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Implant surfaces preventing microbial colonization would be desirable. We examined the preventive effect of a silver-coated titanium-aluminum-niobium (TiAlNb) alloy. The surface elicited a strong, inoculum-dependent activity against\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Staphylococcus epidermidis<\/jats:named-content>\n            and\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Staphylococcus aureus<\/jats:named-content>\n            in an agar inhibition assay. Gamma sterilization and alcohol disinfection did not alter the effect. In a tissue cage mouse model, silver coating of TiAlNb cages prevented perioperative infections in an inoculum-dependent manner and led to a 100% prevention rate after challenge with 2 \u00d7 10\n            <jats:sup>6<\/jats:sup>\n            CFU of\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">S. epidermidis<\/jats:named-content>\n            per cage. In\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">S. aureus<\/jats:named-content>\n            infections, silver coating had only limited effect. Similarly, daptomycin or vancomycin prophylaxis alone did not prevent\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">S. aureus<\/jats:named-content>\n            infections. However, silver coating combined with daptomycin or vancomycin prophylaxis thwarted methicillin-resistant\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">S. aureus<\/jats:named-content>\n            infections at a prevention rate of 100% or 33%, respectively. Moreover, silver release from the surface was independent of infection and occurred rapidly after implantation. On day 2, a peak of 82 \u03bcg Ag\/ml was reached in the cage fluid, corresponding to almost 6\u00d7 the MIC of the staphylococci. Cytotoxicity toward leukocytes in the cage was low and temporary. Surrounding tissue did not reveal histological signs of silver toxicity.\n            <jats:italic>In vitro<\/jats:italic>\n            , no emergence of silver resistance was observed in several clinical strains of staphylococci upon serial subinhibitory silver exposures. In conclusion, our data demonstrate that silver-coated TiAlNb is potent for prevention of IAIs and thus can be considered for clinical application.\n          <\/jats:p>","DOI":"10.1128\/aac.02934-15","type":"journal-article","created":{"date-parts":[[2016,2,17]],"date-time":"2016-02-17T03:49:32Z","timestamp":1455680972000},"page":"2467-2475","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":98,"title":["Preventing Implant-Associated Infections by Silver Coating"],"prefix":"10.1128","volume":"60","author":[{"given":"Richard","family":"Kuehl","sequence":"first","affiliation":[{"name":"Infection Biology Laboratory, Department of Biomedicine, University and University Hospital of Basel, Basel, Switzerland"},{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla 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