Evaluation of antibiotic and cell-based therapy in preventing S. epidermidis-induced nonunion in rats.
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Parole chiave

Methicillin-resistant S. epidermidis
nonunion
mesenchymal stem cells
rat model
osteomyelitis

Abstract

Methicillin-resistant S. epidermidis (MRSE) is responsible for biofilm-related infections (Montanaro,
2011; Romanò, 2013) and fracture nonunion, as recently demonstrated by our group (Lovati, 2016).
The present study aims to investigate the efficacy of antibiotic or cell-based therapies in preventing
bacterial infections and nonunion establishment.
Under anesthesia, femoral fractures were performed in 30 rats, then the site of injury was injected
with a clinical-derived MRSE strain and, finally, synthesized with stainless steel plates. Rats were
differently treated as follows: MRSE-infected controls (IC); systemically-injected vancomycin (s-VANC);
local vancomycin-enriched hydrogel (l-HYD); systemically-injected BMSCs (s-BMSCs); and locallyinjected
BMSCs (l-BMSCs).
After 6 weeks, pro-inflammatory cytokines, quantitative micro-CT, histological and microbiological
analyses were carried out to investigate the host response to the different treatments.
Half of the s-BMSCs rats died closely to the systemic cell injection, thus excluded for further analyses.
Our results for the IC group were consistent with previously published data (Lovati, 2016), showing
signs of osteomyelitis and nonunion development. In s-VANC and l-HYD groups, micro-CT detected a
good bony bridging and the microbiological counts were significantly lower with respect to the other
groups. Our study suggests that the association of s-VANC and l-HYD is an effective treatment to
prevent biofilm-induced nonunions. Differently, we cannot positively support cell therapies for this
purpose due to the high risk related to the systemic cell injection, thus requiring further studies to be
eventually proposed in clinics.

https://doi.org/10.13130/2283-3927/7061
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Riferimenti bibliografici

Lovati, A.B., Romanò, C.L., Bottagisio, M., Monti, L., De Vecchi, E., Previdi, S., Accetta, R., Drago, L., 2016. Modeling Staphylococcus epidermidis-Induced Non-Unions: Subclinical and Clinical Evidence in Rats. PLoS One 11, e0147447.

Montanaro, L., Speziale, P., Campoccia, D., Ravaioli, S., Cangini, I., Pietrocola, G., Giannini, S., Arciola, C.R., 2011. Scenery of Staphylococcus implant infections in orthopedics. Future Microbiol 6, 1329-1349.

Romanò, C.L., Toscano, M., Romanò, D., Drago, L.,2013. Antibiofilm agents and implant-related infections in orthopaedics: where are we? J Chemother 25, 67-80.

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