• 1. Ahern BJ, Richardson DW, Boston RC, et al. Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990–2006). Vet Surg 2010;39:588593.

    • Search Google Scholar
    • Export Citation
  • 2. Carnwath R, Graham EM, Reynolds K, et al. The antimicrobial activity of honey against common equine wound bacterial isolates. Vet J 2014;199:110114.

    • Search Google Scholar
    • Export Citation
  • 3. Ogeer-Gyles JS, Mathews KA, Boerlin P. Nosocomial infections and antimicrobial resistance in critical care medicine. J Vet Emerg Crit Care (San Antonio) 2006;16:118.

    • Search Google Scholar
    • Export Citation
  • 4. Weese JS, Giguère S, Guardabassi L, et al. ACVIM consensus statement on therapeutic antimicrobial use in animals and antimicrobial resistance. J Vet Intern Med 2015;29:487498.

    • Search Google Scholar
    • Export Citation
  • 5. Nandi SK, Bandyopadhyay S, Das P, et al. Understanding osteomyelitis and its treatment through local drug delivery system. Biotechnol Adv 2016;34:13051317.

    • Search Google Scholar
    • Export Citation
  • 6. Wahlig H, Dingeldein E, Bergmann R, et al. The release of gentamicin from polymethylmethacrylate beads. An experimental and pharmacokinetic study. J Bone Joint Surg Br 1978;60-b:270275.

    • Search Google Scholar
    • Export Citation
  • 7. Brown A, Bennett D. Gentamicin-impregnated polymethylmethacrylate beads for the treatment of septic arthritis. Vet Rec 1988;123:625626.

    • Search Google Scholar
    • Export Citation
  • 8. Butson RJ, Schramme MC, Garlick MH, et al. Treatment of intrasynovial infection with gentamicin-impregnated polymethylmethacrylate beads. Vet Rec 1996;138:460464.

    • Search Google Scholar
    • Export Citation
  • 9. Hall MS, Pollock PJ, Russell T. Surgical treatment of septic physitis in 17 foals. Aust Vet J 2012;90:479484.

  • 10. Trostle SS, Peavey CL, King DS, et al. Treatment of methicillin-resistant Staphylococcus epidermidis infection following repair of an ulnar fracture and humeroradial joint luxation in a horse. J Am Vet Med Assoc 2001;218:554559.

    • Search Google Scholar
    • Export Citation
  • 11. Anagnostakos K, Kelm J. Enhancement of antibiotic elution from acrylic bone cement. J Biomed Mater Res B Appl Biomater 2009;90:467475.

    • Search Google Scholar
    • Export Citation
  • 12. Cunningham A, Demarest G, Rosen P, et al. Antibiotic bead production. Iowa Orthop J 2000;20:3135.

  • 13. Traub WH, Leonhard B. Heat stability of the antimicrobial activity of sixty-two antibacterial agents. J Antimicrob Chemother 1995;35:149154.

    • Search Google Scholar
    • Export Citation
  • 14. Rutala WA, Weber DJ. Low-temperature sterilization technologies: do we need to redefine “sterilization”? Infect Control Hosp Epidemiol 1996;17:8791.

    • Search Google Scholar
    • Export Citation
  • 15. da Cunha Mendes GC, da Silva Brandão TR, Miranda Silva CL. Ethylene oxide potential toxicity. Expert Rev Med Devices 2008;5:323328.

  • 16. Tenover FC. Antibiotic susceptibility testing. In: Schaechter M, ed. Encyclopedia of microbiology. 3rd ed. Boston: Elsevier-Academic Press, 2009;6777.

    • Search Google Scholar
    • Export Citation
  • 17. MacDonald DG, Morley PS, Bailey JV, et al. An examination of the occurrence of surgical wound infection following equine orthopaedic surgery (1981–1990). Equine Vet J 1994;26:323326.

    • Search Google Scholar
    • Export Citation
  • 18. Trencart P, Elce YA, Rodriguez Batista E, et al. Sterilization by gamma radiation of antibiotic impregnated polymethylmethacrylate and plaster of Paris beads. A pilot study. Vet Comp Orthop Traumatol 2014;27:97101.

    • Search Google Scholar
    • Export Citation
  • 19. Báez LA, Langston C, Givaruangsawat S, et al. Evaluation of in vitro serial antibiotic elution from meropenem-impregnated polymethylmethacrylate beads after ethylene oxide gas and autoclave sterilization. Vet Comp Orthop Traumatol 2011;24:3944.

    • Search Google Scholar
    • Export Citation
  • 20. Ramos JR, Howard RD, Pleasant RS, et al. Elution of metronidazole and gentamicin from polymethylmethacrylate beads. Vet Surg 2003;32:251261.

    • Search Google Scholar
    • Export Citation
  • 21. McDonnell G. The use of hydrogen peroxide for disinfection and sterilization applications. In: Greer A, Liebman JF, eds. The chemistry of peroxides. Volume 3. Part 1. PATAI'S chemistry of functional groups. Chichester, England: John Wiley & Sons Ltd, 2014;713746.

    • Search Google Scholar
    • Export Citation
  • 22. Imlay JA. The molecular mechanisms and physiological consequences of oxidative stress: lessons from a model bacterium. Nat Rev Microbiol 2013;11:443454.

    • Search Google Scholar
    • Export Citation
  • 23. Garcia LG, Lemaire S, Kahl BC, et al. Intracellular forms of menadione-dependent small-colony variants of methicillin-resistant Staphylococcus aureus are hypersusceptible to β-lactams in a THP-1 cell model due to cooperation between vacuolar acidic pH and oxidant species. J Antimicrob Chemother 2012;67:28732881.

    • Search Google Scholar
    • Export Citation
  • 24. Wentao Z, Lei G, Liu Y, et al. Approach to osteomyelitis treatment with antibiotic loaded PMMA. Microb Pathog 2017;102:4244.

  • 25. Samuel S, Mathew BS, Veeraraghavan B, et al. In vitro study of elution kinetics and bio-activity of meropenem-loaded acrylic bone cement. J Orthop Traumatol 2012;13:131136.

    • Search Google Scholar
    • Export Citation
  • 26. Neut D, van de Belt H, van Horn JR, et al. The effect of mixing on gentamicin release from polymethylmethacrylate bone cements. Acta Orthop Scand 2003;74:670676.

    • Search Google Scholar
    • Export Citation

Advertisement

Evaluation of vaporized hydrogen peroxide sterilization on the in vitro efficacy of meropenem-impregnated polymethyl methacrylate beads

Myra E. Durham DVM, MS1 and Johanna R. Elfenbein DVM, PhD2
View More View Less
  • 1 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.
  • | 2 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

Abstract

OBJECTIVE To evaluate the effects of vaporized hydrogen peroxide (VHP) sterilization on the in vitro antimicrobial efficacy of meropenem-impregnated polymethyl methacrylate (M-PMMA) beads.

SAMPLE 6-mm-diameter polymethyl methacrylate beads that were or were not impregnated with meropenem.

PROCEDURES Meropenem-free polymethyl methacrylate and M-PMMA beads were sterilized by use of an autoclave or VHP or remained unsterilized. To determine the antimicrobial efficacy of each bead-sterilization combination (treatment), Mueller-Hinton agar plates were inoculated with 1 of 6 common equine pathogens, and 1 bead from each treatment was applied to a sixth of each plate. The zone of bacterial inhibition for each treatment was measured after 24 hours. To estimate the duration of antimicrobial elution into a solid or liquid medium, 1 bead from each treatment was transferred every 24 hours to a new Staphylococcus aureus–inoculated agar plate or a tube with PBS solution, and an aliquot of the eluent from each tube was then applied to a paper disc on an S aureus–inoculated agar plate. All agar plates were incubated for 24 hours, and the zone of bacterial inhibition was measured for each treatment.

RESULTS In vitro antimicrobial efficacy of M-PMMA beads was retained following VHP sterilization. The duration of antimicrobial elution in solid and liquid media did not differ significantly between unsterilized and VHP-sterilized M-PMMA beads.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that M-PMMA beads retained in vitro antimicrobial activity and eluted the drug for up to 2 weeks after VHP sterilization.

Abstract

OBJECTIVE To evaluate the effects of vaporized hydrogen peroxide (VHP) sterilization on the in vitro antimicrobial efficacy of meropenem-impregnated polymethyl methacrylate (M-PMMA) beads.

SAMPLE 6-mm-diameter polymethyl methacrylate beads that were or were not impregnated with meropenem.

PROCEDURES Meropenem-free polymethyl methacrylate and M-PMMA beads were sterilized by use of an autoclave or VHP or remained unsterilized. To determine the antimicrobial efficacy of each bead-sterilization combination (treatment), Mueller-Hinton agar plates were inoculated with 1 of 6 common equine pathogens, and 1 bead from each treatment was applied to a sixth of each plate. The zone of bacterial inhibition for each treatment was measured after 24 hours. To estimate the duration of antimicrobial elution into a solid or liquid medium, 1 bead from each treatment was transferred every 24 hours to a new Staphylococcus aureus–inoculated agar plate or a tube with PBS solution, and an aliquot of the eluent from each tube was then applied to a paper disc on an S aureus–inoculated agar plate. All agar plates were incubated for 24 hours, and the zone of bacterial inhibition was measured for each treatment.

RESULTS In vitro antimicrobial efficacy of M-PMMA beads was retained following VHP sterilization. The duration of antimicrobial elution in solid and liquid media did not differ significantly between unsterilized and VHP-sterilized M-PMMA beads.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that M-PMMA beads retained in vitro antimicrobial activity and eluted the drug for up to 2 weeks after VHP sterilization.

Contributor Notes

Address correspondence to Dr. Elfenbein (jrelfenb@ncsu.edu).