title: Biodegradable vancomycin-eluting poly[(d,l)-lactide-co-glycolide] nanofibres for the treatment of postoperative central nervous system infection.
abstract: The incidence of postoperative central nervous system infection (PCNSI) is higher than 5%-7%. Successful management of PCNSI requires a combined therapy of surgical debridement and long-term antibiotic treatment. In this study, Duraform soaked in a prepared bacterial solution was placed on the brain surface of rats to induce PCNSI. Virgin poly[(d,l)-lactide-co-glycolide] (PLGA) nanofibrous membranes (vehicle-control group) and vancomycin-eluting PLGA membranes (vancomycin-nanofibres group) were implanted. The wound conditions were observed and serial brain MRI and pathology examinations were performed regularly. PCNSI was consistently induced in a single, simple step. In the vehicle-control group, most rats died within 1 week, and the survival rate was low (odds ratio = 0.0357, 95% confidence interval = 0.0057-0.2254). The wounds and affected cerebral tissues necrosed with purulence and increased in mass from the resulting PCNSI volumes. Initially, the mean PCNSI volumes showed no significant difference between the two groups. The PCNSI volume in the rats in the vancomycin-nanofibres group significantly decreased (P < 0.01), and the wound appearance was excellent. Pathologic examinations revealed that the necrosis and leukocyte infiltration area decreased considerably. The experimental results suggest that vancomycin-eluting PLGA nanofibres are favourable candidates for treating PCNSI after surgical debridement.
authors.affiliation: 1] Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan [2] Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Yuan-Yun
authors.initials: YY
authors.lastname: Tseng
authors.affiliation: Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Yi-Chuan
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Chen-Hsing
authors.initials: CH
authors.lastname: Su
authors.affiliation: Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Shih-Jung
authors.initials: SJ
authors.lastname: Liu
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000737:chemistry; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002494:Central Nervous System Infections / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D004337:Drug Carriers / Q000737:chemistry*; D053208:Kaplan-Meier Estimate; D019344:Lactic Acid / Q000737:chemistry; D008279:Magnetic Resonance Imaging; D057139:Nanofibers / Q000737:chemistry*; D011100:Polyglycolic Acid / Q000737:chemistry; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011183:Postoperative Complications; D011859:Radiography; D051381:Rats; D017208:Rats, Wistar; D014640:Vancomycin / Q000008:administration & dosage* / Q000737:chemistry
chemical_list: D000900:Anti-Bacterial Agents; D004337:Drug Carriers; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D014640:Vancomycin