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10.1007/s11999-014-4024-9

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suck abstract from ncbi


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pmid25367109
      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]
  • |Staphylococcus aureus [MESH]
  • |Staphylococcus epidermidis [MESH]
  • |Surface Properties [MESH]


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