Bioactive glass bag-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones: An in vitro and prospective clinical study

Lorenzo Drago, Delia Romanò, Elena De Vecchi, Christian Vassena, Nicola Logoluso, Roberto Mattina, Carlo L. Romanò

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background: This study aimed to explore the in vitro antibacterial activity of the bioglass BAG S53P4 against multi-resistant microorganisms commonly involved in osteomyelitis and to evaluate its use in surgical adjunctive treatment of osteomyelitis.Methods: In vitro antibacterial activity of BAG-S53P4 against methicillin resistant Staphylococcus aureus and Staphylococcus epidermidis, Pseudomonas aeruginosa and Acinetobacter baumannii isolates was evaluated by means of time kill curves, with colony counts performed after 24, 48 and 72 hours of incubation. In vivo evaluation was performed by prospectively studying a cohort of 27 patients with a clinically and radiologically diagnosed osteomyelitis of the long bones in an observational study. Endpoints were the absence of infection recurrence/persistence at follow-up, no need for further surgery whenever during follow-up and absence of local or systemic side effects connected with the BAG use.Results: In vitro tests regarding the antibacterial activity of BAG S53P4 showed a marked bactericidal activity after 24 hrs against all the tested species. This activity continued in the subsequent 24 hrs and no growth was observed for all strains after 72 hrs. Results of the clinical study evidenced no signs of infection in 24 patients (88.9%) at the follow-up, while 2 subjects showed infection recurrence at 6 months from index operation and one more needed further surgical procedures. BAG-S53P4 was generally well tolerated.Conclusions: The in vitro and in vivo findings reinforce previous observations on the efficacy of BAG-S53P4 for the treatment of chronic osteomyelitis of the long bones, also in the presence of multi-resistant strains and in immunocompromised hosts, without relevant side effects and without the need for locally adding antibiotics.Trial registration: Deutschen Register Klinischer Studien (DRKS) unique identifier: DRKS00005332.

Original languageEnglish
Article number584
JournalBMC Infectious Diseases
Volume13
Issue number1
DOIs
Publication statusPublished - Dec 10 2013

Fingerprint

Osteomyelitis
Prospective Studies
Bone and Bones
Infection
Therapeutics
Recurrence
Acinetobacter baumannii
Staphylococcus epidermidis
Immunocompromised Host
Methicillin-Resistant Staphylococcus aureus
Pseudomonas aeruginosa
Observational Studies
In Vitro Techniques
bioactive glass S53P4
Clinical Studies
Anti-Bacterial Agents
Growth

Keywords

  • Bioactive glass
  • Bone infections
  • Pseudomonas aeruginosa
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Bioactive glass bag-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones : An in vitro and prospective clinical study. / Drago, Lorenzo; Romanò, Delia; De Vecchi, Elena; Vassena, Christian; Logoluso, Nicola; Mattina, Roberto; Romanò, Carlo L.

In: BMC Infectious Diseases, Vol. 13, No. 1, 584, 10.12.2013.

Research output: Contribution to journalArticle

@article{09b6ec46348643108ab83de2c69dbf89,
title = "Bioactive glass bag-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones: An in vitro and prospective clinical study",
abstract = "Background: This study aimed to explore the in vitro antibacterial activity of the bioglass BAG S53P4 against multi-resistant microorganisms commonly involved in osteomyelitis and to evaluate its use in surgical adjunctive treatment of osteomyelitis.Methods: In vitro antibacterial activity of BAG-S53P4 against methicillin resistant Staphylococcus aureus and Staphylococcus epidermidis, Pseudomonas aeruginosa and Acinetobacter baumannii isolates was evaluated by means of time kill curves, with colony counts performed after 24, 48 and 72 hours of incubation. In vivo evaluation was performed by prospectively studying a cohort of 27 patients with a clinically and radiologically diagnosed osteomyelitis of the long bones in an observational study. Endpoints were the absence of infection recurrence/persistence at follow-up, no need for further surgery whenever during follow-up and absence of local or systemic side effects connected with the BAG use.Results: In vitro tests regarding the antibacterial activity of BAG S53P4 showed a marked bactericidal activity after 24 hrs against all the tested species. This activity continued in the subsequent 24 hrs and no growth was observed for all strains after 72 hrs. Results of the clinical study evidenced no signs of infection in 24 patients (88.9{\%}) at the follow-up, while 2 subjects showed infection recurrence at 6 months from index operation and one more needed further surgical procedures. BAG-S53P4 was generally well tolerated.Conclusions: The in vitro and in vivo findings reinforce previous observations on the efficacy of BAG-S53P4 for the treatment of chronic osteomyelitis of the long bones, also in the presence of multi-resistant strains and in immunocompromised hosts, without relevant side effects and without the need for locally adding antibiotics.Trial registration: Deutschen Register Klinischer Studien (DRKS) unique identifier: DRKS00005332.",
keywords = "Bioactive glass, Bone infections, Pseudomonas aeruginosa, Staphylococcus aureus",
author = "Lorenzo Drago and Delia Roman{\`o} and {De Vecchi}, Elena and Christian Vassena and Nicola Logoluso and Roberto Mattina and Roman{\`o}, {Carlo L.}",
year = "2013",
month = "12",
day = "10",
doi = "10.1186/1471-2334-13-584",
language = "English",
volume = "13",
journal = "BMC Infectious Diseases",
issn = "1471-2334",
publisher = "BioMed Central Ltd.",
number = "1",

}

TY - JOUR

T1 - Bioactive glass bag-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones

T2 - An in vitro and prospective clinical study

AU - Drago, Lorenzo

AU - Romanò, Delia

AU - De Vecchi, Elena

AU - Vassena, Christian

AU - Logoluso, Nicola

AU - Mattina, Roberto

AU - Romanò, Carlo L.

PY - 2013/12/10

Y1 - 2013/12/10

N2 - Background: This study aimed to explore the in vitro antibacterial activity of the bioglass BAG S53P4 against multi-resistant microorganisms commonly involved in osteomyelitis and to evaluate its use in surgical adjunctive treatment of osteomyelitis.Methods: In vitro antibacterial activity of BAG-S53P4 against methicillin resistant Staphylococcus aureus and Staphylococcus epidermidis, Pseudomonas aeruginosa and Acinetobacter baumannii isolates was evaluated by means of time kill curves, with colony counts performed after 24, 48 and 72 hours of incubation. In vivo evaluation was performed by prospectively studying a cohort of 27 patients with a clinically and radiologically diagnosed osteomyelitis of the long bones in an observational study. Endpoints were the absence of infection recurrence/persistence at follow-up, no need for further surgery whenever during follow-up and absence of local or systemic side effects connected with the BAG use.Results: In vitro tests regarding the antibacterial activity of BAG S53P4 showed a marked bactericidal activity after 24 hrs against all the tested species. This activity continued in the subsequent 24 hrs and no growth was observed for all strains after 72 hrs. Results of the clinical study evidenced no signs of infection in 24 patients (88.9%) at the follow-up, while 2 subjects showed infection recurrence at 6 months from index operation and one more needed further surgical procedures. BAG-S53P4 was generally well tolerated.Conclusions: The in vitro and in vivo findings reinforce previous observations on the efficacy of BAG-S53P4 for the treatment of chronic osteomyelitis of the long bones, also in the presence of multi-resistant strains and in immunocompromised hosts, without relevant side effects and without the need for locally adding antibiotics.Trial registration: Deutschen Register Klinischer Studien (DRKS) unique identifier: DRKS00005332.

AB - Background: This study aimed to explore the in vitro antibacterial activity of the bioglass BAG S53P4 against multi-resistant microorganisms commonly involved in osteomyelitis and to evaluate its use in surgical adjunctive treatment of osteomyelitis.Methods: In vitro antibacterial activity of BAG-S53P4 against methicillin resistant Staphylococcus aureus and Staphylococcus epidermidis, Pseudomonas aeruginosa and Acinetobacter baumannii isolates was evaluated by means of time kill curves, with colony counts performed after 24, 48 and 72 hours of incubation. In vivo evaluation was performed by prospectively studying a cohort of 27 patients with a clinically and radiologically diagnosed osteomyelitis of the long bones in an observational study. Endpoints were the absence of infection recurrence/persistence at follow-up, no need for further surgery whenever during follow-up and absence of local or systemic side effects connected with the BAG use.Results: In vitro tests regarding the antibacterial activity of BAG S53P4 showed a marked bactericidal activity after 24 hrs against all the tested species. This activity continued in the subsequent 24 hrs and no growth was observed for all strains after 72 hrs. Results of the clinical study evidenced no signs of infection in 24 patients (88.9%) at the follow-up, while 2 subjects showed infection recurrence at 6 months from index operation and one more needed further surgical procedures. BAG-S53P4 was generally well tolerated.Conclusions: The in vitro and in vivo findings reinforce previous observations on the efficacy of BAG-S53P4 for the treatment of chronic osteomyelitis of the long bones, also in the presence of multi-resistant strains and in immunocompromised hosts, without relevant side effects and without the need for locally adding antibiotics.Trial registration: Deutschen Register Klinischer Studien (DRKS) unique identifier: DRKS00005332.

KW - Bioactive glass

KW - Bone infections

KW - Pseudomonas aeruginosa

KW - Staphylococcus aureus

UR - http://www.scopus.com/inward/record.url?scp=84889818539&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84889818539&partnerID=8YFLogxK

U2 - 10.1186/1471-2334-13-584

DO - 10.1186/1471-2334-13-584

M3 - Article

C2 - 24325278

AN - SCOPUS:84889818539

VL - 13

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

SN - 1471-2334

IS - 1

M1 - 584

ER -