Evaluation of an in vivo model for ventricular shunt infection: a pilot study using a novel antimicrobial-loaded polymer.

Autor:	Iyer RR; Departments of1Neurosurgery., Gorelick N; Departments of1Neurosurgery., Carroll K; 3Infectious Diseases, and., Blitz AM; 2Radiology., Beck S; 4Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland., Garrett CM; 4Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland., Monroe A; Departments of1Neurosurgery., Tyler B; Departments of1Neurosurgery., Zuckerman ST; 5Department of Biomedical Engineering, Case Western Reserve University, Cleveland; and., Capadona JR; 5Department of Biomedical Engineering, Case Western Reserve University, Cleveland; and.; 6Advanced Platform Technology Center, Rehabilitation Research and Development, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio., von Recum HA; 5Department of Biomedical Engineering, Case Western Reserve University, Cleveland; and., Luciano MG; Departments of1Neurosurgery.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery [J Neurosurg] 2018 Aug 03; Vol. 131 (2), pp. 587-595. Date of Electronic Publication: 2018 Aug 03 (Print Publication: 2019).
DOI:	10.3171/2018.1.JNS172523
Abstrakt:	Objective: Ventricular shunt infection remains an issue leading to high patient morbidity and cost, warranting further investigation. The authors sought to create an animal model of shunt infection that could be used to evaluate possible catheter modifications and innovations. Methods: Three dogs underwent bilateral ventricular catheter implantation and inoculation with methicillin-sensitive Staphylococcus aureus (S. aureus). In 2 experimental animals, the catheters were modified with a polymer containing chemical "pockets" loaded with vancomycin. In 1 control animal, the catheters were polymer coated but without antibiotics. Animals were monitored for 9 to 11 days, after which the shunts were explanted. MRI was performed after shunt implantation and prior to catheter harvest. The catheters were sonicated prior to microbiological culture and also evaluated by electron microscopy. The animals' brains were evaluated for histopathology. Results: All animals underwent successful catheter implantation. The animals developed superficial wound infections, but no neurological deficits. Imaging demonstrated ventriculitis and cerebral edema. Harvested catheters from the control animal demonstrated > 104 colony-forming units (CFUs) of S. aureus. In the first experimental animal, one shunt demonstrated > 104 CFUs of S. aureus, but the other demonstrated no growth. In the second experimental animal, one catheter demonstrated no growth, and the other grew trace S. aureus. Brain histopathology revealed acute inflammation and ventriculitis in all animals, which was more severe in the control. Conclusions: The authors evaluated an animal model of ventricular shunting and reliably induced features of shunt infection that could be microbiologically quantified. With this model, investigation of pathophysiological and imaging correlates of infection and potentially beneficial shunt catheter modifications is possible.
Databáze:	MEDLINE
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