<i>Staphylococcus aureus</i> Adhesion to Titanium and Polypropylene Medical Implants: A Comparative Study

BACKGROUND: Infectious complications associated with the use of medical implants pose a significant challenge, particularly for materials prone to bacterial colonization and biofilm formation. Staphylococcus aureus is one of the most critical pathogens responsible for implant-associated infections. The physicochemical properties of implant surfaces, such as roughness, hydrophobicity, and chemical composition, influence bacterial adhesion. Currently, there is insufficient comparative data on Staphylococcus aureus adhesion to different materials used in gynecological practice, including polypropylene and titanium. Studying this process is essential for reducing the risk of infectious complications and optimizing implant properties. AIM: The aim of this study was to conduct a comparative analysis of Staphylococcus aureus adhesion to titanium and polypropylene implants, assessing the impact of their physicochemical characteristics on bacterial attachment. METHODS: This experimental comparative in vitro study examined two types of medical mesh implants made of polypropylene (Gynemesh PS, Johnson Johnson, USA) and titanium (Titanium Silk, Elastic Titanium Implants Ltd., Russia). To assess the adhesive properties, a daily culture of Staphylococcus aureus VT209 was incubated with implant samples at 37 ℃ for 1 hour. After washing, bacterial adhesion was quantitatively assessed using culture-based methods. Scanning electron microscopy and energy-dispersive X-ray spectroscopy were employed to analyze surface microstructure and chemical composition. RESULTS: Quantitative adhesion levels of Staphylococcus aureus to titanium and polypropylene meshes were similar (p 0.05); however, bacterial distribution patterns differed. Polypropylene implants showed uniform bacterial adhesion, whereas titanium implants exhibited localized bacterial concentration at the edges. Scanning electron microscopy analysis revealed surface roughness and microdefects at the edges of titanium implants, likely contributing to increased bacterial adhesion. Energy-dispersive X-ray spectroscopy analysis indicated differences in chemical composition between central and edge regions of titanium implants, with edge areas containing additional elements (carbon, oxygen, fluorine, iron), possibly introduced during mechanical processing and oxidation. CONCLUSION: While the overall bacterial adhesion levels on titanium and polypropylene implants were comparable, the observed differences in bacterial distribution suggest an increased risk of infection in mechanically processed titanium areas. Further research is needed to explore surface modification strategies for titanium implants to minimize bacterial adhesion, including improved surface treatments and antimicrobial coatings. These findings may contribute to the development of safer medical implants and a reduction in implant-associated infections.