Muntendam, R.D. (Rutger) (2014) The influence of High-Intensity Pulsed Ultrasound on the prevention and treatment of Orthopedic Infections with Methicillin-Resistant Bacteria. thesis, Medicine.
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Abstract
Biomaterials are widely used within various medical fields. Despite perioperative prophylaxis, biomaterial-related infections still occur. These infections are hard to treat due to the formation of a biofilm; a biofilm increases the overall resistance of bacteria. Therefore, these infections pose a serious threat towards patients. In orthopedic arthroplasties, the rise of methicillin-resistant bacteria has made this threat more severe. Minimally invasive treatment options have been investigated to enhance prophylaxis and treatment of infected joint prostheses. High-intensity pulsed ultrasound has been proposed as a treatment addition. Using a ultrasonic pulse at a frequency of 520 kHz and an average intensity of 1 W/cm2, this thesis aimed to enhance the antibiotic efficacy of gentamicin against biofilm bacteria: the so-called “bio-acoustic effect”. Ultrasound was applied for 1 hour using methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis strains. First, the influence of pulsed ultrasound on the viability of planktonic MRSA and MRSE was investigated. Furthermore, the release pattern of gentamicin from Palacos gentamicin-loaded bone cement and from Septopal gentamicin-loaded beads was sought to be optimized by ultrasound application. As a main experiment, we investigated the influence of pulsed ultrasound on biofilm bacteria grown on bone cement samples. We found no significant decrease in planktonic bacterial viability. Furthermore, wefound that gentamicin release pattern from both cement and beads did not significantly improve. For the main experiment, we saw that for one MRSA strain and an MRSE strain the biofilm bacterial viability was significantly reduced by ultrasound application. Ultrasound alone, in the absence of gentamicin, seemed to increase viability slightly. This thesis shows that prophylaxis and treatment of orthopedic infections could be enhanced by applying pulsed ultrasound.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Neut, Dr. ir. D. and Jutte, Dr. P.C. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:41 |
| Last Modified: | 25 Jun 2020 10:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/302 |
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