Author/Authors :
Siavashi Babak نويسنده Joint Reconstruction Research Center, Sina Hospital,
Tehran University of Medical Sciences, Tehran, IR
Iran , Sadeghi-Naini Mohsen نويسنده Sina Trauma and Surgery Research Center, Tehran University
of Medical Sciences, Tehran, Iran , Sabagh Mohammadsadegh نويسنده Multidisciplinary Orthopedic and Rheumatologic Research
Association, Tehran University of Medical Sciences, Tehran,
Iran , Yamini Amirhossein نويسنده Department of Medical Virology, Tarbiat Modares
University, Tehran, Iran , Nakhjavani Farrokh نويسنده Associate Professor of Microbiology, Department of
Microbiology, Tehran University of Medical Sciences, Tehran,
Iran , Hing Caroline B نويسنده Consultant Trauma and Orthopaedics, Department of
Orthopaedic Surgery, St George’s Hospital, London, UK
Abstract :
Background Staphylococcus aureus (S.
aureus) is the most common pathogen responsible for
osteomyelitis. Objectives Our objective was to investigate the potential
of a probiotic as a treatment for S. aureus-induced
infection following fracture fixation in a rat model. Methods Fifty male
Sprague-Dawley rats were assigned to five groups (Control, S.
aureus, S. aureus +ceftriaxone, S.
aureus + once weekly probiotic, and S.
aureus + twice weekly probiotic). Lactobacillus casei
subsp. casei (ATCC: 39392) was selected from eight strains of
probiotic bacteria with anti-staphylococcal activity. Infection was
induced by inoculation with106 colony-forming units (CFU) of S.
aureus in a closed femur fracture model stabilized with an
intramedullary pin. Three weeks after the surgery, the development of
infection and response to the therapy was documented using radiographs,
microbiological and histopathological analysis. Results No bacteria were
recovered from rats in the Control group. The analysis of variance
revealed a significant difference in the CFU/femur (P < 0.001)
and CFU/pin (P = 0.001) across all five treatment groups. When the
results were compared, the CFU/femur was significantly lower in the
S. aureus + Probiotic twice weekly in comparison with
S. aureus (P = 0.008) and the S.
aureus + ceftriaxone (P = 0.012) groups. Repeated measure
ANOVA to test the radiographic scores during the follow-up time between
the intervention groups revealed no significant differences (P = 0.179).
Conclusions Parenteral administration of viable L.
casei inhibits S. aureus-induced infection
as shown by the bacteriologic analysis, but makes no difference to the
radiological union rates. This could be the first step towards
developing an effective, biologic adjunctive therapy for the management
of osteomyelitis following fracture fixation.
