Novel Vaccination for the Prevention of Prosthetic Implant Infections
Abstract
Casualties in the United States Central Command operations have seen a dramatic increase in survival rates. With increased survival, a large number of Soldiers are returning with multiple post-traumatic musculoskeletal injuries and indwelling orthopaedic devices. Up to 40% of these individuals will develop orthopedic infection either as a direct result of their injury or as a consequence of surgical procedures performed and/or implants placed during the treatment of such injuries. One very important method used bacteria and fungi to survive within the body, especially on artificial joints and other orthopedic implants, is growing as a "biofilm." A biofilm is formed when microbes stick to a surface and start growing, surrounding itself in a sticky and protective matrix that prevents clearance by antibiotics and the host immune system. When antibiotics fail to eliminate the infection, the only option that remains is for the infected tissue or implant to be removed during surgery. In addition to Wounded Warriors, The Centers for Disease Control and Prevention and National Institutes of Health have estimated that these biofilm infections account for 56% and 80%, respectively, of all infections in modern healthcare facilities. This translates into 17,000,000 infections, 550,000 deaths, and $90 billion annually in the United States (see J Wound Care, 19(2):45-53. 2010). Rapid and accurate pathogen detection and identification is needed to allow physicians to react and respond appropriately to infections. It s vital to treat these types of infection early, before the biofilm has matured and become resistant to antibiotics. If this research project is successful, surgeons would be able to prescribe a vaccine that would prevent biofilms from developing in infected wounds. People who have suffered a serious wound, such as Soldiers struck by bullets or roadside bombs, could be inoculated against biofilm infections before surgery. Then, antibiotics would be more effective in preventing infections from spreading in their wounds and slowing their recovery. The vaccine potentially would be useful in civilian settings, too. The tasks for this project include collecting samples of four types of bacteria that have caused infections among our Soldiers in the War Against Terror. We will find out which bacterial proteins that our bodies immune system could recognize. If we succeed in all those tasks, we will test a vaccine, using rabbits and mouse models to see whether it will prevent biofilm infections. We anticipate that this study will enable us to develop a vaccine that works against biofilm infections and that our next step will be to test the vaccine in a human study. This vaccine will directly benefit military populations and impact combat-related orthopaedic research and patient care. The drawn-out anti-insurgency actions have resulted in a large number of combat injuries. While survival rates have increased, as compared to previous conflicts, use of advanced body armor does not protect the extremities from trauma. As a result, a large number of Soldiers are returning with multiple post-traumatic musculoskeletal injuries and indwelling orthopaedic devices with high infection rates. The research proposed herein will benefit the lives of Warfighters who have sustained such injuries by preventing orthopaedic infections and eliminate the need for invasive surgery.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 29, 2016
- Source ID
- W81XWH1510629
Entities
People
- Mark Shirtliff
Organizations
- United States Army
- University of Maryland, Baltimore