Cell surface characteristics of microbiological isolates from human percutaneous titanium implants in the head and neck

Percutaneous implants are commonly associated with several problems, and di fferent failure modes have been described. Infections constitute one seriou s complication which may lead to the removal of the implant. In contrast to infections around polymer implants, infections around skin-penetrating tit anium implants anchored in the temporal bone are often cured by local treat ment. Coagulase-negative staphylococci are the most common etiological agen ts in infections related to polymers whereas Staphylococcus aureus is consi dered as the main pathogen in infections around metallic implants, Microbia l adhesion is a prerequisite for an infection. In the present study, the ce ll surface of microbes isolated from the skin around skin-penetrating titan ium implants, with and without signs of infection, was characterized with r espect to expression of cell surface hydrophobicity and to binding of immob ilized fibronectin, vitronectin and collagen type 1 which could mediate adh esion. Expression of protein binding was similar in strains isolated from t he two groups. No strain expressed a hydrophobic cell surface as determined by two-phase separation, and we conclude that the microenvironment around a titanium implant promotes expression of a hydrophilic rather than a hydro phobic cell surface which in turn makes many infections around a titanium i mplant curable by local treatment. (C) 1999 Elsevier Science Ltd. All right s reserved.