Topical versus systemic vancomycin for deep sternal wound infection caused by methicillin-resistant Staphylococcus aureus in a rodent experimental model.

Abstract

In 37 Wistar albino rats, we investigated the effects of topical vancomycin on deep sternal wound infection caused by methicillin-resistant Staphylococcus aureus. Partial median sternotomy was performed under sterile conditions. Group I (n=6) was the sham, and group II (n=7) was the control. Group III (n=8) received topical vancomycin, group IV (n=8) received systemic vancomycin, and group V (n=8) received topical and systemic vancomycin (combined). Rats in groups II through V were inoculated with 0.5 mL x 10(8) CFU/mL methicillin-resistant S. aureus in the mediastinum and sternum. No medication was given to groups I and II. Twenty-four hours after surgery, 40 mg/kg/day vancomycin was given topically in group III; systemically in group IV; and topically and systemically in group V After 7 days, smear samples from the mediastinum and tissue cultures from the sternum were obtained. We found 5.00 +/- 0 CFU/mL microorganisms in the mediastinum in group II, 1.90 +/- 1.70 in group III, 3.33 +/- 0.48 in group IV and 1.70 +/- 1.08 in group V. The quantity of microorganisms per gram of tissue in the sternum was 736 +/- 0.23 in group II, 6.01 +/- 0.33 in group III, 5.81 +/- 0.81 in group IV and 3.99 +/- 2.47 in group V The quantity of microorganisms was less in the 3 treatment groups than in the control group (P < 0.05). We conclude that topical plus systemic vancomycin treatment might be more effective in patients with deep sternal wound infections caused by methicillin-resistant S. aureus.

• Authors: Ali V Ozcan, Melek Demir, Gokhan Onem, Ibrahim Goksin, Ahmet Baltalarli, Veli K Topkara, Ilknur Kaleli
• Journal: Texas Heart Institute journal (Tex Heart Inst J) Vol. 33 Issue 2 Pg. 107-10 ( 2006) ISSN: 0730-2347 [Print] United States
• PMID: 16878608 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Vancomycin

Topics

• Administration, Topical
• Animals
• Anti-Bacterial Agents (administration & dosage)
• Infusions, Intravenous
• Male
• Methicillin Resistance
• Rats
• Rats, Wistar
• Staphylococcal Infections (drug therapy)
• Staphylococcus aureus (drug effects)
• Stem Cells
• Sternum (microbiology, surgery)
• Surgical Wound Infection (drug therapy, microbiology)
• Vancomycin (administration & dosage)