title: Hyperbaric oxygen therapy in a mouse model of implant-associated osteomyelitis.
abstract: Implant associated osteomyelitis (OM) is difficult to treat with antibiotics, and outcomes remain poor. Some reports suggest that hyperbaric oxygen treatment is a safe and effective means of treating OM. We tested this hypothesis in a murine model. Clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and Klebsiella pneumoniae were used. The mice were infected with each of the three pathogens, treated with 100% oxygen at high pressure, hyperbaric oxygen (HBO), and monitored for the ability of HBO to prevent and/or clear the OM infection. Assessments included bacterial burden of the tibias and lesion scores, as well as receptor activator of NF-κB ligand (RANKL) and myeloperoxidase (MPO) concentrations. HBO resulted in more severe lesion scores and higher RANKL and MPO concentrations for MRSA. A significant positive correlation was found between RANKL concentration and lesion score. No significant difference was found with HBO in P. aeruginosa infections and K. pneumoniae seems to either not infect bone well or get cleared before establishing an infection. The model is useful for studying OM infections caused by MRSA and P. aeruginosa, but HBO does not appear to be an efficacious treatment of an implant-associated OM infection.
authors.affiliation: Hyperion Biotechnology, San Antonio, Texas 78248, USA. sabrinashandley@hyperionbiotechnology.com
authors.forename: Sabrina
authors.initials: S
authors.lastname: Shandley
authors.forename: Krista Prato
authors.initials: KP
authors.lastname: Matthews
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cox
authors.forename: Desiree
authors.initials: D
authors.lastname: Romano
authors.forename: Allison
authors.initials: A
authors.lastname: Abplanalp
authors.forename: John
authors.initials: J
authors.lastname: Kalns
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D006931:Hyperbaric Oxygenation; D007710:Klebsiella Infections / Q000628:therapy; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D051379:Mice; D008810:Mice, Inbred C57BL; D010019:Osteomyelitis / Q000628:therapy*; D009195:Peroxidase / Q000502:physiology; D019736:Prostheses and Implants / Q000009:adverse effects*; D011552:Pseudomonas Infections / Q000628:therapy; D053245:RANK Ligand / Q000502:physiology; D013203:Staphylococcal Infections / Q000628:therapy; D013977:Tibia / Q000601:surgery
chemical_list: D053245:RANK Ligand; C505689:Tnfsf11 protein, mouse; D009195:Peroxidase