Abstract
Recently, silver (Ag) and copper (Cu) have been incorporated into a titanium (Ti) surface to realize their antibacterial property. This study investigated both the durability of the antibacterial effect and the surface change of the Ag- and Cu-incorporated porous titanium dioxide (TiO2) layer. Ag- and Cu-incorporated TiO2 layers were formed by micro-arc oxidation (MAO) treatment using the electrolyte with Ag and Cu ions. Ag- and Cu-incorporated specimens were incubated in saline during a period of 0–28 days. The changes in both the concentrations and chemical states of the Ag and Cu were characterized using X-ray photoelectron spectroscopy (XPS). The durability of the antibacterial effects against Escherichia coli (E. coli) were evaluated by the international organization for standardization (ISO) method. As a result, the Ag- and Cu-incorporated porous TiO2 layers were formed on a Ti surface by MAO. The chemical state of Ag changed from Ag2O to metallic Ag, whilst that of Cu did not change by incubation in saline for up to 28 days. Cu existed as a stable Cu2O compound in the TiO2 layer during the 28 days of incubation in saline. The concentrations of Ag and Cu were dramatically decreased by incubation for up to 7 days, and remained a slight amount until 28 days. The antibacterial effect of Ag-incorporated specimens diminished, and that of Cu was maintained even after incubation in saline. Our study suggests the importance of the time-transient effects of Ag and Cu on develop their antibacterial effects.
Highlights
Prosthetic joint infection (PJI) is a devastating and threatening complication for patients and orthopedists [1,2]
The chemical states of P, Ca, and Ti in the Ag- and Cu-incorporated oxide layers were phosphate, Ca2+, and TiO2, respectively. These chemical states did not change upon incubation in saline for up to 28 days (Figure 3)
The antibacterial effect of the Cu-incorporated specimen was maintained even after the 28 days of incubation in saline. These results indicate that Cu2O in a stable chemical state has a more important role in the development of an antibacterial effect, compared with the change of surface concentration of Cu
Summary
Prosthetic joint infection (PJI) is a devastating and threatening complication for patients and orthopedists [1,2]. Invaded bacteria generally initiate the infection by adhering onto the implant surface, and grow through a specific mechanism such as extracellular polysaccharide (EPS) production [3,4,5]. The removal of matured biofilms from the implant is difficult because biofilms are resistant to antibiotics due to their bacterial diversity and the presence of the EPS [6,7,8,9]. The only way to eradicate the infection and prevent sepsis is to remove the contaminated device from the patient. Biofilm formation must be prevented by inhibiting the initial stage of biofilm formation, namely bacterial invasion, adhesion and growth
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