title: Adjunctive Hyperbaric Oxygen Therapy or Alone Antibiotherapy? Methicillin Resistant Staphylococcus aureus Mediastinitis in a Rat Model.
abstract: OBJECTIVE
  In the post-sternotomy mediastinitis patients, Staphylococcus aureus is the pathogenic microorganism encountered most often. In our study, we aimed to determine the efficacy of antibiotic treatment with vancomycin and tigecycline, alone or in combination with hyperbaric oxygen treatment, on bacterial elimination in experimental S. aureus mediastinitis.
  
  
  METHODS
  Forty-nine adult female Wistar rats were used. They were randomly divided into seven groups, as follows: non-contaminated, contaminated control, vancomycin, tigecycline, hyperbaric oxygen, hyperbaric oxygen + vancomycin and hyperbaric oxygen + tigecycline. The vancomycin rat group received 10 mg/kg/day of vancomycin twice a day through intramuscular injection. The tigecycline group rats received 7 mg/kg/day of tigecycline twice a day through intraperitoneal injection. The hyperbaric oxygen group underwent 90 min sessions of 100% oxygen at 2.5 atm pressure. Treatment continued for 7 days. Twelve hours after the end of treatment, tissue samples were obtained from the upper part of the sternum for bacterial count assessment.
  
  
  RESULTS
  When the quantitative bacterial counts of the untreated contaminated group were compared with those of the treated groups, a significant decrease was observed. However, comparing the antibiotic groups with the same antibiotic combined with hyperbaric oxygen, there was a significant reduction in microorganisms identified (P<0.05). Comparing hyperbaric oxygen used alone with the vancomycin and tigecycline groups, it was seen that the effect was not significant (P<0.05).
  
  
  CONCLUSIONS
  We believe that the combination of hyperbaric oxygen with antibiotics had a significant effect on mediastinitis resulting from methicillin-resistant Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus mediastinitis can be treated without requiring a multidrug combination, thereby reducing the medication dose and concomitantly decreasing the side effects.
authors.affiliation: Department of Cardiovascular Surgery, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Kurt
authors.affiliation: Department of Microbiology, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Vural
authors.affiliation: Department of Cardiology, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Temiz
authors.affiliation: Department of Cardiovascular Surgery, School of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Ersan
authors.initials: E
authors.lastname: Ozbudak
authors.affiliation: Department of Cardiovascular Surgery, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
authors.forename: Ali Umit
authors.initials: AU
authors.lastname: Yener
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Canakkale Onsekiz Mart University, Canakkale, Turkey.
authors.forename: Suzan
authors.initials: S
authors.lastname: Sacar
authors.affiliation: Department of Cardiovascular Surgery, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sacar
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods* / Q000592:standards; D005260:Female; D006931:Hyperbaric Oxygenation / Q000379:methods*; D008480:Mediastinitis / Q000150:complications / Q000382:microbiology / Q000628:therapy*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000254:growth & development*; D008911:Minocycline / Q000031:analogs & derivatives / Q000627:therapeutic use; D023421:Models, Animal; D011897:Random Allocation; D017208:Rats, Wistar; D013203:Staphylococcal Infections / Q000150:complications / Q000628:therapy; D013249:Sternum / Q000382:microbiology; D000078304:Tigecycline; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D000078304:Tigecycline; D008911:Minocycline