Abstract：
BACKGROUND:Multidrug resistant Acinetobacter baumannii (MDR AB) with and without Staphylococcus aureus (SA) is a commonly isolated organism in infected segmental bone defects in combat-related trauma in Iraq and Afghanistan. Although MDR AB in visceral infections is a therapeutic challenge, control of infection appears more common for combat-related osteomyelitis. QUESTIONS/PURPOSES:Using a rat model, we explored the virulence of MDR AB in segmental bone defects alone and in combination with SA. METHODS:Segmental defects in 60 rat femurs were created, stabilized, and inoculated with MDR AB alone and 60 with MDR AB and SA. We performed qualitative and quantitative bacteriology and radiographic assessments at 2, 4, and 8 weeks for MDR AB and at 1, 2, and 3 weeks for MDR AB and SA. RESULTS:Quantitative bacteriology revealed a 3- to 5-log decrease in MDR AB from the initial inoculum. After polymicrobial inoculation, only 10 of 60 animals had positive cultures for MDR AB, whereas 59 of 60 animals had positive cultures for SA. Recovered SA were 2 to 5 log greater than the initial inoculum, while there again was a 3- to 5-log decrease in MDR AB. MDR AB alone did not cause bony lysis, but there was radiographic evidence of new bone formation in 67% of the segmental defects. Osteolysis was noted with MDR AB and SA. CONCLUSIONS:MDR AB did not appear to cause or contribute to clinically apparent osteomyelitis in this pilot study. CLINICAL RELEVANCE:Resolution of infections in combat-related segmental bone defects inoculated with MDR AB may be attributable to low virulence. Additional studies are needed to confirm low virulence and bone formation with MDR AB.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Collinet-Adler S,Castro CA,Ledonio CG,Bechtold JE,Tsukayama DTdoi
10.1007/s11999-010-1488-0subject
Has Abstractpub_date
2011-01-01 00:00:00pages
274-82issue
1eissn
0009-921Xissn
1528-1132journal_volume
469pub_type
杂志文章abstract：BACKGROUND:Small recent case series using CT-based navigation suggest such approaches may aid in surgical planning and improve accuracy of intended resections, but the accuracy and clinical use have not been confirmed. QUESTIONS/PURPOSES:We therefore evaluated (1) the accuracy; (2) recurrences; and (3) function in pat...
journal_title：Clinical orthopaedics and related research
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abstract：:Reported herein is a rare case of a patient with a pathologic fracture through a cyst in the femoral neck that resulted in avascular necrosis of the femoral epiphysis. This type of necrosis is commonly understood to follow displaced fractures of the femoral neck in children, but has also been reported to follow undisp...
journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s11999-012-2326-3
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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doi：
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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更新日期：2013-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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更新日期：2004-09-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
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更新日期：1999-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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