Orthopedic metal implants are notoriously associated with release of metallic ions able to cause biological adverse reactions which might lead to implant loosening and failure. To limit any possible adverse reactions, ceramic coatings for orthopedic metal implants have been introduced. However, information regarding the interaction of these coatings with microbes responsible for periprosthetic joint infections (PJIs) is lacking. Hence, the aim of the present in vitro study is to assess the microbial affinity to a titanium-niobium nitride (TiNbN) coating. Adhesion and biofilm formation of clinical isolates of Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Cutibacterium acnes were assessed on TiNbN-coated titanium discs in comparison with uncoated titanium and cobalt-chrome alloys discs, with either smooth or rough surfaces. Bacterial adhesion was performed by counting adhered bacteria in the first hours of incubation, and the biofilm formation was performed by means of a spectrophotometric assay and by confocal laser scan microscopy after 72 hours of incubation. Overall, Staphylococcus aureus and Staphylococcus epidermidis, among the most common bacteria responsible for PJIs, displayed a significantly decreased attachment in the first hours of contact and, when cultured in presence of TiNbN coating, in comparison with CoCrMo. Biofilm formation of the four tested strains was comparable on all alloys. Although the onset of a PJI is more complex than in an in vitro scenario, these findings suggest that TiNbN-coated orthopedic implants do not increase PJIs risk while ameliorating tribological and surface properties could represent a valid choice to limit possible complications such as metal hypersensitivity.

中文翻译：

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氮化钛铌（TiNbN）陶瓷涂层上假体周围感染病原体的粘附能力和生物膜形成能力


众所周知，骨科金属植入物与金属离子的释放有关，金属离子的释放会引起生物不良反应，从而可能导致植入物松动和失效。为了限制任何可能的不良反应，引入了用于矫形金属植入物的陶瓷涂层。然而，有关这些涂层与引起假体周围关节感染（PJI）的微生物相互作用的信息尚缺乏。因此，本体外研究的目的是评估微生物对氮化钛铌（TiNbN）涂层的亲和力。将金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌和痤疮皮肤杆菌的临床分离株在 TiNbN 涂层钛盘上的粘附和生物膜形成与光滑或粗糙表面的未涂层钛和钴铬合金盘进行比较进行了评估。通过在孵育的最初几个小时内对粘附的细菌进行计数来进行细菌粘附，并且在孵育72小时后通过分光光度测定和通过共焦激光扫描显微镜来进行生物膜的形成。总体而言，与 CoCrMo 相比，金黄色葡萄球菌和表皮葡萄球菌是导致 PJI 的最常见细菌，在接触的最初几个小时内，以及在 TiNbN 涂层存在下培养时，其附着力显着降低。四种测试菌株的生物膜形成在所有合金上都是可比的。尽管 PJI 的发生比体外情况更为复杂，但这些研究结果表明，TiNbN 涂层骨科植入物不会增加 PJI 风险，同时改善摩擦学和表面特性可能是限制可能出现的并发症（例如金属过敏）的有效选择。