A feared complication of implant surgery is bacterial or fungal infection, initiated by microbial adhesion and biofilm formation, and related to the biomaterial surface characteristics. Staphylococci are the most common microorganisms causing biomaterial associated infection (BAI), followed by streptococci, Gram-negative bacilli and yeasts. With the aim to prevent BAI, the purpose of this study was to evaluate the adhesion of various microbial strains on different prosthetic materials with specific surface chemical characteristics, used in orthopaedic surgery. We compared the effects of vitamin E-added Ultra High Molecular Weight Polyethylene (UHMWPE) and crosslinked UHMWPE with that of standard GUR 1020 UHMWPE, upon the adhesion of ATCC biofilm-producing strains of Staphylococcus epidermidis, S. aureus, Escherichia coli and Candida albicans. After different incubation times the samples were sonicated to release the attached microorganisms and spread onto agar to quantify colony forming units (UFC)/ml. The biomaterials were physico-chemically characterized by means of scanning electron microscopy (SEM), water contact angle (CA) measurements and attenuated total reflectance (ATR)-fourier transform infrared (FTIR) spectroscopy, before and after adhesion assays. The experiments were assayed in triplicate and repeated a minimum of three times. A statistical analysis on results was conducted. No significant difference of the surface roughness, CA and ATR-FTIR spectroscopy was found among the different biomaterials. After 3 and 7 h of incubation microbial adhesion rates were similar with no statistically relevant differences among the samples assayed. On the contrary, after 24 and 48 h of incubation a significantly (p<0.05 and p<0.01) different adhesion trend was achieved on the three biomaterials, highlighting a microbial adhesion significantly lower on vitamin E-added UHMWPE and crosslinked UHMWPE compared with that on standard UHMWPE. Prosthetic UHMWPE added with vitamin E and crosslinked UHMWPE are able to decrease significantly the adhesion of various bacterial and fungal strains limiting biomaterial associated infection and consequent implant failure.
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