Title | University of Utah Undergraduate Research Abstracts, Volume 12, Spring 2012 |
OCR Text | Show A Message from President David Pershing.....2 A Message from Martha Bradley-Evans.....3 A Message from Steve Roens.....4 Undergraduate Abstracts.....5 Francis Family Foundation.....146 A Message from Jill Baeder.....149 Research Posters on the Hill.....150 Charles H. Monson Prize Winners.....179 Undergraduate Research Conferences.....183 Undergraduate Research Scholars.....184 Rio Mesa.....185 Service Learning Scholars.....187 Sustainability.....190 Undergraduate Student Experts On Teaching Program.....196 Health Sciences LEAP Program.....204 Honors College.....227 Alphabetical Index.....292 |
Subject | University of Utah -- Students -- Periodicals |
Publisher | J. Willard Marriott Library, University of Utah |
Date | 2012 |
Type | Text |
Format | application/pdf |
Identifier | Univ_of_Utah_URA_Spring2012 |
Language | eng |
Rights Management | Digital image © copyright 2012, University of Utah. All rights reserved. |
Holding Institution | Office of Undergraduate Studies Sill Center 195 S. Central Campus Dr. Salt Lake City, UT 84112 Office of Undergraduate Studies Sill Center 195 S. Central Campus Dr. Salt Lake City, UT 84112 |
Source Material | Bound journal |
Source Physical Dimensions | 14 cm x 21 cm |
ARK | ark:/87278/s6513z8q |
Temporal Coverage | Spring 2012 |
Setname | uu_urop |
ID | 417967 |
Reference URL | https://collections.lib.utah.edu/ark:/87278/s6513z8q |
Title | 175_171 |
OCR Text | Show 171 THE UNIVERSITY OF UTAH RESEARCH POSTERS ON THE HILL 2012 CATIONIC STEROIDAL ANTIMICROBIAL 13 FOR TREATMENT AND PREVENTION OF PERI OPERATIVE DEVICE RELATED INFECTIONS Pham TX, Farnsworth RW, Ingebretson SH, (Beck JP, Bloebaum RD, Sinclair KD) Department of Veterans A airs Salt Lake City Health Care System University of Utah Department of Orthopaedics Cationic Steroidal Antimicrobial-13 for Treatment and Prevention of Perioperative Device Related Infections Theresa Pham, R.D. Bloebaum, K.D. Sinclair Department of Veterans Affairs and the University of Utah's Department of Orthopaedics Student Photo Faculty Photo Theresa Pham Dr. Kristofer Sinclair Hypothesis Objective The objective of this study was to investigate the efficacy of the Cationic Steroidal Antimicrobial-13 (CSA-13) for the prevention of perioperative device related infections in vivo. The broad-spectrum CSA-13 antimicrobial will prevent methicillin-resistant Staphylococcus aureus (MRSA) derived infection, without affecting skeletal attachment, when eluted from the silicone polymer coating on a porous coated titanium implant. Introduction The first total joint replacement (TJR) performed represented a significant advancement in modern treatment of joint pathologies. Since then, the quality of life for many Americans has been improved and the number of TJRs have been dramatically increasing every year in the United States. It is projected that, by the year 2030, more than 3.5 million total hip and knee replacements will be performed annually in this nation. However, there are significant risks following surgery; perioperative infection poses a serious post-procedural complication. With the current antibiotic therapy technology, it is proposed that cases of perioperative related joint infections will exceed 35,000 annually by 2030. MRSA is responsible for an increasing number of surgical site infections. With the ever increasing number of resistant bacterial strains to antibiotic therapy, it is imperative that an alternative method of treatment is developed. For this line of treatment to be successful, the technology will need to be able to circumvent bacterial resistance and address current limitations. Ceragenins are a synthetic analog of antimicrobial peptides that are one possible solution to these clinical complications. This class of compounds posseses antibacterial activity equipotent to those of naturally occurring antimicrobial peptides. However, ceragenins are capable of bactericidal activity without demonstrating acquired bacterial resistance. This, in combination with its broad-spectrum bactericidal capabilities, makes ceragenins especially useful against MRSA and other multidrug resistant pathogens. The broad-spectrum polymer released CSA-13 antimicrobial demonstrated the ability to eliminate 5x108 CFU of MRSA and prevented the onset of infection in the femoral condyle of the sheep model. Evaluation of the CSA-13 coating/host tissue interface indicated good biocompatibility characterized by thin fibrous encapsulation and sound skeletal attachment within actively remodeling bone. CSA-13 did not appear to adversely affect the rate of bone remodeling. Conclusions Future Work Due to the positive experimental outcome, future work will focus on expanding the numbers per experimental group to provide statistical significance. An intracapsular approach will be utilized to better model conventional TJR approaches. Future studies will also include the testing of the efficacy of CSA-13 against other bacterial strains. Acknowledgements This material is based upon work supported by the Office of Research and Development, Rehabilitation R&D Service, Department of Veterans Affairs, SLC Health Care System, Salt Lake City, UT; Albert and Margaret Hofmann Chair; Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, UT; Bone and Joint Research Laboratory (151F), George E. Wahlen Department of Veterans Affairs Medical Center, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148-0001; and the National Institutes of Health award number R01AR057185-01. *Bacteria spilled during surgery into soft tissue Methods •Group 1 (n=3): Received a titanium plug with a CSA-13 doped silicone combination polymer coating on regions A and C (Figure 3). The lumen of the plug was inoculated with 5x108 CFU of MRSA. •Group 2 (n=5): Received a titanium plug with a CSA-13 doped silicone combination polymer coating on regions A and C. Group 2 was used to asses biocompatibility. •Group 3 (n-3): Received a titanium plug with no CSA-13/polymer coating. Group 3 was used to demonstrate that an infection signal could be achieved. The lumen of the plug was inoculated with 5x108 CFU of MRSA. •Group 4 (n=1): Received a titanium plug with no CSA-13/polymer coating or MRSA. Group 4 was the procedural control. In light of the fact that prophylactic antibiotics were not utilized, the research team wanted to ensure that proper aseptic technique was utilized for the surgical procedure. Four groups of sheep had a titanium plug implanted in the medial aspect of the femoral condyle: All twelve plugs were manufactured from a titanium alloy and had a commercially pure titanium porous coating applied to region B (Figure 1). A.) B.) C.) A clinical isolate of MRSA (ARUP 1709) was acquired from ARUP Laboratories. Planktonic cells of MRSA were obtained by inoculating brain heart infusion (BHI) broth with a fresh strain of the MRSA isolate using pre-established methods from our previous protocol. Hard and soft tissue samples were harvested to characterize the surgical site by means of microbiological and histomorphometric analysis. Figure 1a: Antimicrobial combination coating (containing CSA-13) applied to regions A and C of the titanium plug. Table 1: In vivo analysis of the polymer released CSA-13 antimicrobial. Results Figure 2: Radiograph of plug with CSA-13 combination coating coating inoculated with 5x108 MRSA at 12 weeks. Figure 3: Radiograph of plug containing only the CSA-13 polymer coating at 12 weeks. No MRSA. Group 2: Good biocompatibility was observed between the implant and the host tissue at the conclusion of the 12 week study (Figure 3). Radiographic and microbiologic analyses revealed a normal tissue-implant response characterized by a thin layer of fibrous encapsulation. Good skeletal attachment was achieved and the host bone appeared healthy and was actively remodeling in the periprosthetic region. Group 3: Animals displayed signs of infection three days after surgery. Two were sacrificed 6 days post-op and a third was sacrificed 10 days post-op. Radiographs and microbiology confirmed clinical signs of infection. The infection was determined to be the same strain of MRSA used in the initial inoculum (Figure 4). Group 1: At the 12 week endpoint, 4/5* animals were observed to be healthy without clinical signs of infection. Radiographic and microbiologic analysis revealed good skeletal attachment of the implant with no sign of infection (Figure 2). Figure 4: Radiograph of plug containing only MRSA in the lumen. Group 4: Animals had no signs of infection from the surgical procedure and demonstrated good skeletal attachment. Acquired microradiographs were consistent with those of Group 1 animals. Results Time 0 MRSA MRSA+CSA-13 0 Days 10 Days 12 Weeks Figure 6: The series of BSE images on the left illustrate the hard tissue interface with the porous coated region (Region B) of the plug. Bone=grey and Titanium=white. Figure 7: The series of BSE images on the left illustrate the interface of the hard tissue with the smooth region (Region C) of the titanium plug. Bone = grey. MRSA Only 20x Smooth (Periprosthetic) MRSA+CSA 4x Smooth Si Ti Figure 8: Figure 8a depicts bone resporption in response to FC bacterial presence with pronounced osteoclast activity (arrow). Figure 8b shows healthy, actively remodeling bone and good biocompatibility. Results Figure 8a Figure 8b Figure 1b: SEM image of MRSA that was placed into the lumen of the plug. Figure 1c: Titanium plug implanted in medial face of sheep femoral condyle. More than 400,000 primary hip and knee replace-ments are performed each year in the United States. From these procedures, approximately 2-3% become infected and when considering revision surgeries, this number grows to 22%. Antibiotic resistant bacterial infections are a growing problem in patient care. These infections are di cult to treat and severely a ect the patient's quality of life. This translational experiment investigated the e - cacy of CSA-13 when challenged with 5x108 colony forming units (cfu) of methicillin-resistant Staphylococ-cus aureus (MRSA) for the prevention of perioperative device related infections in vivo. The general hypotheses tested the broad-spectrum CSA-13 antimicrobial for the prevention of planktonic MRSA infections when eluted from the silicone polymer coating on a porous coated titanium implant and the biocompatibility of the antimicrobial coating with the periprosthetic tissue when used as a surface coating on orthopedic devices. These studies were designed to model clinical conditions that are currently reported in total joint replacement patients. The broad-spectrum polymer released CSA-13 antimicrobial eliminated 5x108 cfu of MRSA and prevented the onset of infection in the femoral condyle of the sheep model. Evaluation of the CSA-13 coating/ host tissue interface indicated good biocompatibility characterized by sound skeletal attachment within healthy bone. |
Format | application/pdf |
Setname | uu_urop |
ID | 417838 |
Reference URL | https://collections.lib.utah.edu/ark:/87278/s6513z8q/417838 |