A biodegradable antifungal-loaded sol-gel coating for the prevention and local treatment of yeast prosthetic-joint infections Articles uri icon

authors

  • Romera, David
  • Toirac, Beatriz
  • Aguilera Correa, John Jairo
  • GARCIA CASAS, AMAYA
  • Mediero, Aranzazu
  • JIMENEZ MORALES, ANTONIA
  • Esteban, Jaime

publication date

  • July 2020

start page

  • 3144-1

end page

  • 3144-14

issue

  • 14

volume

  • 13

International Standard Serial Number (ISSN)

  • 1996-1944

abstract

  • Fungal prosthetic-joint infections are rare but devastating complications following arthroplasty. These infections are highly recurrent and expose the patient to the development of candidemia, which has high mortality rates. Patients with this condition are often immunocompromised and present severalcomorbidities, and thus pose a challenge for diagnosis and treatment. The most frequently isolated organisms in these infections are Candida albicans and Candida parapsilosis, pathogens that initiate the infection by developing a biofilm on the implant surface. In this study, a novel hybrid organo&-inorganicsol&-gel coating was developed from a mixture of organopolysiloxanes and organophosphite, to which different concentrations of fluconazole or anidulafungin were added. Then, the capacity of these coatings to prevent biofilm formation and treat mature biofilms produced by reference and clinicalstrains of C. albicans and C. Parapsilosis was evaluated. Anidulafungin-loaded sol&-gel coatings were more effective in preventing C. albicans biofilm formation, while fluconazole-loaded sol&-gel prevented C. parapsilosis biofilm formation more effectively. Treatment with unloaded sol&-gel was sufficientto reduce C. albicans biofilms, and the sol&-gels loaded with fluconazole or anidulafungin slightly enhanced this effect. In contrast, unloaded coatings stimulated C. parapsilosis biofilm formation, and loading with fluconazole reduced these biofilms by up to 99%. In conclusion, these coatings represent a novel therapeutic approach with potential clinical use to prevent and treat fungal prosthetic-joint infections.

keywords

  • candida; fungal prosthetic-joint infection; osteointegration; sol–gel coating; antifungal; anidulafungin