Tseng Yuan-Yun, Wang Yi-Chuan, Su Chen-Hsing, Liu Shih-Jung
1] Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan [2] Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan.
Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan.
Sci Rep. 2015 Jan 19;5:7849. doi: 10.1038/srep07849.
The incidence of postoperative central nervous system infection (PCNSI) is higher than 5%-7%. Successful management of PCNSI requires a combined therapy of surgical debridement and long-term antibiotic treatment. In this study, Duraform soaked in a prepared bacterial solution was placed on the brain surface of rats to induce PCNSI. Virgin poly[(d,l)-lactide-co-glycolide] (PLGA) nanofibrous membranes (vehicle-control group) and vancomycin-eluting PLGA membranes (vancomycin-nanofibres group) were implanted. The wound conditions were observed and serial brain MRI and pathology examinations were performed regularly. PCNSI was consistently induced in a single, simple step. In the vehicle-control group, most rats died within 1 week, and the survival rate was low (odds ratio = 0.0357, 95% confidence interval = 0.0057-0.2254). The wounds and affected cerebral tissues necrosed with purulence and increased in mass from the resulting PCNSI volumes. Initially, the mean PCNSI volumes showed no significant difference between the two groups. The PCNSI volume in the rats in the vancomycin-nanofibres group significantly decreased (P < 0.01), and the wound appearance was excellent. Pathologic examinations revealed that the necrosis and leukocyte infiltration area decreased considerably. The experimental results suggest that vancomycin-eluting PLGA nanofibres are favourable candidates for treating PCNSI after surgical debridement.
术后中枢神经系统感染（PCNSI）的发生率高于5%-7%。成功治疗PCNSI需要手术清创和长期抗生素治疗相结合。在本研究中，将浸泡在制备好的细菌溶液中的Duraform放置在大鼠脑表面以诱导PCNSI。植入了未处理的聚（d，l）-丙交酯-乙交酯（PLGA）纳米纤维膜（载体对照组）和万古霉素洗脱PLGA膜（万古霉素纳米纤维组）。观察伤口情况，并定期进行系列脑部MRI和病理学检查。通过单一的简单步骤持续诱导出PCNSI。在载体对照组中，大多数大鼠在1周内死亡，存活率较低（优势比=0.0357，95%置信区间=0.0057-0.2254）。伤口和受影响的脑组织出现坏死并伴有脓性渗出，因PCNSI体积增大而质量增加。最初，两组的平均PCNSI体积无显著差异。万古霉素纳米纤维组大鼠的PCNSI体积显著减小（P<0.01），伤口外观良好。病理检查显示坏死和白细胞浸润区域明显减少。实验结果表明，万古霉素洗脱PLGA纳米纤维是手术清创后治疗PCNSI的理想选择。
