Nazari Babak, Azizmohammadi Zahra, Rajaei Morteza, Karami Mohsen, Javadi Hamid, Assadi Majid, Asli Isa Neshandar
Department of Nuclear Medicine, Taleghani Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Nucl Med Commun. 2011 Aug;32(8):745-51. doi: 10.1097/MNM.0b013e3283483964.
Ubiquicidin (UBI) 29-41 is a cationic synthetic antimicrobial peptide fragment that binds preferentially with anionic microbial cell membranes at the site of infection. This study evaluated the potential ability of Tc-UBI 29-41 to assess response to antibiotic therapy in orthopedic infection.
A total of 12 patients, 10 men and two women (mean age, 41.6 years; range, 23-75 years), with suspected orthopedic infection (bone, soft tissue, or prosthesis) and positive Tc-UBI scan for infection were included in the study. One day after the Tc-UBI scan, a bone scan was performed as well. After this evaluation, eight of the nine treated cases responded to the treatment. Then, one nonresponder patient and two nontreated patients of three cases underwent antibiotic therapy and were evaluated again 10-14 days later. After this, one of the two patients not treated the first time responded to therapy and two patients did not. Moreover, one patient refused to undergo therapy both the first and second time. Thus, 11 treated cases were analyzed in this study and divided in two groups: (a) nine treated responders and (b) two treated nonresponders. In all patients, erythrocyte sedimentation rate and C-reactive protein were measured and also wound cultures were assessed.
Quantitative analysis of erythrocyte sedimentation rate, C-reactive protein, and bone scan before and after the 10-14-day interval showed no significant change in either group, but a quantitative Tc-UBI scan at 30, 60, and 120 min after tracer injection indicated significant reduction in radiotracer uptake after the 10-14-day interval compared with the Tc-UBI scan before this interval in the responder group, and no significant change in the nonresponder group.
The Tc-UBI scan can determine response to antibiotic therapy in orthopedic infection in humans.
泛杀素（UBI）29 - 41是一种阳离子合成抗菌肽片段，在感染部位优先与阴离子微生物细胞膜结合。本研究评估了锝标记的UBI 29 - 41评估骨科感染对抗生素治疗反应的潜在能力。
本研究纳入了12例患者，其中男性10例，女性2例（平均年龄41.6岁；范围23 - 75岁），怀疑有骨科感染（骨、软组织或假体）且锝标记的UBI扫描显示感染呈阳性。在锝标记的UBI扫描后一天，也进行了骨扫描。在这次评估后，9例接受治疗的病例中有8例对治疗有反应。然后，3例病例中的1例无反应患者和2例未治疗患者接受了抗生素治疗，并在10 - 14天后再次进行评估。在此之后，首次未治疗的2例患者中有1例对治疗有反应，2例患者无反应。此外，1例患者在第一次和第二次均拒绝接受治疗。因此，本研究分析了11例接受治疗的病例，并将其分为两组：（a）9例治疗有反应者和（b）2例治疗无反应者。对所有患者均测量了红细胞沉降率和C反应蛋白，并对伤口培养物进行了评估。
在10 - 14天间隔前后对红细胞沉降率、C反应蛋白和骨扫描进行定量分析，两组均未显示出显著变化，但在注射示踪剂后30、60和120分钟进行的定量锝标记的UBI扫描显示，与该间隔前的锝标记的UBI扫描相比，反应组在10 - 14天间隔后放射性示踪剂摄取显著降低，而无反应组无显著变化。
锝标记的UBI扫描可确定人类骨科感染对抗生素治疗的反应。
