水泥粘度对抗生素化和体外疗效对常见假肢关节感染病原体有影响吗?
Matthew J Dietz1, Brian M McGowan1, Dylan D Thomas1
1Department of Orthopaedics, West Virginia University, Morgantown, WV, USA.
Clinical orthopaedics and related research
|December 26, 2024
概括
中等粘度的带有抗生素的骨水泥 (ALBC) 显示出与同一制造商的高粘度ALBC类似的化. 与Simplex ALBC相比,Palacos ALBC在体外表现出对常见假肢关节感染病原体的优越活性.
科学领域:
- 整形外科手术 整形外科手术
- 生物材料科学 生物材料科学
- 传染性疾病 传染性疾病
背景情况:
- 聚甲基甲酸盐 (PMMA) 带有抗生素的骨质水泥 (ALBC) 对于预防假肢关节感染 (PJIs) 在全关节关节整形中至关重要.
- 水泥粘度是影响抗生素化的一个关键因素,但其对中等粘度配方的具体影响尚不清楚.
- 了解不同ALBC产品对常见PJI病原体的比较化和疗效至关重要.
研究的目的:
- 为了确定水泥粘度是否影响体外抗生素化特性,在比较同一个制造商的中高粘度ALBC时.
- 评估ALBC制造商和氨基甘油酸类型 (甘胺 vs. 托布拉米) 是否会影响体外抗生素对常见PJI病原体的化.
主要方法:
- 三种基于PMMA的ALBC产品进行了测试:Palacos® R (高粘度) + gentamicin,Palacos (中等粘度) + gentamicin,以及SimplexTM P (低粘度) + tobramycin.
- 在5天的时间里对四种常见的PJI病原体进行了化研究:S. aureus (对甲素敏感和耐药) 和S. epidermidis (对甲素敏感和耐药).
- 基比 - 尔测定确定了抑制区,并推断了化抗生素度,以评估疗效和曲线下的面积 (AUC).
主要成果:
- 在比较中高粘度Palacos配方时,水泥粘度没有显著影响抗生素化.
- 帕拉科斯ALBC (中等和高粘度) 在5天内表现出比SimplexTM P显著更大的体外抗生素化和活性.
- 所有测试的ALBC产品最初都超过了所有病原体的最小抑制度 (MIC),但只有Palacos配方在第一天之后保持了MRSA和MSSE的MIC以上的度.
结论:
- 中等粘度的ALBC表现出与同一个制造商的高粘度ALBC相似的化特性.
- 与Simplex低粘度ALBC相比,Palacos中高粘度ALBC在体外抗生素化和对四种常见PJI病原体中的三种抗生素活性更强.
- 需要进一步的体内研究来确认这些ALBC产品在预防PJI方面的临床疗效.
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