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A rabbit osteomyelitis model to simulate multibacterial war wound infections
Li-Yan Yin1, Maurice M Manring, Jason H Calhoun
1Department of Orthopaedic Surgery, The Ohio State University Medical Center, 376 West 10th Avenue, Columbus, OH 43210, USA.
Abstract:
A challenge facing military caregivers is the presence of multidrug-resistant infection in extremity wounds. Most frequently identified resistant strains are methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae (KP), Pseudomonas aeruginosa (PA), and Acinetobacter baumannii (AB). We adapted an existing osteomyelitis model to simulate an infected extremity wound for antibiotic testing. New Zealand White Rabbits (n = 95) were divided into 6 inoculation groups for infection with MRSA, KP, PA, and AB alone, and in multibacteria infections. Sodium morrhuate was injected into the left tibia to simulate blast wound trauma, then the respective bacteria or combination of pathogens, and finally sterile saline were injected. Colony-forming units for the mono-organism groups showed that AB, KP, or PA alone at 10(7) colony-forming units per mL (CFUs/mL) was effective for rabbit osteomyelitis induction. Colony-forming units for the multiorganism groups showed that the combination of AB (10(7) CFUs/mL)/KP (10(7) CFUs/mL)/PA (10(7) CFUs/mL)/MRSA (10(5) CFUs/mL) yielded a 100% osteomyelitis induction rate. At 8 weeks, however, only one mono-bacterial group and one multibacterial group showed significant radiographic improvement (p < 0.05). The rabbit model of osteomyelitis can be adapted to study infected blast wounds typical of those seen in veterans. To our knowledge, this is the first demonstration of the model simulating multibacterial infections with multidrug-resistant organisms.
Insights
A new rabbit osteomyelitis model effectively simulates military blast wounds with multidrug-resistant infections. This adaptable model aids in developing new treatments for complex extremity wound infections.
Area of Science:
- Military medicine
- Infectious diseases
- Wound healing
Background:
- Military caregivers face challenges with multidrug-resistant infections in extremity wounds.
- Common resistant strains include methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae (KP), Pseudomonas aeruginosa (PA), and Acinetobacter baumannii (AB).
Purpose of the Study:
- To adapt an existing osteomyelitis model for simulating infected extremity wounds, specifically blast wounds, for antibiotic testing.
- To evaluate the efficacy of inducing osteomyelitis in rabbits using single and multiple strains of multidrug-resistant bacteria.
Main Methods:
- New Zealand White Rabbits (n=95) were used, with induced tibia trauma followed by inoculation with specific bacteria or combinations.
- Infection was induced using MRSA, KP, PA, and AB, alone and in multibacterial combinations.
- Osteomyelitis induction rates and radiographic improvements were assessed.
Main Results:
- Acinetobacter baumannii, Klebsiella pneumoniae, or Pseudomonas aeruginosa alone at 10(7) CFUs/mL effectively induced osteomyelitis.
- A combination of AB (10(7) CFUs/mL)/KP (10(7) CFUs/mL)/PA (10(7) CFUs/mL)/MRSA (10(5) CFUs/mL) achieved a 100% osteomyelitis induction rate.
- Limited radiographic improvement was observed in only one mono-bacterial and one multibacterial group at 8 weeks.
Conclusions:
- The rabbit osteomyelitis model is adaptable for studying infected blast wounds relevant to veterans.
- This study demonstrates the model's capability in simulating multibacterial infections with multidrug-resistant organisms.
