based surface modifications of titanium alloy prostheses. This review examines research on the most relevant titanium alloy surface modifications that use antibiotics to locally prevent primary PJI.
Collapse
Affiliation(s)
- Jaime Esteban
- Clinical Microbiology Department, Jiménez Díaz Foundation Health Research Institute, Autonomous University of Madrid, Av. Reyes Católicos 2, 28040 Madrid, Spain
- Networking Research Centre on Infectious Diseases (CIBER-ID), 28029 Madrid, Spain
| | - María Vallet-Regí
- Department of Chemistry in Pharmaceutical Sciences, Research Institute Hospital 12 de Octubre (i+12), School of Pharmacy, Complutense University of Madrid, Pza. Ramón y Cajal s/n, 28040 Madrid, Spain
- Networking Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| | - John J Aguilera-Correa
- Networking Research Centre on Infectious Diseases (CIBER-ID), 28029 Madrid, Spain
- Department of Chemistry in Pharmaceutical Sciences, Research Institute Hospital 12 de Octubre (i+12), School of Pharmacy, Complutense University of Madrid, Pza. Ramón y Cajal s/n, 28040 Madrid, Spain
| |
Collapse
|
5
|
Abstract
Stenotrophomonas maltophilia is an opportunistic pathogen of significant concern to susceptible patient populations. This pathogen can cause nosocomial and community-acquired respiratory and bloodstream infections and various other infections in humans. Sources include water, plant rhizospheres, animals, and foods. Studies of the genetic heterogeneity of S. maltophilia strains have identified several new genogroups and suggested adaptation of this pathogen to its habitats. The mechanisms used by S. maltophilia during pathogenesis continue to be uncovered and explored. S. maltophilia virulence factors include use of motility, biofilm formation, iron acquisition mechanisms, outer membrane components, protein secretion systems, extracellular enzymes, and antimicrobial resistance mechanisms. S. maltophilia is intrinsically drug resistant to an array of different antibiotics and uses a broad arsenal to protect itself against antimicrobials. Surveillance studies have recorded increases in drug resistance for S. maltophilia, prompting new strategies to be developed against this opportunist. The interactions of this environmental bacterium with other microorganisms are being elucidated. S. maltophilia and its products have applications in biotechnology, including agriculture, biocontrol, and bioremediation.
Collapse
|
6
|
Auñón Á, Esteban J, Doadrio AL, Boiza-Sánchez M, Mediero A, Eguibar-Blázquez D, Cordero-Ampuero J, Conde A, Arenas MÁ, de-Damborenea JJ, Aguilera-Correa JJ. Staphylococcus aureus Prosthetic Joint Infection Is Prevented by a Fluorine- and Phosphorus-Doped Nanostructured Ti-6Al-4V Alloy Loaded With Gentamicin and Vancomycin. J Orthop Res 2020; 38:588-597. [PMID: 31608498 DOI: 10.1002/jor.24496] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 10/04/2019] [Indexed: 02/04/2023]
Abstract
Prosthetic joint infection (PJI) is one of the most devastating complications in orthopedic surgery. One approach used to prevent PJI is local antibiotic therapy. This study evaluates the antibiotic release, in vitro cytocompatibility and in vivo effectiveness in preventing PJI caused by Staphylococcus aureus (S. aureus) of the fluorine- and phosphorus-doped, bottle-shaped, nanostructured (bNT) Ti-6Al-4V alloy loaded with a mixture of gentamicin and vancomycin (GV). We evaluated bNT Ti-6Al-4V loading with a mixture of GV, measuring the release of these antibiotics using high-performance liquid chromatography. Further, we describe bNT Ti-6Al-4V GV cytocompatibility and its efficacy against S. aureus using an in vivo rabbit model. GV was released from bNT Ti-6Al-4V following a Boltzmann non-linear model and maximum release values were obtained at 240 min for both antibiotics. The cell proliferation of MCT3T3-E1 osteoblastic cells significantly increased at 48 (28%) and 168 h (68%), as did the matrix mineralization (52%) of these cells and the gene expression of three of the most important markers related to bone differentiation (more than threefold for VEGF and BGLAP, and 65% for RunX) on bNT Ti-6Al-4V GV compared with control. In vivo study results show that bNT Ti-6Al-4V GV can prevent S. aureus PJI according to histopathological and microbiological results. According to our results, bNT Ti-6Al-4V loaded with a mixture of GV using the soaking method is a promising biomaterial with favorable cytocompatibility and osteointegration, demonstrating local bactericidal properties against S. aureus. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:588-597, 2020.
Collapse
Affiliation(s)
- Álvaro Auñón
- Department of Orthopedic Surgery, Fundación Jiménez Díaz University Hospital, Av. Reyes Católicos, 2, 28040, Madrid, Spain
| | - Jaime Esteban
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM, Av. Reyes Católicos, 2, 28040, Madrid, Spain
| | - Antonio L Doadrio
- Department of Inorganic and Bioinorganic Chemistry, Health Research Institute, Complutense University of Madrid, 12 de Octubre i+12, 28040, Madrid, Spain
| | - Macarena Boiza-Sánchez
- Department of Pathology, Fundación Jiménez Díaz University Hospital, Av. Reyes Católicos, 2, 28040, Madrid, Spain
| | - Aranzazu Mediero
- Joint and Bone Research Unit, IIS-Fundación Jimenez Diaz, UAM, Av. Reyes Católicos, 2, 28040, Madrid, Spain
| | - Diego Eguibar-Blázquez
- Department of Experimental Surgery and Animal Research, IIS-Fundación Jimenez Diaz, UAM, Av. Reyes Católicos, 2, 28040, Madrid, Spain
| | - José Cordero-Ampuero
- Department of Orthopaedic Surgery, University Hospital La Princesa, c/Océano Antártico 41, 28760, Tres Cantos, Spain
| | - Ana Conde
- Corrosion and Material Protection Group, Surface Engineering, Corrosion and Durability Department National Center for Metallurgical Research, (CENIM-CSIC) Av. Gregorio del Amo, 8, Madrid, 28040, Spain
| | - María-Ángeles Arenas
- Corrosion and Material Protection Group, Surface Engineering, Corrosion and Durability Department National Center for Metallurgical Research, (CENIM-CSIC) Av. Gregorio del Amo, 8, Madrid, 28040, Spain
| | - Juan-José de-Damborenea
- Corrosion and Material Protection Group, Surface Engineering, Corrosion and Durability Department National Center for Metallurgical Research, (CENIM-CSIC) Av. Gregorio del Amo, 8, Madrid, 28040, Spain
| | - John J Aguilera-Correa
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM, Av. Reyes Católicos, 2, 28040, Madrid, Spain
| |
Collapse
|
7
|
Aguilera-Correa JJ, Auñón Á, Boiza-Sánchez M, Mahillo-Fernández I, Mediero A, Eguibar-Blázquez D, Conde A, Arenas MÁ, de-Damborenea JJ, Cordero-Ampuero J, Esteban J. Urine Aluminum Concentration as a Possible Implant Biomarker of Pseudomonas aeruginosa Infection Using a Fluorine- and Phosphorus-Doped Ti-6Al-4V Alloy with Osseointegration Capacity. ACS OMEGA 2019; 4:11815-11823. [PMID: 31460290 PMCID: PMC6682075 DOI: 10.1021/acsomega.9b00898] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/10/2019] [Indexed: 06/10/2023]
Abstract
Joint prosthesis failure is mainly related to aseptic loosening and prosthetic joint infections, both associated with high morbidity and a substantial cost burden for patients and health systems. The development of a biomaterial capable of stimulating bone growth while minimizing bacterial adhesion would reduce the incidence of prosthetic failure. Using an in vivo rabbit model, this study evaluates the osseointegration effect of the fluorine (F)- and phosphorus (P)-doped bottle-shaped nanostructured (bNT) Ti-6Al-4V alloy and effectiveness of monitoring urine aluminum concentration to determine the presence of Pseudomonas aeruginosa infection in Ti-6Al-4V implants. Unlike chemically polished (CP) Ti-6Al-4V alloy implants, bNT Ti-6Al-4V alloy implants promoted osseointegration and showed effectiveness as a biomaterial marker. The bNT Ti-6Al-4V alloy implants were associated with a twofold increase in bone thickness and up to 15% greater bone density compared to the CP alloy. Additionally, bNT Ti-6Al-4V alloy implants allowed for discrimination between P. aeruginosa-infected and noninfected animals for 15 days postoperatively, as indicated by the decrease of aluminum concentration in urine, while this difference was only appreciable over the first 7 days when CP Ti-6Al-4V alloy implants were used. Therefore, bNT Ti-6Al-4V alloys could have clinical applications by detecting the infection and by avoiding aseptic loosening.
Collapse
Affiliation(s)
- John-Jairo Aguilera-Correa
- Clinical Microbiology Department, Joint and Bone Research Unit,
and Experimental Surgery and
Animal Research Service, IIS-Fundación
Jimenez Diaz, UAM. Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Álvaro Auñón
- Orthopedic Surgery Service, Pathology Department, and Epidemiology
and Biostatistics
Service, Fundación Jiménez
Díaz University Hospital, Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Macarena Boiza-Sánchez
- Orthopedic Surgery Service, Pathology Department, and Epidemiology
and Biostatistics
Service, Fundación Jiménez
Díaz University Hospital, Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Ignacio Mahillo-Fernández
- Orthopedic Surgery Service, Pathology Department, and Epidemiology
and Biostatistics
Service, Fundación Jiménez
Díaz University Hospital, Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Aranzazu Mediero
- Clinical Microbiology Department, Joint and Bone Research Unit,
and Experimental Surgery and
Animal Research Service, IIS-Fundación
Jimenez Diaz, UAM. Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Diego Eguibar-Blázquez
- Clinical Microbiology Department, Joint and Bone Research Unit,
and Experimental Surgery and
Animal Research Service, IIS-Fundación
Jimenez Diaz, UAM. Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Ana Conde
- Corrosion
and Material Protection Group, National
Center for Metallurgical Research (CENIM-CSIC), Av. Gregorio del Amo, 8, 28040 Madrid, Spain
| | - María-Ángeles Arenas
- Corrosion
and Material Protection Group, National
Center for Metallurgical Research (CENIM-CSIC), Av. Gregorio del Amo, 8, 28040 Madrid, Spain
| | - Juan-José de-Damborenea
- Corrosion
and Material Protection Group, National
Center for Metallurgical Research (CENIM-CSIC), Av. Gregorio del Amo, 8, 28040 Madrid, Spain
| | - José Cordero-Ampuero
- Department
of Orthopaedic Surgery, University Hospital
La Princesa, c/Diego de León 62, 28006 Madrid, Spain
| | - Jaime Esteban
- Clinical Microbiology Department, Joint and Bone Research Unit,
and Experimental Surgery and
Animal Research Service, IIS-Fundación
Jimenez Diaz, UAM. Av. Reyes Católicos, 2, 28040 Madrid, Spain
| |
Collapse
|