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Master's Dissertation
DOI
10.11606/D.22.2019.tde-07112018-211003
Document
Author
Full name
Daniella Maia Marques
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2018
Supervisor
Committee
Watanabe, Evandro (President)
Andrade, Denise de
Hermann, Paula Regina de Souza
Souza, Marina Trevelin
Title in Portuguese
Biomateriais com aplicabilidade na ortopedia: avanços e desafios na área da infectologia
Keywords in Portuguese
Artroplastia de quadril
Biofilmes
Biovidro F18
Candida albicans
Microscopia de fluorescência
Prótese de quadril
Staphylococcus epidermidis
Abstract in Portuguese
O controle na formação do biofilme em implantes e próteses ortopédicas continua sendo um dos grandes desafios acerca da infeção relacionada aos dispositivos na área da saúde. O objetivo desta pesquisa foi investigar biomateriais com aplicabilidade na ortopedia, visando os avanços e enfrentamentos dos desafios na área da infectologia. Uma revisão integrativa foi realizada a respeito da formação de biofilme em biomateriais de próteses de quadril com a finalidade de contribuir com as medidas de prevenção e controle aos agravos infecciosos. Além disso, a formação in vitro do biofilme em função dos biomateriais (titânio e titânio revestido com biovidro F18), microrganismos (Staphylococcus epidermidis e Candida albicans) e tempos de incubação (2, 4 e 8 horas) foi avaliada por microscopia de fluorescência. A revisão integrativa foi realizada no portal PubMed da National Library of Medicine, bem como nas bases Cochrane, Embase, Web of Science, CINAHL e LILACS com a inclusão de estudos primários sobre a temática, publicados online até novembro de 2017, em português, inglês e espanhol. Na fase experimental / laboratorial, biofilmes de S. epidermidis (ATCC 12228) e C. albicans (ATCC 90028) foram formados em corpos de prova de titânio e titânio revestido com biovidro F18 após 2, 4 e 8 horas de incubação a 37?C sob agitação orbital. As áreas das imagens dos corpos de prova, em porcentagem, recobertas com biofilme (células vivas) foram avaliadas por microscopia de fluorescência. Os dados coletados foram submetidos à análise estatística empregando-se os testes de normalidade Shapiro Wilk, U de Mann-Whitney e t de Student por meio do software IBM SPSS Statistics (versão 25) e nível de significância ?=5%. Na revisão integrativa, os resultados demonstraram que dos 16 estudos primários, 81,25% eram pesquisas experimentais in vitro e que novos biomateriais foram desenvolvidos para prevenir a formação de biofilme. Com relação à fase experimental / laboratorial, houve menor formação de biofilme por S. epidermidis e C. albicans (p<0,001) no titânio revestido com biovidro F18 do que no titânio, após 8 horas de incubação. Entretanto, houve maior formação de biofilme por S. epidermidis e C. albicans após 8 horas do que em 2 horas de incubação, tanto no titânio quanto no titânio revestido com biovidro F18 (p<0,05). Em suma, a revista da literatura mencionou o desenvolvimento de biomateriais novos para prevenir a formação de biofilme. Na fase laboratorial / experimental, o titânio revestido com biovidro F18 apresentou atividade antibiofilme em comparação com o titânio, e os tempos de incubação de 2 para 8 horas aumentaram a formação de biofilme em ambos os biomateriais. Ainda, pesquisas futuras acerca do biovidro F18 fundamentadas nos aspectos físicoquímicos, bioquímicos e microbiológicos são importantes para a elucidação dos mecanismos de ação relacionados ao controle dos biofilmes
Title in English
Biomaterials with applicability in orthopedics: advances and challenges in the infectology area
Keywords in English
Arthroplasty replacement hip
Biofilms
Candida albicans
F18 bioactive glass
Hip prosthesis
Microscopy fluorescence
Staphylococcus epidermidis
Abstract in English
The control of biofilm formation on implants and orthopedic prostheses still is one of the major challenges concerning infection related to devices in the health field. The objective of this research was to investigate biomaterials with applicability in orthopedics, aiming for advances and facing challenges in the infectology area. An integrative review was performed regarding biofilm formation on hip prosthesis biomaterials in order to contribute to the preventive and infection control measures. Moreover, the in vitro biofilm formation according to biomaterials (titanium and titanium coated with F18 bioglass), microorganisms (Staphylococcus epidermidis and Candida albicans) and incubation times (2, 4 and 8 hours) was evaluated by fluorescence microscopy. The integrative review was performed on PubMed portal from National Library of Medicine as well as on Cochrane, Embase, Web of Science, CINAHL and LILACS databases with the inclusion of primary studies about the topic, published online up until November 2017, in Portuguese, English and Spanish. In the experimental / laboratory step, S. epidermidis (ATCC 12228) and C. albicans (ATCC 90028) biofilms were formed on proof bodies of titanium and titanium coated with F18 bioglass after 2, 4 and 8 hours of incubation at 37?C under orbital shaking. The image areas of proof bodies, in percentage, coated with biofilm (living cells) were evaluated by fluorescence microscopy. The data collected were submitted to statistical analysis using normality tests Shapiro Wilk, U from Mann-Whitney and t from Student through IBM SPSS Statistics (version 25) software and significance level ?=5%. In the integrative review, the results showed that among 16 primary studies, 81.25% were in vitro experimental studies and that new biomaterials were developed to prevent biofilm formation. Regarding experimental / laboratory step, there was less biofilm formation by S. epidermidis and C. albicans (p<0.001) on titanium coated with F18 bioglass than on titanium, after 8 hours of incubation. However, there was more biofilm formation by S. epidermidis and C. albicans after 8 hours than in 2 hours of incubation, both on titanium and on titanium coated with F18 bioglass (p<0.05). In sum, the literature review mentioned the development of new biomaterials to prevent biofilm formation. In laboratory / experimental step, titanium coated with F18 bioglass presented antibiofilm activity in comparison with titanium, and the incubation times of 2 to 8 hours increased biofilm formation on both materials. Besides, future studies about F18 bioglass based on physicochemical, biochemical and microbiological aspects are important for the elucidation of action mechanisms related to biofilms control
 
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Publishing Date
2019-01-15
 
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