Yuenyongviwat V, Ingviya N, Pathaburee P, Tangtrakulwanich B
Department of Orthopaedic Surgery and Physical Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand
Department of Orthopaedic Surgery and Physical Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand.
Bone Joint Res. 2017 Mar;6(3):132-136. doi: 10.1302/2046-3758.63.2000639.
Vancomycin and fosfomycin are antibiotics commonly used to treat methicillin-resistant (MRSA) infection. This study compares the inhibitory effects against MRSA of articulating cement spacers impregnated with either vancomycin or fosfomycin.
Vancomycin-impregnated articulating cement spacers and fosfomycin-impregnated articulating cement spacers were immersed in sterile phosphate-buffered saline (PBS) solutions and then incubated. Samples were collected for bioactivity evaluation. The aliquots were tested for MRSA inhibition with the disc diffusion method, and the inhibition zone diameters were measured. The inhibition zone differences were evaluated using the Wilcoxon Rank Sum Test.
The vancomycin group had significantly larger inhibition zones than the fosfomycin group from day three through to completion of the fourth week of incubation (p < 0.001). The vancomycin group exhibited a MRSA inhibition zone up to four weeks but the fosfomycin group showed an inhibition zone for only three days and after that did not show the the potential to inhibit MRSA.
This study found that the inhibitory effect of vancomycin-impregnated articulating cement spacers against MRSA outperformed fosfomycin-impregnated articulating cement spacers. Further comparing our results to other published reports suggests there might be a limitation of the disc diffusion bioassay to show a large inhibitory zone in a high concentration of a highly soluble antibiotic. V. Yuenyongviwat, N. Ingviya, P. Pathaburee, B. Tangtrakulwanich. Inhibitory effects of vancomycin and fosfomycin on methicillin-resistant from antibiotic-impregnated articulating cement spacers. 2017;6:132-136. DOI: 10.1302/2046-3758.63.2000639.
万古霉素和磷霉素是常用于治疗耐甲氧西林金黄色葡萄球菌(MRSA)感染的抗生素。本研究比较了浸渍有万古霉素或磷霉素的关节置换骨水泥间隔物对MRSA的抑制作用。
将浸渍有万古霉素的关节置换骨水泥间隔物和浸渍有磷霉素的关节置换骨水泥间隔物浸入无菌磷酸盐缓冲盐水(PBS)溶液中,然后进行孵育。收集样本进行生物活性评估。采用纸片扩散法检测等分试样对MRSA的抑制作用,并测量抑菌圈直径。使用Wilcoxon秩和检验评估抑菌圈差异。
从孵育的第3天到第4周结束,万古霉素组的抑菌圈明显大于磷霉素组(p < 0.001)。万古霉素组在长达4周的时间内均表现出对MRSA的抑菌圈,而磷霉素组仅在3天内表现出抑菌圈,之后则没有抑制MRSA的潜力。
本研究发现,浸渍有万古霉素的关节置换骨水泥间隔物对MRSA的抑制作用优于浸渍有磷霉素的关节置换骨水泥间隔物。将我们的结果与其他已发表的报告进一步比较表明,纸片扩散生物测定法在显示高浓度高溶性抗生素中的大抑菌圈方面可能存在局限性。V. Yuenyongviwat、N. Ingviya、P. Pathaburee、B. Tangtrakulwanich。万古霉素和磷霉素对来自抗生素浸渍关节置换骨水泥间隔物的耐甲氧西林金黄色葡萄球菌的抑制作用。2017;6:132 - 136。DOI:10.1302/2046 - 3758.63.2000639。