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9 záznamů v Medvik Filtry

Článek online

Intervertebral disc penetration by antibiotics used prophylactically in spinal surgery: implications for the current standards and treatment of disc infections

Capoor, Manu N
Autor Capoor, Manu N Laboratory of Bacterial Pathogenesis and Immunology, Rockefeller University, 1230 York Avenue, New York, NY, USA. mcapoor@mail.rockefeller.edu. Central European Institute of Technology (CEITEC), Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic. mcapoor@mail.rockefeller.edu
Lochman, Jan
Autor Lochman, Jan Department of Biochemistry, Faculty of Science, Masaryk University, Brno, Czech Republic
McDowell, Andrew
Autor McDowell, Andrew Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, Londonderry, UK
Schmitz, Jonathan E
Autor Schmitz, Jonathan E Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA
Solansky, Martin
Autor Solansky, Martin Department of Biochemistry, Faculty of Science, Masaryk University, Brno, Czech Republic
Zapletalova, Martina
Autor Zapletalova, Martina Department of Biochemistry, Faculty of Science, Masaryk University, Brno, Czech Republic
Alamin, Todd F
Autor Alamin, Todd F Department of Orthopedic Surgery, Stanford University Medical Center, Stanford University, Stanford, CA, USA
Coscia, Michael F
Autor Coscia, Michael F Department of Orthopedic Surgery, OrthoIndy Hospital, Indianapolis, IN, USA
Garfin, Steven R
Autor Garfin, Steven R Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
Jancalek, Radim
Autor Jancalek, Radim Department of Neurosurgery, Masaryk University, St. Anne's University Hospital, Brno, Czech Republic

European spine journal. 2019 ; 28 (4) : 783-791. [pub] 20181201

Eur Spine J
ISSN 1432-0932
Medvik
Zdroj

PURPOSE: The presence of Propionibacterium acnes in a substantial component of resected disc specimens obtained from patients undergoing discectomy or microdiscectomy has led to the suggestion that this prominent human skin and oral commensal may exacerbate the pathology of degenerative disc disease. This hypothesis, therefore, raises the exciting possibility that antibiotics could play an important role in treating this debilitating condition. To date, however, little information about antibiotic penetration into the intervertebral disc is available. METHODS: Intervertebral disc tissue obtained from 54 microdiscectomy patients given prophylactic cefazolin (n = 25), clindamycin (n = 17) or vancomycin (n = 12) was assayed by high-performance liquid chromatography, with cefaclor as an internal standard, to determine the concentration of antibiotic penetrating into the disc tissue. RESULTS: Intervertebral disc tissues from patients receiving the positively charged antibiotic clindamycin contained a significantly greater percentage of the antibacterial dose than the tissue from patients receiving negatively charged cefazolin (P < 0.0001) and vancomycin, which has a slight positive charge (P < 0.0001). CONCLUSION: Positively charged antibiotics appear more appropriate for future studies investigating potential options for the treatment of low-virulence disc infections. These slides can be retrieved under Electronic Supplementary Material.

Článek online

Correction to: Intervertebral disc penetration by antibiotics used prophylactically in spinal surgery: implications for the current standards and treatment of disc infections

European spine journal. 2019 ; 28 (6) : 1546-1547. [pub] -

Eur Spine J
ISSN 1432-0932
Medvik
Zdroj

Unfortunately, the complete conflict of interest statement was missed out in the original publication. The same is given below.

Publikační typ
tisková chyba MeSH

Kniha

Rothman-Simeone and Herkowitz's the spine

Philadelphia : Elsevier, Inc., 2018

Seventh edition 2 svazky : ilustrace ; 29 cm

Článek online

Propionibacterium acnes biofilm is present in intervertebral discs of patients undergoing microdiscectomy

PLoS One. 2017 ; 12 (4) : e0174518. [pub] 20170403

ISSN 1932-6203
Medvik
Zdroj

BACKGROUND: In previous studies, Propionibacterium acnes was cultured from intervertebral disc tissue of ~25% of patients undergoing microdiscectomy, suggesting a possible link between chronic bacterial infection and disc degeneration. However, given the prominence of P. acnes as a skin commensal, such analyses often struggled to exclude the alternate possibility that these organisms represent perioperative microbiologic contamination. This investigation seeks to validate P. acnes prevalence in resected disc cultures, while providing microscopic evidence of P. acnes biofilm in the intervertebral discs. METHODS: Specimens from 368 patients undergoing microdiscectomy for disc herniation were divided into several fragments, one being homogenized, subjected to quantitative anaerobic culture, and assessed for bacterial growth, and a second fragment frozen for additional analyses. Colonies were identified by MALDI-TOF mass spectrometry and P. acnes phylotyping was conducted by multiplex PCR. For a sub-set of specimens, bacteria localization within the disc was assessed by microscopy using confocal laser scanning and FISH. RESULTS: Bacteria were cultured from 162 discs (44%), including 119 cases (32.3%) with P. acnes. In 89 cases, P. acnes was cultured exclusively; in 30 cases, it was isolated in combination with other bacteria (primarily coagulase-negative Staphylococcus spp.) Among positive specimens, the median P. acnes bacterial burden was 350 CFU/g (12 - ~20,000 CFU/g). Thirty-eight P. acnes isolates were subjected to molecular sub-typing, identifying 4 of 6 defined phylogroups: IA1, IB, IC, and II. Eight culture-positive specimens were evaluated by fluorescence microscopy and revealed P. acnes in situ. Notably, these bacteria demonstrated a biofilm distribution within the disc matrix. P. acnes bacteria were more prevalent in males than females (39% vs. 23%, p = 0.0013). CONCLUSIONS: This study confirms that P. acnes is prevalent in herniated disc tissue. Moreover, it provides the first visual evidence of P. acnes biofilms within such specimens, consistent with infection rather than microbiologic contamination.