Antibacterial effect of a copper-containing titanium alloy against implant-associated infection induced by methicillin-resistant Staphylococcus aureus. (1st January 2021)

• Record Type: Journal Article
• Authors: Zhuang, Yifu; Ren, Ling; Zhang, Shuyuan; Wei, Xiang; Yang, Ke; Dai, Kerong
• Is Part Of: Acta biomaterialia. Volume 119(2021)
• Page Start: 472
• Page End: 484
• Publication Date: 2021-01-01
• Subjects: Antibacterial effect -- Copper -- Titanium alloy -- Implant-associated infection -- MRSA; Biomedical materials -- Periodicals; 610.28
• DOI: 10.1016/j.actbio.2020.10.026
• Languages: English
• ISSNs: 1742-7061

Abstract

Abstract: Implant-associated infection (IAI) induced by methicillin-resistant Staphylococcus aureus (MRSA) is a devastating complication in the orthopedic clinic. Traditional implant materials, such as Ti6Al4V, are vulnerable to microbial infection. In this study, we fabricated a copper (Cu)-containing titanium alloy (Ti6Al4V-Cu) for the prevention and treatment of MRSA-induced IAI. The material characteristics, antibacterial activity, and biocompatibility of Ti6Al4V-Cu were systematically investigated and compared with those of Ti6Al4V. Ti6Al4V-Cu provided stable and continuous Cu 2+ release, at a rate of 0.106 mg/cm 2 /d. Its antibacterial performance against MRSA in vitro was confirmed by plate counting analysis, crystal violet staining, and scanning electron microscopic observations. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) analysis demonstrated that Ti6Al4V-Cu suppressed biofilm formation, virulence, and antibiotic-resistance of MRSA. The in vivo anti-MRSA effect was investigated in a rat IAI model. Implants were contaminated with MRSA solution, implanted into the femur, and left for 6 weeks. Severe IAI developed in the Ti6Al4V group, with increased radiological score (9.6 ± 1.3) and high histological score (10.1 ± 1.9). However, no sign of infection was found in the Ti6Al4V-Cu group, as indicated by decreased radiological score (1.3 ± 0.4) and low histological score (2.3 ± 0.5). In addition, Ti6Al4V-Cu had favorable biocompatibility both in vitro and in vivo . In summary, Ti6Al4V-Cu is a promising implant material to protect against MRSA-induced IAI. Graphical abstract: Image, graphical abstract