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Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_15 | Pages 50 - 50
1 Dec 2021
Gelderman S Faber C Ploegmakers J Jutte P Kampinga G Glaudemans A Wouthuyzen-Bakker M
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Aim

Low-grade infections are difficult to diagnose. As the presence of a chronic infection requires extensive surgical debridement and antibiotic treatment, it is important to diagnose a SII prior to surgery, especially when the hardware is revised. We investigated whether serum inflammatory markers or nuclear imaging can accurately diagnose a chronic spinal instrumentation infection (SII) prior to surgery.

Method

All patients who underwent revision spinal surgery after a scoliosis correction between 2017 and 2019 were retrospectively evaluated. The diagnostic accuracy of serum C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR), 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) and Technetium-99m-methylene diphosphonate (99mTc-MDP) 3-phase bone scintigraphy (TPBS) to diagnose infection were studied. Patients with an acute infection or inadequate culture sampling were excluded. SII was diagnosed if ≥ 2 of the same microorganism(s) were isolated from intra-operative tissue cultures.


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 249 - 249
1 Sep 2005
Faber C Stallmann H Lyaruu D Joosten U von Eiff C van Nieuw Amerongen A Wuisman P
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Introduction: Antimicrobial peptides (AMP) are a novel class of antimicrobial agents effective against among others MRSA in vitro. Previously, we reported the release of AMP Dhvar-5 and hLF1-11 from different bone cements(1,4). In this study we investigated the efficacy of calcium phosphate cement (Calcibon®) loaded with hLF1-11 for the treatment of MRSA osteomyelitis in vivo.

Materials and Methods: Osteomyelitis was induced in 14 rabbits by MRSA, as described by Norden et al.(2) After 3 weeks all animals were treated by a thorough local debridement and subsequent filling of the tibial cavity with Calcibon® bone cement. Six control animals received Calcibon® without additives and 8 animals received Calcibon® loaded with 50 mg hLFl-11 per g cement powder. Treatment outcome was analyzed by microbiology, radiology and histology after 3 weeks follow-up.

Results: The results are shown in table 1. The number of CFU per gram of bone were significantly lower in the 50 mg hLFl-11 group (median 3.0x103 CFU/g bone) compared to the control group (median 3.5xl06 CFU/g bone).

Conclusion: This study demonstrates that hLFl-11 has the ability to cure an existing MRSA osteomyelitis in 5 out of 8 animals. The data suggest that the antimicrobial peptide, hLFl-11 in Calcibon® is able to treat osteomyelitis in vivo.