Sánchez-Somolinos Mar, Díaz-Navarro Marta, Benjumea Antonio, Tormo Marta, Matas José, Vaquero Javier, Muñoz Patricia, Sanz-Ruíz Pablo, Guembe María
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain.
Antibiotics (Basel). 2022 Sep 23;11(10):1300. doi: 10.3390/antibiotics11101300.
Antibiotic-loaded bone cement is the most widely used approach for the treatment of biofilm-induced septic sequelae in orthopedic surgery. Dalbavancin is a lipoglycopeptide that acts against Gram-positive bacteria and has a long half-life, so we aimed to assess whether it could be a new alternative drug in antibiotic-loaded bone cement for the treatment of periprosthetic joint infections. We assessed the elution capacity of dalbavancin and compared it with that of vancomycin in bone cement. PalacosR (Heraeus Medical GmbH, Wehrheim, Germany) bone cement was manually mixed with each of the antibiotics studied at 2.5% and 5%. Three cylinders were obtained from each of the mixtures; these were weighed and incubated in 5 mL phosphate-buffered saline at 37°C under shaking for 1 h, 2 h, 4 h, 8 h, 24 h, 48 h, 168 h, and 336 h. PBS was replenished at each time point. The samples were analyzed using high-performance liquid chromatography (vancomycin) and mass cytometry (dalbavancin). Elution was higher than the minimum inhibitory concentration (MIC)90 for both antibiotics after 14 days of study. The release of vancomycin at 14 days was higher than of dalbavancin at each concentration tested ( = 0.05, both). However, the cumulative release of 5% dalbavancin was similar to that of 2.5% vancomycin ( = 0.513). The elution capacity of dalbavancin reached a cumulative concentration similar to that of vancomycin. Moreover, considering that the MIC90 of dalbavancin is one third that of vancomycin (0.06 mg/L and 2 mg/L, respectively) and given the long half-life of dalbavancin, it may be a new alternative for the treatment of biofilm-related periprosthetic infections when loaded in bone cement.
载抗生素骨水泥是骨科手术中治疗生物膜引起的败血症后遗症最广泛使用的方法。达巴万星是一种作用于革兰氏阳性菌且半衰期长的脂糖肽，因此我们旨在评估它是否可能成为载抗生素骨水泥治疗假体周围关节感染的一种新的替代药物。我们评估了达巴万星在骨水泥中的洗脱能力，并将其与万古霉素的洗脱能力进行比较。将PalacosR（德国韦尔海姆的贺利氏医疗有限公司）骨水泥与研究的每种抗生素按2.5%和5%的比例手动混合。从每种混合物中获取三个圆柱体；称取它们的重量，并在37℃下于5mL磷酸盐缓冲盐水中振荡孵育1小时、2小时、4小时、8小时、24小时、48小时、168小时和336小时。在每个时间点补充PBS。使用高效液相色谱法（用于万古霉素）和质谱流式细胞术（用于达巴万星）对样品进行分析。研究14天后，两种抗生素的洗脱量均高于最低抑菌浓度（MIC）90。在每个测试浓度下，14天时万古霉素的释放量均高于达巴万星（两者均P = 0.05）。然而，5%达巴万星的累积释放量与2.5%万古霉素的累积释放量相似（P = 0.513）。达巴万星的洗脱能力达到了与万古霉素相似的累积浓度。此外，考虑到达巴万星的MIC90是万古霉素的三分之一（分别为0.06mg/L和2mg/L），并且鉴于达巴万星的半衰期长，当加载到骨水泥中时，它可能是治疗生物膜相关假体周围感染的一种新的替代药物。
