Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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In Vitro Study Evaluating the Antimicrobial Activity of Vancomycin-Impregnated Cement Stored at Room Temperature in Methicillin-Resistant Staphylococcus aureus

상온에서 보관한 반코마이신 함유 항생제 시멘트의 메티실린 내성 포도상구균에 대한 항균력 조사

  • Park, Se-Jin (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Cho, Yongun (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Seok Won (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Woo, Hee-Yeon (Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lim, Sang Eun (Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 박세진 (성균관대학교 의과대학 강북삼성병원 정형외과학교실) ;
  • 조용운 (성균관대학교 의과대학 강북삼성병원 정형외과학교실) ;
  • 이석원 (성균관대학교 의과대학 강북삼성병원 정형외과학교실) ;
  • 우희연 (성균관대학교 의과대학 강북삼성병원 진단검사의학교실) ;
  • 임상은 (성균관대학교 의과대학 강북삼성병원 진단검사의학교실)
  • Received : 2017.11.13
  • Accepted : 2018.01.06
  • Published : 2018.03.15
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Abstract

Purpose: Treatment of diabetic foot infection due to methicillin-resistant Staphylococcus aureus (MRSA) remains challenging. Applying vancomycin-impregnated cement is one of the best methods of treatment. Vancomycin-impregnated cement has been used worldwide; however, to date, there is a limited number of studies regarding its use. We evaluated the duration of antimicrobial activity of vancomycin-impregnated cement stored at room temperature after manufacturing. Materials and Methods: The vancomycin-impregnated cement was manufactured by mixing 1 g of vancomycin with 40 g of polymer and adding 17.90 g of liquid monomer. The cement dough was shaped into flat cylinders with diameter and height of 6 mm and 2 mm, respectively. Another cement of the same shape without mixing vancomycin was prepared as the negative control. All manufactured cements were sterilized with ethylene oxide gas and stored at room temperature. Each cement was placed on Mueller Hinton agar plate lawned with standard MRSA strain. Standard vancomycin disk and gentamicin disk were placed together. After 24 hours, the diameter of inhibition zone was measured, and if the diameter was less than 15 mm, vancomycin-impregnated cement was regarded as a loss of antimicrobial activity. The study was repeated every 2 weeks until vancomycin-impregnated cements lost their antimicrobial activity. Results: Vancomycin-impregnated cement stored for a duration of 16 weeks created a 14 mm inhibition zone, while vancomycin disk created a 15 mm inhibition zone. Vancomycin-impregnated cement stored for a duration of 17 weeks created 7 mm and 9 mm inhibition zones, while vancomycin disk created 16 mm and 15 mm inhibition zones, respectively. Conclusion: We found a decrease of antimicrobial activity in vancomycin-impregnated cements after 16 weeks. After 17 weeks, they showed definite loss of antimicrobial activity. Therefore, we recommend not using vancomycin-impregnated cement spacers that has been stored for more than 16 weeks at room temperature.

Keywords

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