Guiboux J P, Ahlgren B, Patti J E, Bernhard M, Zervos M, Herkowitz H N
Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak., Michigan, USA.
Spine (Phila Pa 1976). 1998 Mar 15;23(6):653-6. doi: 10.1097/00007632-199803150-00002.
A rabbit model was used to test the efficacy of cefazolin administered in various therapeutic regimens in preventing iatrogenic Staphylococcus aureus infections during spinal instrumentation.
To assess the efficacy of various prophylactic therapeutic regimens of cefazolin in preventing iatrogenic S. aureus infections during spinal instrumentation.
Previous studies have not dealt specifically with the occurrence of iatrogenic S. aureus infections during spinal instrumentation in a prospective fashion.
Twenty New Zealand White rabbits underwent a posterior approach to the lumbar spine. Fifteen of the animals then had double-braided 26-gauge surgical wire placed around bilateral L3-L4 and L4-L5 facet joints. A standardized volume of a 103 S. aureus/mL of solution was then inoculated onto the fusion-hardware site in all rabbits. The rabbits were divided into four groups receiving various antibiotic dose regimens. Five days after surgery, the animals were killed, and cultures were obtained.
All of the rabbits receiving no antibiotic had fusion sites infected with S. aureus. None of the animals who received prophylactic cefazolin produced cultures that grew S. aureus. A specimen from one fusion site cultured Staphylococcus epidermidis, which is not sensitive to cefazolin. Analysis of these data using Fisher's exact test resulted in a P value of 0.008 when results in antibiotic groups were compared with those in a group receiving no antibiotics and a P value of 0.0003 when all groups were compared.
This model was valid and reproducible for the study of spinal instrumentation and infection. In addition, the data support the efficacy and use of prophylactic intravenous antibiotics in preventing infection in spinal instrumentation and fusion surgery.
采用兔模型来测试头孢唑林在不同治疗方案中预防脊柱内固定术期间医源性金黄色葡萄球菌感染的疗效。
评估头孢唑林的各种预防性治疗方案在预防脊柱内固定术期间医源性金黄色葡萄球菌感染方面的疗效。
以往的研究尚未以前瞻性方式专门探讨脊柱内固定术期间医源性金黄色葡萄球菌感染的发生情况。
20只新西兰白兔接受了腰椎后路手术。其中15只动物在双侧L3-L4和L4-L5小关节周围放置了双股编织的26号手术线。然后在所有兔子的融合硬件部位接种标准化体积的每毫升含103个金黄色葡萄球菌的溶液。将兔子分为四组，接受不同的抗生素剂量方案。术后5天，处死动物并进行培养。
所有未接受抗生素治疗的兔子的融合部位均感染了金黄色葡萄球菌。接受预防性头孢唑林治疗的动物中，没有一只培养出金黄色葡萄球菌。一个融合部位的标本培养出表皮葡萄球菌，其对头孢唑林不敏感。使用Fisher精确检验分析这些数据，将抗生素组的结果与未接受抗生素组的结果进行比较时，P值为0.008；当对所有组进行比较时，P值为0.0003。
该模型对于脊柱内固定术和感染的研究是有效且可重复的。此外，数据支持预防性静脉使用抗生素在预防脊柱内固定术和融合手术感染方面的疗效及应用。
