Background. Naturally occurring antimicrobial peptides are possibly the “next frontier” in infection prevention. Binding them to mesh could reduce the rate of mesh infections. This study identifies an antimicrobial agent capable of significant antibacterial activity when bound to mesh. Methods. Lysozyme, human beta defensin (HBD-3), human cathelicidin (LL-37), and lysostaphin were adsorbed to polypropylene mesh at various concentrations. Treated meshes were placed in a suspension of 1 × 106Staphylococcus aureus. Antibacterial action was monitored by turbidimetric assay, fluorescent imaging, and a colony counting method. Results. A very high rate of lysis of S aureus cells was observed in the lysostaphin-treated group as measured by optical density; none survived as seen on colony count assays. Optical density for mesh coated with lysozyme, HBD-3, and LL-37 did not differ from untreated controls, with 100% survival rates by colony counts. Conclusion. Lysostaphin had superior antibacterial activity following adsorption to mesh.
LuijendijkRWHopWCvan den TolMP. A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med. 2000;343:392-398.
2.
GrantAM. Open mesh versus non-mesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data [corrected]. Hernia. 2002;6:130-136.
3.
HenifordBTParkARamshawBJVoellerG. Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg. 2003;238:391-399.
4.
RiosARodriguezJMMunitizVAlcarazPPerez FloresDParrillaP. Antibiotic prophylaxis in incisional hernia repair using a prosthesis. Hernia. 2001;5:148-152.
5.
ChavarriagaLFLinELoskenA. Management of complex abdominal wall defects using acellular porcine dermal collagen. Am Surg. 2010;76:96-100.
6.
CobbWSCarbonellAMKalbaughCLJonesYLokeyJS. Infection risk of open placement of intraperitoneal composite mesh. Am Surg. 2009;75:762-767.
7.
ForbesSSEskiciogluCMcLeodRSOkrainecA. Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg. 2009;96:851-858.
8.
HaroldKMekeelKSpitlerJ. Outcomes analysis of laparoscopic ventral hernia repair in transplant patients. Surg Endosc. 2009;23:1835-1838.
9.
LinHJSpoerkeNDeveneyCMartindaleR. Reconstruction of complex abdominal wall hernias using acellular human dermal matrix: a single institution experience. Am J Surg. 2009;197:599-603.
10.
FarrowBAwadSBergerDH. More than 150 consecutive open umbilical hernia repairs in a major Veterans Administration Medical Center. Am J Surg. 2008;196:647-651.
11.
PetersenSHenkeGFreitagMFaulhaberALudwigK. Deep prosthesis infection in incisional hernia repair: predictive factors and clinical outcome. Eur J Surg. 2001;167:453-457.
12.
CobbWSPatonBLNovitskyYW. Intra-abdominal placement of antimicrobial-impregnated mesh is associated with noninfectious fever. Am Surg. 2006;72:1205-1208.
GristinaAGNaylorPMyrvikQ. Infections from biomaterials and implants: a race for the surface. Med Prog Technol. 1988;14:205-224.
18.
CochraneDMBrownMRAnwarHWellerPHLamKCostertonJW. Antibody response to Pseudomonas aeruginosa surface protein antigens in a rat model of chronic lung infection. J Med Microbiol. 1988;27:255-261.
19.
CostertonJWStewartPSGreenbergEP. Bacterial biofilms: a common cause of persistent infections. Science. 1999;284:1318-1322.
20.
PhadkeSMDeslouchesBHilemanSEMontelaroRCWiesenfeldHCMietznerTA. Antimicrobial peptides in mucosal secretions: the importance of local secretions in mitigating infection. J Nutr. 2005;135:1289-1293.
21.
ChenXNiyonsabaFUshioH. Synergistic effect of antibacterial agents human beta-defensins, cathelicidin LL-37 and lysozyme against Staphylococcus aureus and Escherichia coli. J Dermatol Sci. 2005;40: 123-132.
22.
Centers for Disease Control and Prevention. Preventing emerging infectious diseases: a strategy for the 21st century. http://www.cdc.gov/mmwr/pdf/rr/rr4715.pdf. Accessed January 17, 2011.
23.
WuJAKusumaCMondJJKokai-KunJF. Lysostaphin disrupts Staphylococcus aureus and Staphylococcus epidermidis biofilms on artificial surfaces. Antimicrob Agents Chemother. 2003;47:3407-3414.
ShimodaMOhkiKShimamotoYKohashiO. Morphology of defensin-treated Staphylococcus aureus. Infect Immun. 1995;63:2886-2891.
26.
KumarJK. Lysostaphin: an antistaphylococcal agent. Appl Microbiol Biotechnol. 2008;80:555-561.
27.
Kokai-KunJFChanturiyaTMondJJ. Lysostaphin eradicates established Staphylococcus aureus biofilms in jugular vein catheterized mice. J Antimicrob Chemother. 2009;64:94-100.
28.
PlacenciaFXKongLWeismanLE. Treatment of methicillin-resistant Staphylococcus aureus in neonatal mice: lysostaphin versus vancomycin. Pediatr Res. 2009;65:420-424.
29.
Van HekkenDLWallRJSomkutiGAPowellMATunickMHTomasulaPM. Fate of lysostaphin in milk from individual cows through pasteurization and cheesemaking. J Dairy Sci. 2009;92:444-457.
30.
ClimoMWEhlertKArcherGL. Mechanism and suppression of lysostaphin resistance in oxacillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2001;45:1431-1437.
31.
Boyle-VavraSCareyRBDaumRS. Development of vancomycin and lysostaphin resistance in a methicillin-resistant Staphylococcus aureus isolate. J Antimicrob Chemother. 2001;48:617-625.
KusumaCJadanovaAChanturiyaTKokai-KunJF. Lysostaphin-resistant variants of Staphylococcus aureus demonstrate reduced fitness in vitro and in vivo. Antimicrob Agents Chemother. 2007;51:475-482.
