Influence of biomaterials on scintigraphic diagnosis of periprosthetic infections. Ceftizoxime-99m technetium model

Teixeira, Luiz Eduardo Moreira; Pádua, Bruno Jannotti; Castilho, André Moreira; Araújo, Ivana Duval; Andrade, Marco Antônio Percope de; Cardoso, Valbert Nascimento; Diniz, S.A.; Leal, Jefferson Soares; Takenaka, Isabella Kuniko

doi:10.1590/s0102-865020180010000002

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…Besides the marked progress in operating standards and amelioration of perioperative measures, especially implant-associated and perioperative infections in trauma and orthopedic surgery still represent significant complications [3]. In literature, the incidence of infection shows a wide range from 1% in primary fracture stabilization up to 55% in the treatment of open fractures [4]. Apart from that the development of an osteitis depends on individual risk factors provided by the patient such as obesity, anemia and diabetes [5].…”

Section: Introductionmentioning

confidence: 99%

Effect of antibiotic infused calcium sulfate/hydroxyapatite (CAS/HA) insets on implant-associated osteitis in a femur fracture model in mice

et al. 2019

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Cerament (Bonesupport Holding, Lund, Sweden) is a bioresorbable synthetic bone substitute consisting of calcium sulfate and hydroxyapatite which is successfully used as a bone graft in bone defects or in delayed and non-unions after fractures. Besides, calcium sulfate/ hydroxyapatite (CAS/HA) could have, attributed to its composition and osteoinductive properties, have great importance in the treatment of bone infections with critical size defects (CSD). Aim of the study was to evaluate the effects of antibiotic infused CAS/HA on inflammation and bone healing in an implant-associated osteitis mice model. In a standardized murine model, the left femur of 72 BALB/c mice were osteotomized, generating a CSD (2,5 mm) with stabilization through a 6-hole titanium locking plate. Osteitis has been induced through inoculation of Staphylococcus aureus (SA) into the fracture gap. To analyze the effect of CAS/HA, following groups were generated with either CAS/HA, CAS/HA with gentamycin (CAS/ HA-G) or CAS/HA with vancomycin (CAS/HA-V) insets placed into the osteotomy. Debridément and lavages were progressed on day 7 and 42 to determine the local bacterial growth and the immune reaction. Fracture healing was quantified on day 7 and 42 by x-ray and bone healing markers from blood samples. Progression of infection was assessed by estimation of colony-forming units (CFU) and immune response was analyzed by determination of Interleukin (IL)– 6 and polymorphonuclear neutrophils (PMN) in lavage samples. Osteitis induced higher IL-6 and PMN-levels in the lavage samples on day 7. Both parameters showed a reduction in all groups on day 42. CAS/HA-V revealed a significant reduction of CFU and PMNs in lavage samples on day 42. A positive effect on bone healing could only be shown in non-infected mice. Whereas, application of mere CAS/HA in infected mice did show tendencies of bone destruction and lysis, independent of impregnation with antibiotics or not. Thus, application of CAS/HA in acute implant-associated infections is not recommended. In non-infectious environments or after infect-convalescence CAS/HA could albeit serve as a suggestive tool in trauma and orthopedic surgery.

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Section: Introductionmentioning

confidence: 99%

Effect of antibiotic infused calcium sulfate/hydroxyapatite (CAS/HA) insets on implant-associated osteitis in a femur fracture model in mice

et al. 2019

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“…99m Tc‐ceftizoxime scintigraphy study using titanium implants in rats showed accumulation specially periprosthetic infected areas adjacent to metal‐implants (Teixeira et al, 2015). Other published study on 99m Tc‐ceftizoxime scintigraphy using four groups of patients having different implants such as titanium implants (group A; n = 5) contaminated titanium implants (group B; n = 5) and sterile stainless steel implants (group C; n = 5) and contaminated stainless steel implants (group D; n = 5) showed 0.98 ± 0.04, 1.68 ± 0.62, 1.22 ± 0.08, and 2.14 ± 0.84 infection to normal muscle ratio, respectively (Teixeira et al, 2018). A study was also reported which indicated the potential of 99m Tc‐ceftizoxime to diagnose diabetic foot osteomyelitis infection (Ahmed et al, 2019).…”

Section: Mtc‐labeled Aminoglycosidesmentioning

confidence: 99%

^99mTc‐labeled antibiotics for infection diagnosis: Mechanism, action, and progress

Naqvi

2021

Chem Biol Drug Des

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Discovery of penicillin marked a turning point in the history of infection therapy which also led to the emergence of bacterial resistance. It is now 100 years to fight with ever‐muted variants of pathogens by developing more and more antibiotics. Since 1987 to todate, no successful class of antibiotic was introduced; this three decade period is known as “the discovery void” period. While, the clinically approved antibiotics are gradually dying in front of bacterial resistance due to which bacterial infections are appearing leading cause of death and disability. Nuclear medicine imaging technique is the strongest modality to diagnose and follow‐up of deep‐seated and complicated infections. However, the selection of radiolabeled antimicrobial agents plays critical role in gaining sensitivity and specificity of the imaging results. This review comprises of two main sections; first section explains antibiotic targets, and second section explains the imaging efficacy of 99mTc‐labeled antimicrobial agents against bacterial infection along with the emphasis on progress and update of 99mTc‐labeled antibiotics as infection imaging probes. The review, in conclusion, could be an acceleration for radiopharmaceutical chemists for designing and developing 99mTc‐labeled antimicrobial agents to improve infection imaging quality.

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“…When it comes to open fractures and fracture infections, the healing process is even more complicated and often results in large bone defects [ 10 ]. The risk of infection after open fractures amounts to up to 50% [ 11 ], which is a major risk factor for non-healing. For example, in a Gustilo–Anderson Type III tibial shaft fracture, non-healing is found in 80% of cases [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Infection-Related Non-Unions with Bioactive Glass—A Promising Approach or Just Another Method of Dead Space Management?

et al. 2022

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The treatment of infected and non-infected non-unions remains a major challenge in trauma surgery. Due to the limited availability of autologous bone grafts and the need for local anti-infective treatment, bone substitutes have been the focus of tissue engineering for years. In this context, bioactive glasses are promising, especially regarding their anti-infective potential, which could reduce the need for local and systemic treatment with conventional antibiotics. The aim of this study was to investigate the osteoinductive and osteoconductive effects, as well as the anti-infectious potential, of S53P4 using a standardized non-union model, which had not been investigated previously. Using an already established sequential animal model in infected and non-infected rat femora, we were able to investigate bioactive glass S53P4 under realistic non-union conditions regarding its osteoinductive, osteoconductive and anti-infective potential with the use of µCT scans, biomechanical testing and histological, as well as microbiological, analysis. Although S53P4 did not lead to a stable union in the non-infected or the infected setting, µCT analysis revealed an osteoinductive effect of S53P4 under non-infected conditions, which was diminished under infected conditions. The osteoconductive effect of S53P4 remained almost negligible in histological analysis, even 8 weeks after treatment. Additionally, the expected anti-infective effect could not be demonstrated. Our data suggested that S53P4 should not be used in infected non-unions, especially in those with large bone defects.

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Influence of biomaterials on scintigraphic diagnosis of periprosthetic infections. Ceftizoxime-99m technetium model

Cited by 5 publications

References 17 publications

Effect of antibiotic infused calcium sulfate/hydroxyapatite (CAS/HA) insets on implant-associated osteitis in a femur fracture model in mice

Effect of antibiotic infused calcium sulfate/hydroxyapatite (CAS/HA) insets on implant-associated osteitis in a femur fracture model in mice

^99mTc‐labeled antibiotics for infection diagnosis: Mechanism, action, and progress

Treatment of Infection-Related Non-Unions with Bioactive Glass—A Promising Approach or Just Another Method of Dead Space Management?

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