Prophylaxis of implant-related staphylococcal infections using tobramycin-containing bone cement.

M W Nijhof, W J Dhert, A Fleer, H C Vogely, A J Verbout
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引用次数: 48

Abstract

In a rabbit model, premixed tobramycin-containing bone cement was studied for its efficacy to prevent infections with two frequently encountered staphylococcal species in arthroplasty surgery. After intramedullary inoculation with staphylococci, either standard or premixed tobramycin-containing Simplex-P bone cement was injected in the right femur of 120 rabbits. Development of infection was examined by culture of femoral bone after 7 or 28 days. Loss of body weight and elevated erythrocyte sedimentation rate in the control rabbits inoculated with Staphylococcus aureus were seen in the first postoperative week, returning to normal in 28 days. Inoculation with Staphylococcus epidermidis resulted only in a low-grade infection. All rabbits receiving premixed tobramycin-containing bone cement were free of signs of infection, and all their cultures were negative. Culture yield from Staphylococcus aureus controls increased with time and inoculum dose. Staphylococcus epidermidis controls needed higher inoculum doses to establish an infection, while culture yield decreased in time. These differences in mode of prosthesis-related infection are explained by differences in virulence factors.

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含妥布霉素骨水泥预防种植体相关葡萄球菌感染。
在兔模型中,研究了含妥布霉素的预混合骨水泥预防关节置换术中常见的两种葡萄球菌感染的效果。120只家兔右股骨经葡萄球菌髓内接种后,分别注射含妥布霉素的标准型或预混型Simplex-P骨水泥。7天或28天后用股骨培养检查感染的发展情况。接种金黄色葡萄球菌的对照兔术后第一周体重减轻,红细胞沉降率升高,28天后恢复正常。接种表皮葡萄球菌只导致低度感染。所有接受含妥布霉素骨水泥预混剂的家兔均无感染迹象,培养结果均为阴性。金黄色葡萄球菌对照的培养产量随时间和接种量的增加而增加。表皮葡萄球菌对照需要较高的接种剂量来建立感染,而培养产量随着时间的推移而下降。这些假体相关感染模式的差异是由毒力因素的差异来解释的。
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