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Microorganisms 2017, 5(2), 21; doi:10.3390/microorganisms5020021

Hyperbaric Oxygen Therapy is Ineffective as an Adjuvant to Daptomycin with Rifampicin Treatment in a Murine Model of Staphylococcus aureus in Implant-Associated Osteomyelitis

1
Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus, Denmark
2
Department of Clinical Microbiology, Aarhus University Hospital, 8200 Aarhus, Denmark
3
Comparative Medicine Lab, Department of Clinical Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark
4
Department of Rheumatology, Aarhus University Hospital, 8200 Aarhus, Denmark
5
Microbiology and Infection Control, Statens Serum Institut, 2300 Copenhagen, Denmark
6
Interdisciplinary Nanoscience Center (iNANO), Aarhus University, 8000 Aarhus, Denmark
7
Department of Bioscience, Aarhus University, 8000 Aarhus, Denmark
*
Author to whom correspondence should be addressed.
Academic Editors: Gianfranco Donelli and Claudia Vuotto
Received: 19 March 2017 / Revised: 18 April 2017 / Accepted: 19 April 2017 / Published: 25 April 2017
(This article belongs to the Special Issue Microbial Biofilms and Human Infections)
View Full-Text   |   Download PDF [1967 KB, uploaded 25 April 2017]   |  

Abstract

Implant-associated infections caused by bacterial biofilms are difficult to treat. Surgical intervention is often necessary to cure the patient, as the antibiotic recalcitrance of biofilms renders them untreatable with conventional antibiotics. Intermittent hyperbaric oxygen treatment (HBOT) has been proposed as an adjuvant to conventional antibiotic treatment and it has been speculated that combining HBOT with antibiotics could improve treatment outcomes for biofilm infections. In this study we addressed whether HBOT could improve treatment outcomes of daptomycin and rifampicin combination therapy. The effect of HBOT on the treatment outcomes of daptomycin and rifampicin against implant-associated osteomyelitis was quantified in a murine model. In total, 80 mice were randomized into two groups receiving antibiotics, either alone or in combination with daily intermittent HBOT (304 kPa for 60 min) following injection of antibiotics. Treatment was initiated 11 days after animals were infected with Staphylococcus aureus and treatment duration was 14 days. We found that HBOT did not improve the cure rate and did not reduce the bacterial load on the implant surface or in the surrounding tissue. Cure rates of daptomycin + rifampicin were 40% in infected tibias and 75% for implants while cure rates for HBOT-daptomycin + rifampicin were 50% and 85%, respectively, which were not significantly higher (Fisher’s exact test). While it is encouraging that the combination of daptomycin and rifampicin is very effective, our study demonstrates that this efficacy cannot be improved by adjuvant HBOT. View Full-Text
Keywords: Implant-associated osteomyelitis; hyperbaric oxygen therapy; biofilm; Staphylococcus aureus; bone turnover; inflammation Implant-associated osteomyelitis; hyperbaric oxygen therapy; biofilm; Staphylococcus aureus; bone turnover; inflammation
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MDPI and ACS Style

Jørgensen, N.P.; Hansen, K.; Andreasen, C.M.; Pedersen, M.; Fuursted, K.; Meyer, R.L.; Petersen, E. Hyperbaric Oxygen Therapy is Ineffective as an Adjuvant to Daptomycin with Rifampicin Treatment in a Murine Model of Staphylococcus aureus in Implant-Associated Osteomyelitis. Microorganisms 2017, 5, 21.

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