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Staphylococcal infection prevention using antibiotic‐loaded mannitol–chitosan paste in a rabbit model of implant‐associated osteomyelitis
Author(s) -
Harrison Zoe L.,
Pace Leslie R.,
Brown Madison N.,
Beenken Karen E.,
Smeltzer Mark S.,
Bumgardner Joel D.,
Haggard Warren O.,
Amber Jennings J.
Publication year - 2021
Publication title -
journal of orthopaedic research®
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.24986
Subject(s) - mannitol , chitosan , bone infection , staphylococcus aureus , antibiotics , microbiology and biotechnology , vancomycin , biofilm , osteomyelitis , chemistry , materials science , medicine , surgery , bacteria , biology , biochemistry , genetics
Abstract Antibiotic‐loaded chitosan pastes have shown advantages in the treatment and coverage of complex musculoskeletal defects. We added mannitol, previously shown to increase antibiotic susceptibility of biofilm, to an injectable chitosan/polyethylene glycol paste for delivery of antibiotics. Ground sponges (0.85% acetic acid solution, 1% chitosan, 0% or 2% mannitol, 1% polyethylene glycol) were hydrated using phosphate‐buffered saline with 10 mg/ml amikacin and 10 mg/ml vancomycin added to form pastes. We inoculated rabbit radial defects with 10 5 colony‐forming units of Staphylococcus aureus (UAMS‐1) and inserted titanium pins into the cortical bone. Groups compared included mannitol blend pastes, non‐mannitol blends, antibiotic‐loaded bone cement, vancomycin powder, and no treatment controls. We harvested tissue samples and retrieved the pins retrieved at 3 weeks. All antibiotic‐loaded groups lowered bacterial growth and colony‐forming unit counts in soft and bone tissue and on titanium pins in in vivo studies. The results indicate this biomaterial is capable of eluting active antibiotics at concentrations that reduce bacterial growth on biomaterials and tissue, which, in turn, may prevent biofilm formation. Blends of chitosan and mannitol may be useful in prevention and treatment of osteomyelitis and implant‐associated infections.