Drug Delivery Systems for Bacteriophages: New Approach for Therapy and Prevention of Implant-Associated Infections

Objectives: Despite the observance of the conditions of asepsis and systemic prophylactic administration of antibiotics, bacterial contamination of implantable materials often occurs. For example, the incidence of vascular implant infections ranges from 1 to 6% of cases, depending on the location and type of an implant, which is associated with high morbidity and mortality. Bacteriophages have been known for more than a hundred years and their application is good alternative or a support to standard antibacterial therapy. However adequate local delivery of phages in case of implant-associated infections is still a challenge.

Methods: Polymeric scaffolds based on a fibrin sealant were tested in vitro in order to assess a potency to carry bacteriophage virions of different morphology and to be used as a functional coating for implanted medical devices and materials. Antibacterial action was investigated in in vitro models of Staphylococcus aureus and Pseudomonas aeruginosa graft infections with different bacterial load, dosage of phages, and combination with antibiotics. Protective effect of the coatings against immunoglobulins was tested in order to evaluate their ability to protect phages from neutralizing antibodies.

Results: Fibrin glue containing coatings showed good adhesive properties to used model materials. Phages embedded to variants of the coatings showed their ability to protect surfaces of implantable medical devices and materials from the bacterial infections.

Conclusion: Phage containing surface coatings are promising approach for therapy and prevention of implant-associated infections. Tested variants of the coatings are suitable for their preparation and application at an operation room on demand.