The bactericidal and biocompatible characteristics of reinforced calcium phosphate cements

Infection remains a serious medical problem in orthopaedic surgery. Antibiotic administration can be available either systemically via the blood stream or locally, directly into the infected bone. One of the main limitations of antibiotic administration is the development of multi-antibiotic-resistant bacterial strains. In this study, we developed bactericidal calcium phosphate cements (CPC) by incorporation of different molecular weight chitosan and hydroxypropyltrimethyl ammonium chloride chitosan (HACC). Two standard strains, S. epidermidis (ATCC35984) and S. aureus (ATCC25923), and one clinical isolate, methicillin-resistant S. epidermidis (MRSE), were selected to evaluate the antibacterial activity of these bone cements. Our data showed that the CPC loaded with low molecular weight chitosan and HACC significantly inhibited the bacterial adhesion and biofilm formation. In addition, HACC-containing CPC has no cytotoxic effects on both mouse pluripotent C3H10T1/2cell line and a murine L929 fibroblast cell line. We propose that HACC-containing CPC represents a promising polymer-based bactericidal bone scaffold in controlling orthopaedic surgery-related infection.