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Bacterial Colonization of Bone Allografts: Establishment and Effects of Antibiotics

  • Symposium: Papers Presented at the 2009 Meeting of the Musculoskeletal Infection Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Bone grafts are frequently used to supplement bone stock and to establish structural stability. However, graft-associated infection represents a challenging complication leading to increased patient morbidity and healthcare costs.

Questions/purposes

We therefore designed this study to (1) determine if increasing initial S. aureus inoculation of bone allograft results in a proportionate increase in colonization; (2) assess if antibiotics decrease colonization and if antibiotic tethering to allograft alters its ability to prevent bacterial colonization; and (3) determine if covalent modification alters the allograft topography or its biological properties.

Methods

Allograft bone and vancomycin-modified bone (VAN-bone) was challenged with different doses of S. aureus for times out to 24 hours in the presence or absence of solution vancomycin. Bacterial colonization was assessed by fluorescence, scanning electron microscopy (SEM), and by direct colony counting. Cell density and distribution of osteoblast-like cells on control and modified allograft were then compared.

Results

Bacterial attachment was apparent within 6 hours with colonization and biofilm formation increasing with time and dose. Solution vancomycin failed to prevent bacterial attachment whereas VAN-bone successfully resisted colonization. The allograft modification did not affect the attachment and distribution of osteoblast-like cells.

Conclusions

Allograft bone was readily colonized by S. aureus and covered by a biofilm with especially florid growth in natural topographic niches. Using a novel covalent modification, allograft bone was able to resist colonization by organisms while retaining the ability to allow adhesion of osteoblastic cells.

Clinical Relevance

Generation of allograft bone that can resist infection in vivo would be important in addressing one of the most challenging problems associated with the use of allograft, namely infection.

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Acknowledgments

We thank the Musculoskeletal Transplant Foundation for providing samples for this work as well as for their generous support of these studies.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA

    Constantinos Ketonis PhD, Stephanie Barr BS, Christopher S. Adams PhD & Noreen J. Hickok PhD

  2. Department of Biochemistry and Molecular Biology, Thomas Jefferson University, Philadelphia, PA, USA

    Noreen J. Hickok PhD

  3. Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, 19107, USA

    Javad Parvizi MD

Authors
  1. Constantinos Ketonis PhD
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  2. Stephanie Barr BS
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  3. Christopher S. Adams PhD
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  5. Javad Parvizi MD
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Correspondence to Javad Parvizi MD.

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Ketonis, C., Barr, S., Adams, C.S. et al. Bacterial Colonization of Bone Allografts: Establishment and Effects of Antibiotics. Clin Orthop Relat Res 468, 2113–2121 (2010). https://doi.org/10.1007/s11999-010-1322-8

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  • DOI: https://doi.org/10.1007/s11999-010-1322-8

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