The effect of local release antibiotic beads on in-vitro bacterial growth from tissue taken from infected diabetic foot ulcers
The effect of local release antibiotic beads on in-vitro bacterial growth from tissue taken from infected diabetic foot ulcers
复制标题
局部释放抗生素珠对感染糖尿病足溃疡组织体外细菌生长的影响
DOI：
10.1099/acmi.ac2019.po0258
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发表时间：
2019
影响因子：
--
通讯作者：
Fletcher J
中科院分区：
文献类型：
--
作者：
Fletcher J
糖尿病足感染是糖尿病相关住院的主要原因，也是糖尿病相关截肢的主要原因。英国公共卫生局最近公布的数据显示，英国每周有超过163例糖尿病相关截肢。本研究探讨了负载抗生素的硫酸钙（Stimulan®Rapid Cure）珠对取自糖尿病足感染组织的体外细菌生长的影响。患者从皇家德文郡和埃克塞特医院的麦克劳德糖尿病和内分泌中心招募。本研究的入选是基于临床识别需要伤口清创的感染性足部溃疡。将清创组织匀浆，并将50 μl涂布在哥伦比亚血琼脂和苛养厌氧菌琼脂表面。然后将含有万古霉素和庆大霉素组合的三个重复硫酸钙珠置于琼脂表面上。每个微珠分别含有约3.4 mg和1.6 mg万古霉素和庆大霉素。适当时，对平板进行有氧或厌氧孵育。在第1天和第4天记录抑制区。含有万古霉素和庆大霉素的硫酸钙珠能够抑制所有测试组织匀浆中的细菌生长，区域直径范围为16至40 mm。抗生素的局部释放可能具有在血管化不良的组织内实现高局部浓度的益处，这可能抑制伤口部位的细菌生长。通过改善糖尿病足感染的治疗，有可能预防截肢，保持活动能力和保护生活质量。
Diabetic foot infection is the main reason for diabetes-related hospitalisation and is a major cause of diabetes-related amputation. Recent figures published by Public Health England show that there are more than 163 diabetes related amputations in England every week. This study investigates the effect of antibiotic loaded calcium sulfate (Stimulan®Rapid Cure) beads onin-vitrobacterial growth from tissue taken from diabetic foot infections. Patients were recruited from the Macleod Diabetes and Endocrine Centre at the Royal Devon and Exeter Hospital. Inclusion in the study was based on clinical recognition of an infected foot ulcer requiring wound debridement. Debrided tissue was homogenised and 50 µl spread over the surface of Columbia blood agar and fastidious anaerobe agar. Three replicate calcium sulfate beads containing a combination of vancomycin and gentamicin were then placed on the surface of the agar. Each bead contained approximately 3.4 mg and 1.6 mg of vancomycin and gentamicin respectively. Plates were incubated aerobically or anaerobically as appropriate. Zones of inhibition were recorded at 1 and 4 days. Calcium sulfate beads containing vancomycin and gentamicin were able to inhibit bacterial growth in all tissue homogenates tested with zone diameters ranging from 16 to 40 mm. Local release of antibiotics could have the benefit of achieving high local concentrations within poorly vascularised tissue which may inhibit bacterial growth at the wound site. By improving treatment of diabetic foot infections, it may be possible to prevent amputation, maintain mobility and conserve quality of life.