Comparative efficacy of resorbable fiber wraps loaded with gentamicin sulfate or gallium maltolate in the treatment of osteomyelitis
Taneidra W. Buie
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Search for more papers by this authorMichael Whitely
Department of Orthopaedic Trauma, US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, USA
Search for more papers by this authorJoshua McCune
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Search for more papers by this authorZiyang Lan
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Search for more papers by this authorAnupriya Jose
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Search for more papers by this authorAnnika Balakrishnan
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Search for more papers by this authorJoseph Wenke
Department of Orthopaedic Trauma, US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, USA
Search for more papers by this authorCorresponding Author
Elizabeth Cosgriff-Hernandez
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Correspondence
Elizabeth Cosgriff-Hernandez, Department of Biomedical Engineering, The University of Texas, 107 W. Dean Keeton, BME 3.503D, 1 University Station, C0800, Austin, TX 78712, USA.
Email: [email protected]
Search for more papers by this authorTaneidra W. Buie
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Search for more papers by this authorMichael Whitely
Department of Orthopaedic Trauma, US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, USA
Search for more papers by this authorJoshua McCune
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Search for more papers by this authorZiyang Lan
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Search for more papers by this authorAnupriya Jose
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Search for more papers by this authorAnnika Balakrishnan
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Search for more papers by this authorJoseph Wenke
Department of Orthopaedic Trauma, US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, USA
Search for more papers by this authorCorresponding Author
Elizabeth Cosgriff-Hernandez
Department of Biomedical Engineering, The University of Texas, Austin, Texas, USA
Correspondence
Elizabeth Cosgriff-Hernandez, Department of Biomedical Engineering, The University of Texas, 107 W. Dean Keeton, BME 3.503D, 1 University Station, C0800, Austin, TX 78712, USA.
Email: [email protected]
Search for more papers by this authorFunding information: National Science Foundation Graduate Research Fellowship Program and the National Institutes of Health, Grant/Award Number: R03 AI136060
Abstract
The high incidence of osteomyelitis associated with critical-sized bone defects raises clinical challenges in fracture healing. Clinical use of antibiotic-loaded bone cement as an adjunct therapy is limited by incompatibility with many antimicrobials, sub-optimal release kinetics, and requirement of surgical removal. Furthermore, overuse of antibiotics can lead to bacterial modifications that increase efflux, decrease binding, or cause inactivation of the antibiotics. Herein, we compared the efficacy of gallium maltolate, a new metal-based antimicrobial, to gentamicin sulfate released from electrospun poly(lactic-co-glycolic) acid (PLGA) wraps in the treatment of osteomyelitis. In vitro evaluation demonstrated sustained release of each antimicrobial up to 14 days. A Kirby Bauer assay indicated that the gentamicin sulfate-loaded wrap inhibited the growth of osteomyelitis-derived isolates, comparable to the gentamicin sulfate powder control. In contrast, the gallium maltolate-loaded wrap did not inhibit bacteria growth. Subsequent microdilution assays indicated a lower than expected sensitivity of the osteomyelitis strain to the gallium maltolate with release concentrations below the threshold for bactericidal activity. A comparison of the selectivity indices indicated that gentamicin sulfate was less toxic and more efficacious than gallium maltolate. A pilot study in a contaminated femoral defect model confirmed that the sustained release of gentamicin sulfate from the electrospun wrap resulted in bacteria density reduction on the surrounding bone, muscle, and hardware below the threshold that impedes healing. Overall, these findings demonstrate the efficacy of a resorbable, antimicrobial wrap that can be used as an adjunct or stand-alone therapy for controlled release of antimicrobials in the treatment of osteomyelitis.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
Filename | Description |
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jbma37210-sup-0001-FigureS1.tifTIFF image, 1.7 MB | Figure S1: Effect of gallium loading of release kinetics from electrospun PLGA. A) Release kinetics after 14 days with gallium maltolate loaded at 20% of the polymer mass (gray- dotted line), 38% of the polymer mass (red-dashed line), and 50% of the polymer mass (blue-solid line). B) Representative scanning electron micrographs depict the porous microarchitecture that results after 24 h soaking in deionized water as a function of gallium maltolate loading concentration. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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