Antimicrobial activity of gentamicin and vancomycin combination in joint fluids after antibiotic-loaded cement spacer implantation in two-stage revision surgery
| Autor: | Manuel Bondi, Bruno Magnan, Elisa Bertazzoni Minelli, Elena Manuela Samaila, Anna Benini |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Prosthesis-Related Infections medicine.drug_class Antibiotics medicine.disease_cause Microbiology Two stage revision Vancomycin Drug Resistance Multiple Bacterial medicine Humans Polymethyl Methacrylate local antibiotic Pharmacology (medical) Antibiotic loaded cement Release of gentamicin and vancomycin from removed temporary hip prosthesis (spacers) Aged Pharmacology Bacteriological Techniques Chemistry antibiotic-loaded spacer Bone Cements Drug Synergism Middle Aged Antimicrobial Anti-Bacterial Agents Surgery Titer Infectious Diseases Oncology Staphylococcus aureus Female Gentamicin Gentamicins medicine.drug |
| Popis: | Gentamicin (G) and vancomycin (V) concentrations in joints fluids obtained from patients during the first 24 hours after implantation of antibiotic-loaded polymethylmethacrylate (PMMA) spacers in two-stage revision for infected arthroplasty, and the inhibitory activity of joint fluids against different multiresistant clinical isolates were studied. A total of 12 patients undergoing two-stage revision surgery with implantation of industrial G spacers added with different amounts of V was studied. Serum and joint fluid samples were collected 1, 4, and 24 hours after spacer implantation. Antibiotics concentrations and joint bactericidal titer (JBT) of combination were determined against multiresistant staphylococcal strains. The local release of G and V from PMMA cement seemed prompt and effective. Serum levels were below the limit of detection. The same joint fluid showed different activity according to the susceptibility of the pathogens tested. Gentamicin and V were released from spacers at bactericidal concentrations exerting a strong inhibition against methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative staphylococci (CoNS) strains. |
| Databáze: | OpenAIRE |
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