Bactericidal activity of the Ti-13Nb-13Zr alloy against different species of bacteria related with implant infection.

The Ti-6Al-4V alloy is one of the most commonly used in orthopedic surgery. Despite its advantages, there is an increasing need to use new titanium alloys with no toxic elements and improved biomechanical properties, such as Ti-13Nb-13Zr. Prosthetic joint infections (PJI) are mainly caused by Gram-positive bacteria; however, Gram-negative bacteria are a growing problem due to associated multidrug resistance. In this study, the bacterial adherence and viability on the Ti-13Nb-13Zr alloy have been compared to that of the Ti-6Al-4V alloy using 16 collection and clinical strains of bacterial species related to PJI: Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas aeruginosa. When compared with the Ti-6Al-4V alloy, bacterial adherence on the Ti-13Nb-13Zr alloy was significantly higher in most staphylococcal and P. aeruginosa strains and lower for E. coli strains. The proportion of live bacteria was significantly lower for both Gram-negative species on the Ti-13Nb-13Zr alloy than on the Ti-6Al-4V alloy pointing to some bactericidal effect of the Ti-13Nb-13Zr alloy. This bactericidal effect appears to be a consequence of the formation of hydroxyl radicals, since this effect is neutralized when dimethylsulfoxide was added to both the saline solution and water used to wash the stain. The antibacterial effect of the Ti-13Nb-13Zr alloy against Gram-negative bacteria is an interesting property useful for the prevention of PJI caused by these bacteria on this potential alternative to the Ti-6Al-4V alloy for orthopedic surgery.