The use of local therapy with antibiotics in a suitable carrier is essential in the treatment and prevention of infections in orthopedic surgery and traumatology. In our orthopedic surgery department, a synthetic calcium sulfate hemihydrate (CaSO4·1⁄2H2O) is used as an antibiotic carrier, enabling the application of most types of intravenous antibiotics in the form of powder and liquid. This type of carrier with antibiotics is prepared in the theater during the procedure. During a surgical procedure, a small dead space is created (hand and foot area), which must be filled with an antibiotic carrier, and the situations arise where a large amount of the carrier is not used and thrown away. Therefore, we verified the efficacy of vancomycin in the pre-prepared carrier by an orientation microbiological method and by measuring the concentrations of the vancomycin released in active form and its two crystalline degradation products. Based on the agar diffusion test, we did not measure any difference in the effectiveness of the antibiotic in the carrier after its 12-day storage. Although vancomycin concentrations decreased by approximately 32% at the end of 12 days of storage, the concentrations of the released active form of vancomycin are many times higher than the minimum inhibitory concentrations for resistant strains of Staphylococcus aureus. Thus, the calcium sulfate carrier with vancomycin can be prepared several days in advance before its application, certainly up to 12 days.
The level of an antibiotic capable of inhibiting the etiological agent at the site of infection is an essential prerequisite for successful antibiotic therapy. In some cases, locally applied antibiotics may compensate for limitations of systemic administration and shorten systemic therapy. We aimed at verifying to what extent vancomycin (Van) bound to ground bone grafts is usable in the treatment of serious infections. The levels of released Van significantly exceeded the Van minimum inhibitory concentration, which can suppress Van-sensitive staphylococci and Van intermediate Staphylococcus aureus, for the whole period of a 16-day measurement. Our results indicate that bone grafts can be used as Van carriers in therapy of osteomyelitis caused by Van-sensitive Staphylococcus strains.
- MeSH
- antibakteriální látky terapeutické užití MeSH
- bakteriální léková rezistence účinky léků MeSH
- lidé MeSH
- nosiče léků chemie MeSH
- osteomyelitida farmakoterapie mikrobiologie chirurgie MeSH
- stafylokokové infekce farmakoterapie mikrobiologie chirurgie MeSH
- Staphylococcus aureus účinky léků fyziologie MeSH
- systémy cílené aplikace léků metody MeSH
- transplantace kostí * MeSH
- vankomycin terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH
Cíl: Stanovení fetálního hemoglobinu (HbF) je důležité pro diagnostiku hemoglobinopatií a jiných onemocnění. Cílem naší práce bylo zhodnotit možnost presumptivního stanovení HbF v modu pro stanovení glykovaného hemoglobinu (HbA1c) na automatickém HPLC analyzátoru Tosoh HLC-723 G7. Materiál a metody: K analýze HbF v modu pro stanovení HbA1c bylo použito 63 vzorků nesrážlivé krve. Vzorky byly rozděleny do 3 skupin: 1. skupina (n = 24), HbF v intervalu 1–2 % z celkového hemoglobinu (Hb); 2. skupina (n = 21), HbF v intervalu 2–5 % z celkového Hb; 3. skupina (n = 18), HbF > 5 % z celkového Hb. U těchto vzorků byl zároveň kvantifikován HbF v thalasemickém modu stejného přístroje. Výsledky: Hodnoty HbF mezi 1–2 % spolu nekorelovaly (r = 0,241). Naopak byla nalezena korelace hodnot mezi 2–5 % (r = 0,825; p < 0,001), stejně tak jako hodnot HbF > 5 % (r = 0,889; p < 0,001). Klinický význam mají především hodnoty patologické, tedy hodnoty HbF větší než 2 % z celkového Hb. Takové hodnoty stanovené v modu pro analýzu glykovaného hemoglobinu je možno pokládat za správné. Naopak hodnoty HbF pod 2 % z celkového Hb stanovené v modu pro glykovaný hemoglobin nejsou analyticky správné. Závěr: Závěrem je možné konstatovat, že analytický mod pro stanovení glykovaného hemoglobinu na analyzátoru Tosoh HLC-723 G7 je možné použít také pro presumptivní kombinované HPLC stanovení fetálního hemoglobinu.
Objective: Measurement of foetal hemoglobin (HbF) has an important clinical value in the diagnosis as well as in characterization of some Hb structural variants and other hemoglobinopathies. We evaluated presumptive HbF quantification in analytical mode for glycated hemogobin (HbA1c) on Tosoh HLC-723 G7 analyser. Material and Methods: We analysed 63 blood samples and quantified HbF by mode for glycated hemoglobin. The samples were sorted to 3 groups according HbF values: group 1 (n = 24) included HbF values 1–2 % of total hemoglobin (Hb), group 2 (n = 21) included HbF values 2–5 % of total Hb, and group 3 (n = 18) included HbF > 5 % of total Hb. We simultaneously measured HbF in all samples in mode for β-thalassemia determination on the same analyser. Results: The HbF values between 1–2 % obtained by glycated mode did not correlated with results by β-thalassemia mode (r = 0.241). The both HbF values between 2–5 % and HbF values > 5 % of total Hb correlated acceptable with results by β-thalassemia mode (r = 0.825 and 0.889 respectively; p < 0.001). Only pathological HbF values higher than 2 % of total Hb have the clinical significance. These values measured by mode for HbA1c determination is possible to take as correct. On the contrary, all HbF values lower then 2 % of total Hb, measured by mode for HbA1c determination, are not reliable. Conclusion: We conclude that analytical mode for HbA1c determination is also suitable to use for presumptive combined HbF quantification on Tosoh HLC-723 G7 analyser.
