Long-term antimicrobial polyamide 6/silver-nanocomposites

Infections with multiresistant bacteria have become a serious problem in joint arthroplasty. This study reports about in vitro antibacterial activity against multiresistant bacteria and in vitro cytotoxicity of polymethylmetacrylate bone cement loaded with metallic silver particles with a size of 5-50 nm called NanoSilver. In vitro antibacterial activity against S. epidermidis, methicillin-resistant S. epidermidis (MRSE), and methicillin-resistant S. aureus (MRSA) was studied by microplate proliferation tests. Quantitative elution testing and qualitative ongrowth of human osteoblasts was done to study in vitro cytotoxicity. Only NanoSilver cement showed high-antibacterial activity against all strains, including MRSE and MRSA. Gentamicin cement was not effective against MRSA and MRSE due to the high-level gentamicin resistance of the tested strains. Plain cement did not inhibit proliferation of any strains. There was no significant difference regarding in vitro cytotoxicity between NanoSilver and the non-toxic control. Cytotoxicity of cement loaded with silver salts made this kind of silver unsuitable for all day clinical use in the past. This new form of silver called NanoSilver was free of in vitro cytotoxicity and showed high effectiveness against multiresistant bacteria. If the results can be confirmed in vivo NanoSilver may have a high interest in joint arthroplasty.

Silver ion (Ag(+)) the versatile antimicrobial species was released in a steady and prolonged manner from a silver-filled polyamide composite system. Metallic silver powder having varying specific surface area (SSA) has been used as a resource of biocide in polyamide. Strong evidences are found showing the release of the antimicrobial species from the resulting composite upon soaking it in water due to the interaction of the diffused water molecules with the dispersed silver powder within the matrix. The Ag(+) release was observed as increasing with time and concentration of the silver powder and is found to be influenced by the SSA of the silver powder, changes in the physical state of the composite specimen as a result of the water diffusion and the composite morphology. It is observed that the Ag(+) release increases initially which is followed by a marginal increase between day 4 and 6. Composites containing higher amounts of silver (4 and 8 wt%) exhibit a further rise in Ag(+) release from the sixth day of storage in water. Composite containing silver particles with the lowest specific surface area (0.78 m(2)/g) showed highest Ag(+) release. SEM shows a finer dispersion of the silver powder (4 wt%) having lowest SSA. However particles with higher (1.16 and 2.5 m(2)/g) SSA possess an agglomerated morphology leading to lower Ag(+) release. The composites are found to release Ag(+) at a concentration level capable of rendering an antimicrobial efficacy.

Although many antimicrobial biomaterials have shown promising activity in vitro, few anti-infective prosthetic devices manufactured from these materials have yet achieved any degree of success in clinical trials. Controversy surrounds the exploitation of antibiotics in these materials and the microbiological methods that have been used in the clinical trials on the devices.