Osteomyelitis

Staphylococcus aureusbiofilms

“…102 Resolution of S. aureus biofilm infections continues to require surgical removal of the nidus of infection due to innate resistance to antimicrobial and host response factors. 103 However, attempts to develop an effective anti-S. aureus vaccine have often ignored this mode of growth in favor of using planktonic cells and infection models. [104][105][106] This is further complicated by the fact that S. aureus-during biofilm formation and maturation-releases a number of extracellular factors that induce an inflammatory, Th1-type immune response rather than the more effective Th2-type as mentioned before.…”

An Osteoconductive Antibiotic Bone Eluting Putty with a Custom Polymer Matrix

“…Multidrug resistant bacteria are becoming almost universal, provoked by the pervasive and often extended use of antibiotics [ 4 ]; moreover, many of these once powerful antimicrobial drugs are now rendered impotent by inappropriate prescribing patterns [ 5 , 6 , 7 ] and poor patient compliance [ 4 , 8 , 9 , 10 ]. Almost 70% of nosocomial infections are linked to antibiotic resistant pathogens [ 11 , 12 , 13 , 14 ]. Beyond clinical practice, microbial characteristics as well as societal and technical changes have led to the frightening revelation that development of antibiotic resistance is almost virtually certain given enough time [ 15 , 16 , 17 ].…”

“…While considered generally effective, problems with systemic antibiotic delivery include systemic side effects and low antibiotic concentrations at the local site of infection, unintentionally favoring antibiotic resistance [ 10 , 12 ]. Bone’s limited vascular supply and the presence of sequestra or void space [ 14 ] compounds the problem, inhibiting both delivery of systemic antibiotics and compromising host defenses [ 4 , 7 ]. Sequestra present a favorable, inert environment for harboring bacteria and allowing their unmitigated persistence in the protected avascular wound space [ 14 ].…”

“…Bone’s limited vascular supply and the presence of sequestra or void space [ 14 ] compounds the problem, inhibiting both delivery of systemic antibiotics and compromising host defenses [ 4 , 7 ]. Sequestra present a favorable, inert environment for harboring bacteria and allowing their unmitigated persistence in the protected avascular wound space [ 14 ]. Bacterial persistence in the protected avascular space can lead to progressive acute and chronic osteomyelitis.…”

Πειραματική Οστεομυελίτιδα Και Αξιολόγηση Της Θεραπείας Με FDG - PET

“…Ο πληθυσμός του βιοφίλμ, έτσι λειτουργεί ως μόνιμη πηγή παθογόνου την ίδια στιγμή που τα βακτήρια είναι απρόσβλητα από το ανοσοποιητικό σύστημα και τη χορήγηση αντιβιοτικών. Ως εκ τούτου, η ασφαλέστερη θεραπεία επί του παρόντος, είναι η χειρουργική απομάκρυνση του απολύματος που φέρει το βιοφίλμ[ 43].Μια άλλη αιτία των χρόνιων λοιμώξεων είναι τα βραδείας ανάπτυξης παθογόνα, τα οποία αποτελούν αυτό που είναι γνωστό ως, "παραλλαγές μικρής αποικίας" (SCV) και είναι δύσκολο να καλλιεργηθούν. Μπορούν να διεισδύουν στα κύτταρα που αδυνατούν να προβούν σε φαγοκυττάρωση και παράλληλα μπορούν να επιβιώσουν ενδοκυτταρικά χωρίς να επηρεάζονται από τα σημερινά διαθέσιμα αντιβιοτικά[ 42].2.…”