Cemal KAZIMOĞLU, Hasan KARAPINAR, Muhittin ŞENER, İlhan AFŞAR, Karataş Aslı Gamze ŞENER, ULAŞ AKGÜN

İnsan süngerimsi kemiğinden gentamisin ve teikoplanin salınımının in vitro değerlendirilmesi

Amaç: Bu çalışmada teikoplanin veya gentamisin emdirilen insan süngerimsi kemiğinin lokal antibiyotik taşıyıcısı olarak in vitro antibakteriyel etkinliği araştırıldı. Çalışma planı: Çalışmada parsiyel veya total kalça protezi uygulanan yedi hastanın eksize edilen femur başlarındaki süngerimsi kemikten elde edilen örnekler kullanıldı. Kemik örnekleri iki gruba ayrılarak bir grup gentamisin, diğer grup ise tekoplanin içinde bir saat bekletildi. Kontrol amaçlı olarak, steril salin solüsyonu içinde bekletilmiş kemik örnekleri kullanıldı. Kemik örneklerinin antibiyotik salgılama özellikleri disk difüzyon yöntemiyle, her bir günde yedişer örnekte olmak üzere, 1, 3, 7, 10, 14, 18 ve 21. günlerde in vitro olarak değerlendirildi. Gentamisin için E. coli ATCC 25922, teikoplanin için S. aureus ATCC 25923 suşları kullanıldı ve sırasıyla ≥15 mm ve ≥14 mm zon çapları in vitro etkinlik olarak kabul edildi. Sonuçlar: Test edilen günlerde ölçülen agar disk çapları incelendiğinde, teikoplanin + kemik (12-18 gün) yapısının gentamisin + kemik yapısına (7-10 gün) oranla daha uzun süreli salınım oluşturduğu izlendi. Kontrol grubunda inhibisyon oluşmadı. Teikoplanin ve gentamisin arasında agar disk çapları ortalamaları açısından birinci ve üçüncü günlerde anlamlı farklılık bulunmazken, yedinci (p=0.008) ve 10. günlerde (p=0.003) teikoplanin örneklerinin inhibisyon alanı anlamlı derecede fazla bulundu. Çıkarımlar: Bulgularımız, insan süngerimsi kemiğinin uygun koşullarda teikoplanin ile önemli miktarda birleşme oluşturduğunu ve yaklaşık iki hafta boyunca etkin düzeyde antibiyotik salınımı sağladığını göstermektedir.

Anahtar Kelimeler:

Antibiyotik proflaksisi, Artroplasti, replasman, kalça, Staphylococcus aureus, Ameliyat sonrası komplikasyonlar, Mikrobiyal duyarlılık testleri, Gentamisinler, Femur başı, Escherichia coli, Anti-bakteriyel ajanlar, Teikoplanin, Proteze bağlı enfeksiyonlar

In vitro evaluation of gentamicin and teicoplanin release from cancellous human bone

Objectives: This study was designed to determine the in vitro antibacterial activity of gentamicin- or teicoplanin-impregnated human cancellous bone as a local antibiotic carrier. Methods: The study samples were obtained from human cancellous bone within the femur head in seven patients who underwent partial or total hip arthroplasty. Bone specimens were processed and incubated with gentamicin or teicoplanin for an hour. Control bone specimens were soaked in sterile saline solution for the same duration. Antibiotic release of bone specimens was assessed by the disc diffusion technique after 1, 3, 7, 10, 14. 18, and 21 days of antibiotic impregnation, with seven samples in each group. The test strains were E. coli ATCC 25922 for gentamicin, and S. aureus ATCC 25923 for teicoplanin. In vitro antibiotic efficacy was defined as an inhibition zone diameter of ≥15 mm for gentamicin, and ≥14 mm for teicoplanin. Results: Evaluation of inhibition zone diameters showed that bone + teicoplanin complexes had a longer duration of antibiotic release than that of bone + gentamicin complexes (12 to 18 days vs 7 to 10 days). There was no inhibition in the control group. There were no significant differences in inhibition zone diameters of teicoplanin- and gentamicin- treated specimens on the first and third days; however, teicoplanin exhibited significantly greater zone diameters on the seventh (p=0.008) and tenth (p=0.003) days. Conclusion: Our data show that, under appropriate conditions, human cancellous bone incorporates a considerable amount of teicoplanin and exhibits effective antibiotic release for approximately two weeks.

Keywords:

Antibiotic Prophylaxis, Arthroplasty, Replacement, Hip, Staphylococcus aureus, Postoperative Complications, Microbial Sensitivity Tests, Gentamicins, Femur Head, Escherichia coli, Anti-Bacterial Agents, Teicoplanin, Prosthesis-Related Infections,

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