A large animal model for a failed two-stage revision of intramedullary nail-related infection by methicillin-resistant Staphylococcus aureus.

Details

Serval ID
serval:BIB_43663C16E91C
Type
Article: article from journal or magazin.
Collection
Publications
Title
A large animal model for a failed two-stage revision of intramedullary nail-related infection by methicillin-resistant Staphylococcus aureus.
Journal
European cells & materials
Author(s)
Moriarty T.F., Schmid T., Post V., Samara E., Kates S., Schwarz E.M., Zeiter S., Richards R.G.
ISSN
1473-2262 (Electronic)
ISSN-L
1473-2262
Publication state
Published
Issued date
30/08/2017
Peer-reviewed
Oui
Volume
34
Pages
83-98
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
The treatment of chronic orthopaedic device-associated infection (ODRI) often requires multiple surgeries and prolonged antibiotic therapy. Despite this extensive treatment protocol, the procedure is associated with significant failure rates. Currently, no large animal model is available that recapitulates a failed revision. Therefore, our aim was to establish a large animal model for failed treatment of an ODRI in order to serve as a testbed for future interventional strategies. Adult Swiss Alpine sheep received an intramedullary nail in the tibia and a localised inoculum of either a methicillin-sensitive or methicillin-resistant Staphylococcus aureus (MSSA, MRSA respectively). After 8 weeks, when chronic infection had been established, the animals underwent a staged revision with debridement and temporary placement of an antibiotic-loaded cement spacer. Antibiotics were delivered systemically in a standard or pathogen-adapted manner. Debridement and implant exchange alone failed to treat the MSSA infection. Neither local therapy alone nor systemic therapy alone were effective in resolving infection with MSSA, but a combination of local and systemic therapy was effective against it. MRSA infection was not resolved by the combination of local and systemic antibiotics (standard or pathogen-adapted). A model for failed revision of MRSA infection is described despite the use of local and systemic antibiotics. Novel interventions may be assessed using this model, including antibiotic and non-antibiotic interventions.
Keywords
Animals, Anti-Bacterial Agents/therapeutic use, Body Weight, Disease Models, Animal, Female, Fracture Fixation, Intramedullary/adverse effects, Intraoperative Care, Leukocyte Count, Methicillin-Resistant Staphylococcus aureus/physiology, Prosthesis-Related Infections/diagnostic imaging, Prosthesis-Related Infections/drug therapy, Prosthesis-Related Infections/microbiology, Prosthesis-Related Infections/pathology, Sheep, Staphylococcal Infections/diagnostic imaging, Staphylococcal Infections/drug therapy, Staphylococcal Infections/microbiology, Staphylococcal Infections/pathology
Pubmed
Web of science
Open Access
Yes
Create date
26/07/2021 8:00
Last modification date
27/07/2021 5:37
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