2-Methacryloyloxyethyl Phosphorylcholine Polymer Coating Inhibits Bacterial Adhesion and Biofilm Formation on a Suture: An In Vitro and In Vivo Study.

Taizo Kaneko,Junpei Matsuda,Hiroshi Miyamoto,Taku Saito,Kyoko Fukazawa,Toru Moro,Kazuhiko Ishihara,Sakae Tanaka,Takeo Shobuike,Silvia Todros

doi:10.1155/2020/5639651

Taizo Kaneko, Junpei Matsuda + Show 8 more

Open Access

https://doi.org/10.1155/2020/5639651

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Abstract

Initial bacterial adhesion to medical devices and subsequent biofilm formation are known as the leading causes of surgical site infection (SSI). Therefore, inhibition of bacterial adhesion and biofilm formation on the surface of medical devices can reduce the risk of SSIs. In this study, a highly hydrophilic, antibiofouling surface was prepared by coating the bioabsorbable suture surface with poly(2-methacryloyloxyethyl phosphorylcholine (MPC)-co-n-butyl methacrylate) (PMB). The PMB-coated and noncoated sutures exhibited similar mechanical strength and surface morphology. The effectiveness of the PMB coating on the suture to suppress adhesion and biofilm formation of methicillin-resistant Staphylococcus aureus and methicillin-susceptible Staphylococcus aureus was investigated both in vitro and in vivo. The bacterial adhesion test revealed that PMB coating significantly reduced the number of adherent bacteria, with no difference in the number of planktonic bacteria. Moreover, fluorescence microscopy and scanning electron microscopy observations of adherent bacteria on the suture surface after contact with bacterial suspension confirmed PMB coating-mediated inhibition of biofilm formation. Additionally, we found that the PMB-coated sutures exhibited significant antibiofouling effects in vivo. In conclusion, PMB-coated sutures demonstrated bacteriostatic effects associated with a highly hydrophilic, antibiofouling surface and inhibited bacterial adhesion and biofilm formation. Therefore, PMB-coated sutures could be a new alternative to reduce the risk of SSIs.

Highlights

Surgical site infections (SSIs) are the most common surgical complications, accounting for approximately 40% of all healthcare-associated infections [1] and 5% of all surgical complications [2]
It is widely accepted that initial bacterial adhesion to biomaterial surfaces and biofilm formation secondary to bacterial adhesion are primary causes of surgical site infection (SSI) [6, 7]
Inhibition of the initial bacterial adherence and biofilm formation on the surface of implanted sutures could be an effective countermeasure to reduce the incidence of SSIs

Summary

Introduction

Surgical site infections (SSIs) are the most common surgical complications, accounting for approximately 40% of all healthcare-associated infections [1] and 5% of all surgical complications [2]. SSIs result in further surgical intervention, prolonged treatment period, and unexpected high medical costs [3, 4]. Several factors are believed to be involved in the onset of SSIs, including implanted surgical sutures [5]. It is widely accepted that initial bacterial adhesion to biomaterial surfaces and biofilm formation secondary to bacterial adhesion are primary causes of SSI [6, 7]. BioMed Research International antibiotics [7], rendering the SSI intractable [4, 7].

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