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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Orthop+Relat+Res
2015 ; 473
(3
): 974-86
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Do crosslinking and vitamin E stabilization influence microbial adhesions on
UHMWPE-based biomaterials?
#MMPMID25367109
Banche G
; Bracco P
; Allizond V
; Bistolfi A
; Boffano M
; Cimino A
; Brach del Prever EM
; Cuffini AM
Clin Orthop Relat Res
2015[Mar]; 473
(3
): 974-86
PMID25367109
show ga
BACKGROUND: Microorganism adhesion on polyethylene for total joint arthroplasty
is a concern. Many studies have focused on vitamin E-stabilized
ultrahigh-molecular-weight polyethylene (UHMWPE), whereas first-generation,
highly crosslinked UHMWPE, which is the most commonly used in clinical practice,
has been scarcely evaluated. QUESTIONS/PURPOSES: We aimed (1) to compare the
adherence of Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli,
and Candida albicans with virgin (untreated) UHMWPE (PE) and crosslinked UHMWPE
(XLPE); (2) to correlate the results with the biomaterial surface properties; and
(3) to determine whether the decreased adhesion on vitamin E-stabilized UHMWPE
(VE-PE) previously recorded for bacteria can also be confirmed for C albicans.
METHODS: Microbial adhesion of biofilm-producing American Type Culture Collection
(ATCC) and clinical strains on XLPE and VE-PE were compared with PE at 3, 7, 24,
and 48 hours of incubation and quantified, as colony forming units (CFU)/mL,
using a sonication protocol. Sample surfaces were characterized by scanning
electron microscopy, roughness and contact angle measurements, attenuated total
reflection-Fourier transform infrared spectroscopy, and x-ray photoelectron
spectroscopy (XPS) to reveal qualitative differences in surface composition and
topography that could influence the microbial adhesion. The results were analyzed
by descriptive statistics and tested by unpaired t-tests. RESULTS: All
microorganisms, both ATCC and clinical strains, showed lower adhesion (p < 0.05)
on XLPE with adhesion percentages ranging from 18% to 25%, compared with PE with
adhesion percentages ranging from 51% to 55%, after 48 hours. Only the ATCC S
epidermidis showed a reduced adhesion profile even at 3 hours (adhesion ratio of
14% on XLPE versus 50% on PE) and 24 hours (19% on XLPE versus 55% on PE) of
incubation. ATCC and clinical C albicans were less adherent to XLPE than to PE (p
< 0.05) showing even at the earlier incubation time points adhesion values always
of 10(3) CFU/mL and 10(4) CFU/mL, respectively. Roughness and contact angle were
0.8 ± 0.2 ?m and 92° ± 3°, respectively, with no differences among samples.
Qualitative differences in the surface chemical composition were revealed by XPS
only. A confirmation of the decreased adhesion on VE-PE respect to PE was also
registered here for C albicans strains (p < 0.05). CONCLUSIONS: Vitamin E
stabilization and crosslinking of UHMWPE are capable of reducing microbial
adhesion. Further studies are needed to fully elucidate the mechanisms of
modulation of microbial adhesion to medical-grade UHMWPE. CLINICAL RELEVANCE: Our
results suggest that VE-PE and XLPE may have an added benefit of being more
resistant to bacterial adhesion, even fungal strains.
|*Materials Testing
[MESH]
|Biocompatible Materials
[MESH]
|Biofilms/*drug effects
[MESH]
|Candida albicans
[MESH]
|Escherichia coli
[MESH]
|Humans
[MESH]
|Polyethylenes/*chemistry
[MESH]
|Prosthesis Design
[MESH]
|Prosthesis-Related Infections/drug therapy/microbiology/*prevention & control
[MESH]
|Staphylococcal Infections/drug therapy/*prevention & control
[MESH]