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达托霉素：在植入物相关感染和复杂性骨髓炎中的局部应用。

Daptomycin: local application in implant-associated infection and complicated osteomyelitis.

作者信息

Rosslenbroich Steffen B, Raschke Michael J, Kreis Carolin, Tholema-Hans Nancy, Uekoetter Andreas, Reichelt Rudolf, Fuchs Thomas F

机构信息

Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Muenster, Westfalian-Wilhelm's-University Muenster, 48149 Muenster, Germany.

出版信息

ScientificWorldJournal. 2012;2012:578251. doi: 10.1100/2012/578251. Epub 2012 Jun 18.

DOI:10.1100/2012/578251
PMID:22792046
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3385625/
Abstract

BACKGROUND

The rise of highly resistant bacteria creates a persistent urge to develop new antimicrobial agents. This paper investigates the application of the lipopeptide antibiotic daptomycin in infections involving the human bone.

METHODS

Compressive and tensile strength testing of daptomycin-laden PMMA was performed referring to the ISO 5833. The microstructure of the antibiotic-laden PMMA was evaluated by scanning electron microscopy. Intracellular activity of daptomycin was determined by a human osteoblast infection model. Elution kinetics of the antibiotic-laden bone cement was measured by using a continuous flow chamber setup.

RESULTS

There was no significant negative effect of adding 1.225% and 7.5% per weight of daptomycin to the PMMA. There was no significant difference in intracellular activity comparing gentamicin to daptomycin. Elution of daptomycin from PMMA showed within the first-hour initial peak values of 15-20 μg/mL.

CONCLUSION

Daptomycin has a certain degree of activity in the intracellular environment of osteoblasts. Daptomycin admixed to PMMA remains bactericidal and does not significantly impair structural characteristics of the PMMA. The results of this paper suggest that daptomycin might be a potent alternative for treating osteomyelitis and implant-associated infection in trauma and orthopedic surgery caused by multiresistant strains.

摘要

背景

高耐药性细菌的出现促使人们不断开发新的抗菌药物。本文研究脂肽抗生素达托霉素在涉及人体骨骼感染中的应用。

方法

参照ISO 5833对载有达托霉素的聚甲基丙烯酸甲酯（PMMA）进行抗压和抗拉强度测试。通过扫描电子显微镜评估载抗生素PMMA的微观结构。采用人成骨细胞感染模型测定达托霉素的细胞内活性。使用连续流动腔装置测量载抗生素骨水泥的洗脱动力学。

结果

按重量计向PMMA中添加1.225%和7.5%的达托霉素没有显著的负面影响。庆大霉素与达托霉素相比，细胞内活性没有显著差异。达托霉素从PMMA中的洗脱在第一小时内显示出15 - 20μg/mL的初始峰值。

结论

达托霉素在成骨细胞的细胞内环境中具有一定程度的活性。与PMMA混合的达托霉素仍具有杀菌作用，且不会显著损害PMMA的结构特性。本文结果表明，达托霉素可能是治疗由多重耐药菌株引起的创伤和骨科手术中骨髓炎及植入物相关感染的有效替代药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/518ed95fc1c0/TSWJ2012-578251.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/8845827e8226/TSWJ2012-578251.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/8ce00f847bf3/TSWJ2012-578251.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/89527e4127b7/TSWJ2012-578251.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/8be27508cf01/TSWJ2012-578251.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/7d5a828fb807/TSWJ2012-578251.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/518ed95fc1c0/TSWJ2012-578251.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/8845827e8226/TSWJ2012-578251.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/8ce00f847bf3/TSWJ2012-578251.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/89527e4127b7/TSWJ2012-578251.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/8be27508cf01/TSWJ2012-578251.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/7d5a828fb807/TSWJ2012-578251.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069e/3385625/518ed95fc1c0/TSWJ2012-578251.006.jpg

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