In:
Journal of Orthopaedic Research, Wiley, Vol. 39, No. 2 ( 2021-02), p. 356-364
Abstract:
When antibiotic laden bone cement is used to manage periprosthetic joint infection (PJI), failure still occurs with its use in up to 30% of cases. Therefore, we designed an in vitro study to assess the bactericidal effect of N ‐acetylcysteine (NAC), an antibacterial adjuvant, in cement against planktonic and biofilm forms of common PJI pathogens. NAC (10%, 20%, 30%, 40%, and 50% w/v) added to polymethyl methacrylate (PMMA) and incubated in broth at 36°C. PMMA‐alone and/or culture bacteria alone were used as a negative control. Aliquots of cement elution from each group were taken at 1 day and 1 week and then were investigated for antimicrobial efficacy against the planktonic‐form and the biofilm‐form of Staphylococcus aureus and Escherichia coli . The primary outcome was the residual colony‐forming unit count. The cytotoxicity and mechanical properties of the NAC–PMMA cement‐blocks were also assessed. NAC–PMMA efficacy against the planktonic bacteria was demonstrated at a minimum of 30% at Day 1 and a minimum of 20% at 1 week after ( p 〈 .001). NAC–PMMA cement was effective against biofilm at a minimum of 30% of NAC at 1 day and 1 week of cement immersion ( p 〈 .001). The PMMA alone group was identified as having the highest cytotoxicity ( p 〈 .001). NAC decreased the stiffness ( p = .004) and maximum load breaking point of the cement ( p = .029). NAC is an effective and biocompatible adjuvant to PMMA in terms of antibacterial activity against Staphylococcus aureus and Escherichia coli . The broad antibacterial spectrum of NAC, its low expense, and minimal cytotoxicity makes it an ideal agent for addition to PMMA cement.
Type of Medium:
Online Resource
ISSN:
0736-0266
,
1554-527X
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2050452-4
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