Pathological and microbiological impact of a gentamicin-loaded biocomposite following limited or extensive debridement in a porcine model of osteomyelitis

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  • Sophie A. Blirup-Plum, University of Copenhagen
  • ,
  • T. Bjarnsholt, University of Copenhagen
  • ,
  • H. E. Jensen, University of Copenhagen
  • ,
  • K. N. Kragh, Costerton Biofilm Center
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  • B. Aalbæk, University of Copenhagen
  • ,
  • H. Gottlieb, Herlev Hospital
  • ,
  • M. Bue
  • L. K. Jensen, University of Copenhagen

Aims: CERAMENT|G is an absorbable gentamicin-loaded biocomposite used as an on-site vehicle of antimicrobials for the treatment of chronic osteomyelitis. The purpose of the present study was to investigate the sole effect of CERAMENT|G, i.e. without additional systemic antimicrobial therapy, in relation to a limited or extensive debridement of osteomyelitis lesions in a porcine model. Methods: Osteomyelitis was induced in nine pigs by inoculation of 104 colony-forming units (CFUs) of Staphylococcus aureus into a drill hole in the right tibia. After one week, the pigs were allocated into three groups. Group A (n = 3) received no treatment during the study period (19 days). Groups B (n = 3) and C (n = 3) received limited or extensive debridement seven days postinoculation, respectively, followed by injection of CERAMENT|G into the bone voids. The pigs were euthanized ten (Group C) and 12 (Group B) days after the intervention. Results: All animals presented confirmatory signs of bone infection post-mortem. The estimated amount of inflammation was substantially greater in Groups A and B compared to Group C. In both Groups B and C, peptide nucleic acid fluorescence in situ hybridization (PNA FISH) of CERAMENT|G and surrounding bone tissue revealed bacteria embedded in an opaque matrix, i.e. within biofilm. In addition, in Group C, the maximal measured post-mortem gentamicin concentrations in CERAMENT|G and surrounding bone tissue samples were 16.6 µg/ml and 6.2 µg/ml, respectively. Conclusion: The present study demonstrates that CERAMENT|G cannot be used as a standalone alternative to extensive debridement or be used without the addition of systemic antimicrobials.

Original languageEnglish
JournalBone and Joint Research
Volume9
Issue7
Pages (from-to)394-401
ISSN2046-3758
DOIs
Publication statusPublished - Jul 2020

    Research areas

  • Animal model, Antimicrobial carrier, Calcium sulphate, Hydroxyapatite, Osteomyelitis

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