Team Develops Anti-Infection Technology

Combat-related injuries have long plagued the military in part because of multidrug-resistant bacteria. Imagine being able to spray a compound fracture with microcapsules that deliver a drug to bolster the immune system, stopping infection before it starts.

That technology might be around the corner, says Bingyun Li, of the West Virginia University Department of Orthopaedics and director of the WVU Biomaterials, Bioengineering & Nanotechnology Laboratory. Li's team has developed a drug-delivery technology involving microcapsules - and a second technique, nanocoating -- that have been shown to work in animal studies.

Results of the team's research involving the drug interleukin-12, a drug currently in anti-cancer clinical trials, has been published in the May issue of the journal Biomaterials. A deeper explanation of the approach, which could develop into an alternative to antibiotic therapy, is scheduled to be published in an upcoming issue of the Journal of Orthopaedic Research.

"These pioneering techniques could be important to the United States because of the wars in Iraq and Afghanistan," Li says. "The treatment of battlefield casualties is expensive, and the infection rate runs from 2 percent to 15 percent. In some cases, because the organisms have developed resistance, antibiotics don't work."

Outside the arena of warfare, millions of people could potentially be helped by the technology because infections can result whenever a biomedical device is implanted.

Li's team developed two ways to deliver interleukin-12.

The first is in microcapsules that can be injected or, potentially, delivered in a fine-mist spray directly to the site of an injury. The second is a nanocoating of interleukin-12 applied directly to stents, pacemakers, pain pumps, artificial limbs -- virtually any biomedical device -- before implantation. The coating is measured on the nano scale; one nanometer is one billionth of a meter.

"Interleukin-12 will maximize the body's natural response to an extent where infections can be prevented without the risk of the offending bacteria developing resistance to the treatment, as is becoming more of a problem with antibiotic therapy alone. With nanocoating, the drug is right where it needs to be - at the interface of the implant and your tissue," Li says. "With the microcapsule, the drug can be injected or sprayed where desired, and the nanocoating and microcapsule prolong the half-life of interleukin-12."

In both methods, because the interleukin-12 is delivered locally rather than spread throughout the body, as in antibiotic therapy, side effects are minimal, Li explains.

Li drew his team from the WVU Department of Orthopaedics, the WVU School of Pharmacy, the National Institute for Occupational Health and Safety (NIOSH), and the WVU Department of Microbiology, Immunology and Cell Biology.

Li, who is also a guest researcher with NIOSH, is giving a presentation on the technology later this summer to officials from the Naval Medical Research Center in Silver Spring, Md. He is also working with Christopher Kolanko, a Department of Defense consultant for the WVU Research Corporation, and program managers with the Department of Defense, to discuss further research possibilities and possible military applications.

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Greater Hospital Vigilance Urged Over Water Systems in Summer

Patients who are vulnerable to infection run a greater risk of contracting Legionnaires’ disease, a severe form of pneumonia, during warm, humid weather, according to a study published in the Journal of Infectious Diseases. The infection is caused by Legionella bacteria that can live in hospital water systems and throughout the environment.

Legionella bacteria, while usually not a problem for healthy adults, can be most serious and even fatal for patients who are immune compromised, including those in Intensive Care Units, the very young and the very old, the chronically ill, and post-surgical, cancer and transplant patients. These patients risk becoming infected through a buildup of microbes that can inhabit a hospital’s water system, where they have oftentimes become resistant to traditional methods of cleaning and disinfection.

At-risk patients can become ill through any exposure to hospital water, whether through ingestion, comforting mouth sores with ice cubes, bathing, inhalation of shower mist or being treated with equipment washed in hospital water.

“Many healthcare professionals aren’t aware of what’s lurking in their water in the summer or any season, especially the water used with critically ill and at-risk patients. As a result, countless Legionella and other harmful microorganisms that can cause serious infections go undetected,” says Janet Stout, an international expert on Legionella and other microbes in hospital water.

Stout, director of the Special Pathogens Laboratory and a microbiologist at the University of Pittsburgh, is a strong advocate for reducing the risk of waterborne infection in hospitals, nursing homes and other healthcare facilities. She is on a mission to get these institutions to test their water and then do something about it.

Speaking at the annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC) in San Jose, California, Stout shared stories that vividly illustrated the problem:

• A hospital’s Burn Unit treated its badly burned patients with a cooling water spray to ease their pain…until it was discovered that the water was loaded with dangerous, infection-causing microbes.
• Another hospital, attempting to prevent the spread of infection, installed non-touch faucets. But a study found that every faucet tested positive for Legionella bacteria, and that 74 percent were also contaminated with Pseudomonas aeruginosa, another bacterium associated with serious, often fatal, pneumonia.

Patients, their families and caregivers need to be aware of the potential for waterborne infection any time they are hospitalized, particularly if they are seriously ill or undergoing treatment that affects their immune systems, according to Stout.

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