Bioactive glass BAG-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones: an in vitro and prospective clinical study
Bioactive glass BAG-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones: an in vitro and prospective clinical study
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DOI：
10.1186/1471-2334-13-584
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发表时间：
2013-12-10
影响因子：
3.7
通讯作者：
Romano, Carlo Luca
中科院分区：
文献类型：
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作者：
Drago, Lorenzo;Romano, Delia;Romano, Carlo Luca
背景资料：本研究旨在探讨S53 P4玻璃袋对骨髓炎常见多重耐药菌的体外抗菌活性，并评价其在骨髓炎外科预防治疗中的应用。方法：BAG-S53 P4对耐甲氧西林金黄色葡萄球菌和表皮葡萄球菌的体外抗菌活性，通过时间杀灭曲线评价铜绿假单胞菌和鲍曼不动杆菌分离株，并在孵育24、48和72小时后进行菌落计数。在一项观察性研究中，通过前瞻性研究27例临床和放射学诊断为长骨骨髓炎的患者队列进行体内评价。终点是没有感染复发/持久性在后续行动中，不需要进一步的手术，无论何时在后续行动和没有局部或全身的副作用连接与袋use.Results：在体外测试的抗菌活性的袋S53 P4显示出显着的杀菌活性后，24小时对所有的测试物种。该活性在随后的24小时内持续，并且在72小时后，所有菌株均未观察到生长。临床研究结果表明，24例患者（88.9%）在随访时无感染体征，而2例受试者在首次手术后6个月时显示感染复发，还有1例需要进一步手术。BAG-S53P4一般耐受良好。结论：在体外和体内的研究结果加强了以前的观察BAG-S53P4治疗慢性骨髓炎的长骨的疗效，也在存在多耐药菌株和免疫功能低下的主机，没有相关的副作用，而不需要局部添加抗生素。
Background: This study aimed to explore the in vitro antibacterial activity of the bioglass BAG S53P4 against multi-resistant microorganisms commonly involved in osteomyelitis and to evaluate its use in surgical adjunctive treatment of osteomyelitis.Methods: In vitro antibacterial activity of BAG-S53P4 against methicillin resistant Staphylococcus aureus and Staphylococcus epidermidis, Pseudomonas aeruginosa and Acinetobacter baumannii isolates was evaluated by means of time kill curves, with colony counts performed after 24, 48 and 72 hours of incubation. In vivo evaluation was performed by prospectively studying a cohort of 27 patients with a clinically and radiologically diagnosed osteomyelitis of the long bones in an observational study. Endpoints were the absence of infection recurrence/persistence at follow-up, no need for further surgery whenever during follow-up and absence of local or systemic side effects connected with the BAG use.Results: In vitro tests regarding the antibacterial activity of BAG S53P4 showed a marked bactericidal activity after 24 hrs against all the tested species. This activity continued in the subsequent 24 hrs and no growth was observed for all strains after 72 hrs. Results of the clinical study evidenced no signs of infection in 24 patients (88.9%) at the follow-up, while 2 subjects showed infection recurrence at 6 months from index operation and one more needed further surgical procedures. BAG-S53P4 was generally well tolerated.Conclusions: The in vitro and in vivo findings reinforce previous observations on the efficacy of BAG-S53P4 for the treatment of chronic osteomyelitis of the long bones, also in the presence of multi-resistant strains and in immunocompromised hosts, without relevant side effects and without the need for locally adding antibiotics.