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Silver-Carboxylate/Chlorhexidine Gluconate Eluting Hybrid Matrix as Preventatives of Surgical Site Infections by MRSA and Cutibacterium acnes (C. acnes)

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Year:
2020
Contributor:
Dockery, Dominique (Author)
Allu, Sai (Author)
Born, Christopher (Author)
Garcia, Dioscaris (Author)
Brown University. Alpert Medical School. Scholarly Concentration Program. Non-Scholarly Concentrator (research program)
Subject:
Surgical wound infections
Orthopedic surgery
DOI
https://doi.org/10.26300/05vf-de74

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Abstract:
Background Surgical wounds are highly susceptible to infection which can lead to prolonged hospitalization, higher healthcare costs, poor surgical outcomes, and death.1 This is particularly true following orthopedic procedures in which two of the primary microbes related to surgical site infections (SSIs) are Cutibacterium acnes (C. acnes) and methicillin-resistant Staphylococcus aureus (MRSA).2 Research has shown that there is a 70% rate of persistence of C. acnes after the application of the most popular modern surgical skin prep, chlorhexidine gluconate (CHG), under the brand name ChloraPrep™.3 Current antiseptic solutions are not efficient in protecting surgical patients from post-operative infection and work needs to be done to decrease the incidence of SSIs which are still prevalent despite national surgical guidelines. Prior research in our laboratory showed that silver carboxylate is prophylactic for C. acnes and MRSA infection. With the knowledge that other studies have combined CHG with other antimicrobial agents including sodium hypochlorite, povidone-iodine, and calcium hydroxide, this project aimed to see if a combination of CHG and silver carboxylate could be an effective solution to combat SSIs caused by C. acnes and MRSA.4 This project specifically looked at the application of the coating on suture material. Methods • Bacterial culture: C. acnes and MRSA were propagated in RCM and BHI media, respectively at 370C. C. acnes was grown in anaerobic conditions and had a 24-hour growth lag. • Silver carboxylate coating: Varying concentrations of 95% heptane and AgNeo were combined with a vehicle made of IPA, PDMS, and Ti-Iso to make the coating. For MRSA silver concentrations of 120x, 130x, 140x, and 150x were used. For C. acnes, conditions were 30x, 40x, 50x, and 60x. • Dose response curves: Will be generated using spectroscopy obtained from inoculated and coated well plates. • Kirby-Bauer assay: Agar plates coated with bacterial dilution were used. Sutures were dipped in the silver carboxylate coating followed by CHG and placed on the plates. Zones of inhibition were imaged at 3 time points (24, 48, 72 hours for MRSA and 48, 72, and 96 hours for C. acnes) and will be analyzed using ImageJ. • Graphite Furnace Atomic Absorption Spectroscopy: GFAAS will be used to measure silver elution at time points. Results: See poster Conclusions: • The combination of silver carboxylate and CHG combination was effective at preventing bacterial growth on a gross visual scale • Clear zones of inhibition were not obtained which could be due to inadequate drying time of the coating or due to the addition of CHG to the matrix hence statistical analysis was unable to be obtained • Dose response curves and GFAAS were unable to be obtained due to lab equipment availability during COVID-19 reopening Future Directions • Repeat trials with adequate drying time to better evaluate zones of inhibition and the effect of CHG addition using ImageJ for analysis • Obtain dose response curves and GFAAS to evaluate effectiveness of each concentration and silver elution over time • Evaluate the ability of the silver carboxylate coating to penetrate and disperse biofilms and eradicate persister cells • Demonstrate the safety of this coating on human cells
Notes:
Scholarly concentration: Non-Scholarly Concentrator

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Dockery, Dominique, Allu, Sai, Born, Christopher, et al., "Silver-Carboxylate/Chlorhexidine Gluconate Eluting Hybrid Matrix as Preventatives of Surgical Site Infections by MRSA and Cutibacterium acnes (C. acnes)" (2020). Warren Alpert Medical School Academic Symposium. Brown Digital Repository. Brown University Library. https://doi.org/10.26300/05vf-de74

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    Warren Alpert Medical School Academic Symposium

    The Warren Alpert Medical School Academic Symposium is an annual event at Warren Alpert Medical School of Brown University that provides Year II medical students a venue to present their summer research in a poster format. Participation in the Symposium …
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