Comparative efficacy of topical versus systemic teicoplanin in experimental model of wound infections.
BACKGROUND
Surgical site infections are the second most common cause of nosocomial infections and, typically, gram-positive pathogens are involved.


METHODS
A mouse model was used to investigate the efficacy of different methods for the treatment of wound infections. A full thickness wound was established on the back subcutaneous tissue of adult male BALB/c mice. A small gauze was placed over each wound and then inoculated with 5 x 10(7) colony-forming units of Staphylococcus aureus. The study included a control group that did not receive any treatment and four contaminated groups treated, respectively, with: (1) drug-free Allevyn (Smith and Nephew Healthcare, Yorkshire, United Kingdom), (2) teicoplanin-soaked Allevyn, (3) drug-free Allevyn and daily intraperitoneal teicoplanin (7 mg/kg) and, finally, (4) teicoplanin-soaked Allevyn and daily intraperitoneal teicoplanin (7 mg/kg). Main outcome measures were quantitative bacterial culture, assessment of vascular endothelial growth factor (VEGF) plasma levels, histological examination with assessment of microvessel density, and of VEGF expression in tissue sections.


RESULTS
Data analysis showed that strong inhibition of bacterial growth was achieved in any group treated with intraperitoneal teicoplanin. However, the highest inhibition of bacterial growth was obtained in the group that received teicoplanin-soaked Allevyn and intraperitoneal teicoplanin. Histological examination showed that each treatment modality was able to reduce the delay in wound repair. The most effective treatment appeared to be the local application of teicoplanin-soaked hydro gel foam. The tissue effects were associated with an increase in neovascularization and VEGF expression by endothelial cells and fibroblasts in the granulation tissue. Bacterial colonies also were reduced, especially when teicoplanin was given parenterally.


CONCLUSIONS
Soaking a hydro cellular foam with an antistaphylococcal agents, such as teicoplanin, may be useful for the management of infected wounds.
Ghiselli
Roberto
R
Department of General Surgery, I.N.R.C.A. I.R.R.C.S., Università Politecnica delle Marche, Ancona, Italy.
Cirioni
Oscar
O
Giacometti
Andrea
A
Scalise
Alessandro
A
Simonetti
Oriana
O
Mocchegiani
Federico
F
Orlando
Fiorenza
F
Goteri
Gaia
G
Della Vittoria
Agnese
A
Filosa
Alessandra
A
Silvestri
Carmela
C
Offidani
Annamaria
A
Bertani
Aldo
A
Scalise
Giorgio
G
Saba
Vittorio
V
D000287:Administration, Topical; D000818:Animals; D000900:Anti-Bacterial Agents / Q000097:blood / Q000494:pharmacology*; D004195:Disease Models, Animal; D007274:Injections, Intraperitoneal; D007275:Injections, Intravenous; D008297:Male; D016106:Methicillin Resistance; D051379:Mice; D008807:Mice, Inbred BALB C; D008833:Microcirculation; D012867:Skin / Q000098:blood supply / Q000382:microbiology / Q000473:pathology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000473:pathology; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000473:pathology; D017334:Teicoplanin / Q000097:blood / Q000494:pharmacology*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
D000900:Anti-Bacterial Agents; D042461:Vascular Endothelial Growth Factor A; C467480:vascular endothelial growth factor A, mouse; D017334:Teicoplanin