Treatment of implant-related methicillin-resistant <i>Staphylococcus aureus</i> osteomyelitis with vancomycin-loaded VK100 silicone cement: An experimental study in rats

Neyisci, Cagri; Erdem, Yusuf; Bilekli, Ahmet Burak; Demiralp, Bahtiyar; Köse, Özkan; Bek, Doğan; Korkusuz, Feza; Kankilic, Berna

doi:10.1177/2309499017754093

Cited by 6 publications

(8 citation statements)

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“…In studies such as the one by Neyisci et al, 30 a vancomycin-loaded VK100 silicone cement drug delivery system seems to be an effective method for the treatment of implant-related chronic MRSA osteomyelitis in rats. Additionally, Kaur et al’s 31 examination of the efficacy of linezolid presents an attractive and aggressive early approach in preventing, as well as treating, implant-associated infections caused by MRSA strains.…”

Section: Discussionmentioning

confidence: 99%

Animal experimental investigation on the efficacy of antibiotic therapy with linezolid, vancomycin, cotrimoxazole, and rifampin in treatment of periprosthetic knee joint infections by MRSA

Goetz

Keyssner

Hanses

et al. 2022

Bone & Joint Research

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Aims Periprosthetic joint infections (PJIs) are rare, but represent a great burden for the patient. In addition, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) is increasing. The aim of this rat experiment was therefore to compare the antibiotics commonly used in the treatment of PJIs caused by MRSA. Methods For this purpose, sterilized steel implants were implanted into the femur of 77 rats. The metal devices were inoculated with suspensions of two different MRSA strains. The animals were divided into groups and treated with vancomycin, linezolid, cotrimoxazole, or rifampin as monotherapy, or with combination of antibiotics over a period of 14 days. After a two-day antibiotic-free interval, the implant was explanted, and bone, muscle, and periarticular tissue were microbiologically analyzed. Results Vancomycin and linezolid were able to significantly (p < 0.05) reduce the MRSA bacterial count at implants. No significant effect was found at the bone. Rifampin was the only monotherapy that significantly reduced the bacterial count on implant and bone. The combination with vancomycin or linezolid showed significant efficacy. Treatment with cotrimoxazole alone did not achieve a significant bacterial count reduction. The combination of linezolid plus rifampin was significantly more effective on implant and bone than the control group in both trials. Conclusion Although rifampicin is effective as a monotherapy, it should not be used because of the high rate of resistance development. Our animal experiments showed the great importance of combination antibiotic therapies. In the future, investigations with higher case numbers, varied bacterial concentrations, and changes in individual drug dosages will be necessary to be able to draw an exact comparison, possibly within a clinical trial. Cite this article: Bone Joint Res 2022;11(3):143–151.

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Section: Discussionmentioning

confidence: 99%

Animal experimental investigation on the efficacy of antibiotic therapy with linezolid, vancomycin, cotrimoxazole, and rifampin in treatment of periprosthetic knee joint infections by MRSA

Goetz

Keyssner

Hanses

et al. 2022

Bone & Joint Research

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“…MRSA chronic osteomyelitis is a devastating disease with limited cure, including long-term systemic antibiotic administration and repetitive surgeries (25). Poor blood circulation in the infection area and bone necrosis makes osteomyelitis a persistent disease, and treatment can hardly be achieved (26); so, local antibiotic delivery systems are generated (27). Various polymers, calcium-based composites, and manufacturing methods for local drug delivery systems reveal that an optimum system has not yet been produced (28)(29)(30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

Vancomycin Containing PDLLA and PLGA/β-TCP Inhibit Biofilm Formation but Do Not Stimulate Osteogenic Transformation of Human Mesenchymal Stem Cells

Kankilic

Bayramlı²,

Korkusuz³

et al. 2022

Front. Surg.

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AimsChronic osteomyelitis, including implant-related prosthetic joint infection, is extremely difficult to cure. We develop vancomycin containing release systems from poly(d,l-lactide) (PDLLA) and poly(d,l-lactide-co-glycolide) (PLGA) composites with beta-tricalcium phosphate (β-TCP) to treat methicillin-resistant Staphylococcus aureus osteomyelitis. We ask whether vancomycin containing PDLLA/β-TCP and PLGA/β-TCP composites will prevent early biofilm formation, allow cell proliferation and osteogenic differentiation, and stimulate osteogenic signaling molecules in the absence of an osteogenic medium.MethodsComposites were produced and characterized with scanning electron microscopy. In vitro vancomycin release was assessed for 6 weeks. Biofilm prevention was calculated by crystal violet staining. Human bone marrow-derived mesenchymal stem cells (hBM-MSCs) and osteosarcoma cell (SaOS-2) proliferation and differentiation were assessed with water soluble tetrazolium salt and alkaline phosphatase (ALP) staining. Real-time quantitative polymerase chain reaction defined osteogenic signaling molecules for hBM-MSCs.ResultsTotally, 3.1 ± 0.2 mg and 3.4 ± 0.4 mg vancomycin released from PDLLA/β-TCP and the PLGA/β-TCP composites, respectively, and inhibited early biofilm formation. hBM-MSCs and SaOS-2 cells proliferated on the composites and stimulated ALP activity of cells. Runt-related transcription factor 2 (RUNX2) and SRY-Box transcription Factor 9 (SOX9) expressions were, however, lower with composites when compared with control.ConclusionVancomycin containing PDLLA/β-TCP and PLGA/β-TCP composites inhibited early biofilm formation and proliferated and differentiated hBM-MSCs and SaOS-2 cells, but osteogenesis-related RUNX2 and SOX9 transcription factors were not strongly expressed in the absence of an osteogenic medium for 14 days.

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“…In microbiological tissue cultures, bone tissue MRSA colonization was numerically determined and all groups were compared. At this stage, clinical osteomyelitis scores were calculated for each rat based on the clinical scoring system used by Neyisci et al [ 10 ] ( Table 3 ). In addition, bone and soft tissue samples were taken into separate pathology containers with 10% buffered formaldehyde solution for pathological evaluation and prepared for histopathological examination.…”

Section: Methodsmentioning

confidence: 99%

Rifaximine Spacer Application is not Superior to Local Teicoplanin Treatment in a Rat Model of Osteomyelitis

Yucel¹

2022

North Clin Istanbul

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OBJECTIVE Acute and chronic osteomyelitis generally require long-term antibiotic therapy and surgical debridement. Implant-associated osteomyelitis, particularly from methicillin-resistant Staphylococcus aureus (MRSA) strains, is difficult to treat. Rifaximin is an antibiotic derived from rifamycin which may be effective in the treatment of osteomyelitis in terms of its wide spectrum of action and pharmacological properties. The aim of this experimental study was to investigate the local efficacy of rifaximin in rat models with MRSA and implant associated osteomyelitis. METHODS This study was carried out with 40 adult Wistar albino rats. The rats were randomly divided into 4 equal groups with 10 rats in each. An implant related MRSA osteomyelitis was created in the right tibia metaphysis of each rat by Norden’s experimental osteomyelitis model. After 4 weeks, the implants of each tibia were removed and debridement was applied. Group 1 was designed as control group and no other treatment was applied other than debridement. Bone cement without any antibiotic was applied to Group 2, bone cement with teicoplanin was applied to Group 3 and bone cement with rifaximin was applied to Group 4. After 4 weeks from the second surgery, euthanasia was performed to the rats and the clinical, histopathological and microbiological results were compared. RESULTS There was no statistically significant difference between the groups in clinical scoring. A statistically significant difference was found between the histopathological scores of Group 1 and Group 2 and the histopathological scores of Groups 3 and 4; the histopathological scores of Group 1 and Group 2 were found to be higher than Group 3 and Group 4. When the pre-and post-treatment colony numbers were compared, although there was a statistically significant difference between Group 3 and Group 2, no statistically significant difference was found between Group 4 and Group 1 results. CONCLUSION In spite of its wide spectrum, the local efficacy of rifaximin in the treatment of osteomyelitis could not be demonstrated. This study shows the ability to shed light on some future comprehensive studies with the inclusion of infection markers.

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Treatment of implant-related methicillin-resistant Staphylococcus aureus osteomyelitis with vancomycin-loaded VK100 silicone cement: An experimental study in rats

Abstract: vVK100 polymer, as a local antibiotic delivery system, seems to be an effective method for the treatment of implant-related chronic MRSA osteomyelitis.

Cited by 6 publications

References 29 publications

Animal experimental investigation on the efficacy of antibiotic therapy with linezolid, vancomycin, cotrimoxazole, and rifampin in treatment of periprosthetic knee joint infections by MRSA

Animal experimental investigation on the efficacy of antibiotic therapy with linezolid, vancomycin, cotrimoxazole, and rifampin in treatment of periprosthetic knee joint infections by MRSA

Vancomycin Containing PDLLA and PLGA/β-TCP Inhibit Biofilm Formation but Do Not Stimulate Osteogenic Transformation of Human Mesenchymal Stem Cells

Rifaximine Spacer Application is not Superior to Local Teicoplanin Treatment in a Rat Model of Osteomyelitis

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