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Zhao, You ; Mannala, Gopala Krishna ; Youf, Raphaëlle ; Humez, Martina ; Schewior, Ruth ; Kühn, Klaus-Dieter ; Alt, Volker ; Riool, Martijn

Efficacy of Dual-Antibiotic-Loaded Bone Cement Against Multi-Drug-Resistant Staphylococcus aureus and Enterococcus faecalis in a Galleria mellonella Model of Periprosthetic Joint Infection

Zhao, You, Mannala, Gopala Krishna, Youf, Raphaëlle , Humez, Martina, Schewior, Ruth, Kühn, Klaus-Dieter, Alt, Volker and Riool, Martijn (2025) Efficacy of Dual-Antibiotic-Loaded Bone Cement Against Multi-Drug-Resistant Staphylococcus aureus and Enterococcus faecalis in a Galleria mellonella Model of Periprosthetic Joint Infection. Antibiotics 14 (12), p. 1280.

Date of publication of this fulltext: 18 Dec 2025 11:01
Article
DOI to cite this document: 10.5283/epub.78350


Abstract

Background: Antibiotic-loaded bone cement (ALBC) is widely used for local antibiotic delivery in joint arthroplasty to prevent and treat prosthetic joint infections (PJIs). In this study, we evaluated the efficacy of cemented Kirschner (K)-wires coated with various ALBC formulations using a Galleria mellonella infection model against multidrug-resistant (MDR) Staphylococcus aureus and ...

Background: Antibiotic-loaded bone cement (ALBC) is widely used for local antibiotic delivery in joint arthroplasty to prevent and treat prosthetic joint infections (PJIs). In this study, we evaluated the efficacy of cemented Kirschner (K)-wires coated with various ALBC formulations using a Galleria mellonella infection model against multidrug-resistant (MDR) Staphylococcus aureus and Enterococcus faecalis. Methods: We tested commercially available bone cements, including gentamicin-only formulations (PALACOS R+G) and dual-antibiotic formulations, combining gentamicin with either clindamycin (COPAL G+C) or vancomycin (COPAL G+V), alongside an antibiotic-free control (PALACOS R). In vitro assays—including minimum inhibitory/bactericidal concentration (MIC/MBC) determination, antibiotic release kinetics, agar diffusion, and antibiofilm evaluations—demonstrated effective antibiotic release and significant antimicrobial activity against both planktonic and biofilm-associated bacteria. Results: In vivo, ALBC-coated K-wires were well tolerated in G. mellonella and significantly protected the larvae from S. aureus infection compared to controls. Notably, dual-antibiotic formulations provided superior protection, correlating with substantial reductions in bacterial colonisation on implant surfaces and in surrounding tissues. Conclusions: These findings support the utility of the G. mellonella model as a high-throughput, cost-effective platform for the preclinical evaluation of antimicrobial strategies to prevent and treat PJIs and further demonstrate the effectiveness of dual-loaded ALBC against multidrug-resistant bacteria.



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Details

Item typeArticle
Journal or Publication TitleAntibiotics
Publisher:MDPI
Volume:14
Number of Issue or Book Chapter:12
Page Range:p. 1280
Date17 December 2025
InstitutionsMedicine > Lehrstuhl für Unfallchirurgie
Identification Number
ValueType
10.3390/antibiotics14121280DOI
Keywordsantibiotic-loaded bone cement (ALBC); polymethylmethacrylate (PMMA); Galleria mellonella; prosthetic joint infection (PJI); multidrug-resistant bacteria
Dewey Decimal Classification500 Science > 570 Life sciences
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgPartially
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-783502
Item ID78350

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