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纵向延时活体 micro-CT 揭示了大鼠模型中亚临床细菌感染后种植体周围骨变化的不同模式。

Longitudinal time-lapse in vivo micro-CT reveals differential patterns of peri-implant bone changes after subclinical bacterial infection in a rat model.

机构信息

AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos Platz, Switzerland.

Schulthess Klinik, Department of Research and Development, Lengghalde 2, 8008, Zurich, Switzerland.

出版信息

Sci Rep. 2020 Dec 1;10(1):20901. doi: 10.1038/s41598-020-77770-z.

Abstract

Subclinical infection associated with orthopedic devices can be challenging to diagnose. The goal of this study was to evaluate longitudinal, microcomputed tomography (microCT) imaging in a rat model of subclinical orthopedic device-related infection caused by Staphylococcus epidermidis and four different Cutibacterium (previously Propionibacterium) acnes strains, and compare outcomes with non-inoculated and historical S. aureus-inoculated controls. Sterile screws or screws colonized with bacteria were placed in the tibia of 38 adult Wistar rats [n = 6 sterile screws; n = 6 S. epidermidis-colonized screws; n = 26 C. acnes-colonized screws (covering all three main subspecies)]. Regular microCT scans were taken over 28 days and processed for quantitative time-lapse imaging with dynamic histomorphometry. At euthanasia, tissues were processed for semiquantitative histopathology or quantitative bacteriology. All rats receiving sterile screws were culture-negative at euthanasia and displayed progressive bony encapsulation of the screw. All rats inoculated with S. epidermidis-colonized screws were culture-positive and displayed minor changes in peri-implant bone, characteristic of subclinical infection. Five of the 17 rats in the C. acnes inoculated group were culture positive at euthanasia and displayed bone changes at the interface of the screw and bone, but not deeper in the peri-implant bone. Dynamic histomorphometry revealed significant differences in osseointegration, bone remodeling and periosteal reactions between groups that were not measurable by visual observation of still microCT images. Our study illustrates the added value of merging 3D microCT data from subsequent timepoints and producing inherently richer 4D data for the detection and characterization of subclinical orthopedic infections, whilst also reducing animal use.

摘要

与骨科植入物相关的亚临床感染很难诊断。本研究旨在评估在表皮葡萄球菌和四种不同的痤疮丙酸杆菌(以前称为丙酸杆菌)定植的大鼠模型中,纵向微计算机断层扫描(microCT)成像,并将结果与未接种和历史金黄色葡萄球菌接种对照进行比较。将无菌螺钉或定植细菌的螺钉植入 38 只成年 Wistar 大鼠的胫骨中[n=6 枚无菌螺钉;n=6 枚定植表皮葡萄球菌的螺钉;n=26 枚定植痤疮丙酸杆菌的螺钉(涵盖所有三个主要亚种)]。在 28 天内定期进行 microCT 扫描,并进行定量时相成像的动态组织形态计量学处理。安乐死后,对组织进行半定量组织病理学或定量细菌学处理。所有接受无菌螺钉的大鼠在安乐死时均未培养出细菌,且螺钉逐渐被骨组织包裹。所有接种定植表皮葡萄球菌螺钉的大鼠均为培养阳性,且显示出种植体周围骨的轻微变化,这是亚临床感染的特征。在接种痤疮丙酸杆菌的 17 只大鼠中,有 5 只在安乐死时培养阳性,并显示螺钉和骨界面处的骨变化,但在种植体周围骨深部没有变化。动态组织形态计量学显示,各组之间的骨整合、骨重塑和骨膜反应存在显著差异,而这些差异在静态 microCT 图像的肉眼观察中无法测量。我们的研究表明,通过融合后续时间点的 3D microCT 数据并为检测和表征亚临床骨科感染生成内在更丰富的 4D 数据,同时减少动物使用,可以增加价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df30/7708479/47f3876edf77/41598_2020_77770_Fig1_HTML.jpg

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