Τίτλος:
Treatment of experimental osteomyelitis by Methicillin Resistant Staphylococcus Aureus with bone cement system releasing grepafloxacin
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The authors examined the effectiveness of the local anti-microbial treatment on methicillin resistant Staphylococcus aureus (MRSA) experimental osteomyelitis. Thirty-six rabbits with chronic MRSA osteomyelitis of the right femur were treated with local grepafloxacin delivery system prepared by a mixture of acrylic bone cement (polymethyl methacrylate, PMMA) plus 4% grepafloxacin. Osteomyelitis was induced by inoculating MRSA (100 μl of cultured bacteria; 107) and the local insertion of a needle, serving as a foreign body, at the upper third of the femur. The course of the infection was followed by clinical, radiographic and microbiological examination. In the third week, all animals were re-operated, needles were removed, and antibiotic containing acrylic cement was implanted. Thereafter, one control and five treated animals were sacrificed per week, within 6 weeks. Osteomyelitis was found in all rabbits. In vitro grepafloxacin levels remained high throughout the 6 weeks of the experiment. Histologically tissue reaction against the cement was not observed. Osteomyelitis lesions and bone structure were progressively repaired after cement implantation. Biomechanical analysis showed no significant influence on the mechanical properties of acrylic cement due to grepafloxacin. The above mixture could prove to be an important supplementary method for the treatment of bone infections. Such a system could replace the use of gentamycin PMMA beads in the treatment of patients with chronic osteomyelitis due to MRSA. Furthermore, the proposed method could be used as a spacer after removal septic loosened prostheses in combination with systemic administration of antibiotics. © 2008 Elsevier Ltd. All rights reserved.
Συγγραφείς:
Efstathopoulos, N.
Giamarellos-Bourboulis, E.
Kanellakopoulou, K.
Lazarettos, I.
Giannoudis, P.
Frangia, K.
Magnissalis, E.
Papadaki, M.
Nikolaou, V.S.
Λέξεις-κλειδιά:
acrylic cement; grepafloxacin, animal experiment; animal model; animal tissue; antimicrobial therapy; article; bacterium culture; biomechanics; bone marrow; bone radiography; bone structure; cell aggregation; compressive strength; controlled study; device removal; disease course; drug delivery system; drug efficacy; experimental rabbit; femur; foreign body; granuloma; methicillin resistant Staphylococcus aureus; microbiological examination; nonhuman; osteoblast; osteomyelitis; priority journal; reoperation; Staphylococcus infection; tissue reaction; young modulus, Animals; Anti-Bacterial Agents; Bone Cements; Fluoroquinolones; Methicillin-Resistant Staphylococcus aureus; Osteomyelitis; Piperazines; Prosthesis-Related Infections; Rabbits; Staphylococcal Infections
DOI:
10.1016/j.injury.2008.04.006
