Name: in vivo mouse model of spinal implant infection
Uploaded: 2020-06-23T12:30:00
Description: Watch this Scientific Journal Video about In Vivo Mouse Model of Spinal Implant Infection at JoVE.com

Os autores gostariam de acusar o recebimento da Pediatric Orthopaedic Society of North America Biomet Spine Grant e do National Institutes of Health Clinical and Translational Science Institute KL2 Grant, e do HH Lee Surgical Research Grant como principais fontes de financiamento para esses experimentos.

Todos os animais foram manuseados em estrita conformidade com as boas práticas animais, conforme definido nas regulamentações federais, conforme estabelecido na Lei de Bem-Estar Animal (AWA), no Guia para o Cuidado e Uso de Animais de Laboratório de 1996, na Política PHS para o Cuidado e Uso Humano de Animais de Laboratório, bem como nas políticas e procedimentos da instituição, conforme estabelecido no Manual de Treinamento de Cuidados e Uso de Animais, e todo o trabalho com animais foi aprovado pelo Comitê d...

<ol>
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S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rates+of+infection+after+spine+surgery+based+on+108,419+procedures:+a+report+from+the+Scoliosis+Research+Society+Morbidity+and+Mortality+Committee.">Rates of infection after spine surgery based on 108,419 procedures: a report from the Scoliosis Research Society Morbidity and Mortality Committee.</a> Spine. 36 (7), 556-563 (2011).</li><li>Abbey, D. M., Turner, D. M., Warson, J. S., Wirt, T. C., Scalley, R. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+postoperative+wound+infections+following+spinal+fusion+with+instrumentation.">Treatment of postoperative wound infections following spinal fusion with instrumentation.</a> Journal of Spinal Disorders. 8 (4), 278-283 (1995).</li><li>Silber, J. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Management+of+postprocedural+discitis.">Management of postprocedural discitis.</a> Spine Journal. 2 (4), 279-287 (2002).</li><li>Pappou, I. P., Papadopoulos, E. C., Sama, A. A., Girardi, F. P., Cammisa, F. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Postoperative+infections+in+interbody+fusion+for+degenerative+spinal+disease.">Postoperative infections in interbody fusion for degenerative spinal disease.</a> Clinical Orthopaedics and Related Research. 444, 120-128 (2006).</li><li>Sampedro, M. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+biofilm+approach+to+detect+bacteria+on+removed+spinal+implants.">A biofilm approach to detect bacteria on removed spinal implants.</a> Spine. 35 (12), 1218-1224 (2010).</li><li>Pull ter Gunne, A. F., Mohamed, A. S., Skolasky, R. L., van Laarhoven, C. J., Cohen, D. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+presentation,+incidence,+etiology,+and+treatment+of+surgical+site+infections+after+spinal+surgery.">The presentation, incidence, etiology, and treatment of surgical site infections after spinal surgery.</a> Spine. 35 (13), 1323-1328 (2010).</li><li>Olsen, M. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Risk+factors+for+surgical+site+infection+in+spinal+surgery.">Risk factors for surgical site infection in spinal surgery.</a> Journal of Neurosurgery. 98, 149-155 (2003).</li><li>Ofluoglu, E. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Implant-related+infection+model+in+rat+spine.">Implant-related infection model in rat spine.</a> Archives of Orthopaedic and Trauma Surgery. 127 (5), 391-396 (2007).</li><li>Guiboux, J. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+role+of+prophylactic+antibiotics+in+spinal+instrumentation.+A+rabbit+model.">The role of prophylactic antibiotics in spinal instrumentation. A rabbit model.</a> Spine. 23 (6), 653-656 (1998).</li><li>Stavrakis, A. I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Current+Animal+Models+of+Postoperative+Spine+Infection+and+Potential+Future+Advances.">Current Animal Models of Postoperative Spine Infection and Potential Future Advances.</a> Frontiers in Medicine (Lausanne). 2, 34 (2015).</li><li>Pribaz, J. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mouse+model+of+chronic+post-arthroplasty+infection:+noninvasive+in+vivo+bioluminescence+imaging+to+monitor+bacterial+burden+for+long-term+study.">Mouse model of chronic post-arthroplasty infection: noninvasive in vivo bioluminescence imaging to monitor bacterial burden for long-term study.</a> Journal of Orthopaedic Research. 30 (3), 335-340 (2012).</li><li>Bernthal, N. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+mouse+model+of+post-arthroplasty+Staphylococcus+aureus+joint+infection+to+evaluate+in+vivo+the+efficacy+of+antimicrobial+implant+coatings.">A mouse model of post-arthroplasty Staphylococcus aureus joint infection to evaluate in vivo the efficacy of antimicrobial implant coatings.</a> PLoS One. 5 (9), 12580 (2010).</li><li>Niska, J. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Monitoring+bacterial+burden,+inflammation+and+bone+damage+longitudinally+using+optical+and+muCT+imaging+in+an+orthopaedic+implant+infection+in+mice.">Monitoring bacterial burden, inflammation and bone damage longitudinally using optical and muCT imaging in an orthopaedic implant infection in mice.</a> PLoS One. 7 (10), 47397 (2012).</li><li>Francis, K. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Monitoring+bioluminescent+Staphylococcus+aureus+infections+in+living+mice+using+a+novel+luxABCDE+construct.">Monitoring bioluminescent Staphylococcus aureus infections in living mice using a novel luxABCDE construct.</a> Infection and Immunity. 68 (6), 3594-3600 (2000).</li><li>Dworsky, E. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Novel+in+vivo+mouse+model+of+implant+related+spine+infection.">Novel in vivo mouse model of implant related spine infection.</a> Journal of Orthopaedic Research. 35 (1), 193-199 (2017).</li><li>Hegde, S. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Activity+of+telavancin+against+heterogeneous+vancomycin-intermediate+Staphylococcus+aureus+(hVISA)+in+vitro+and+in+an+in+vivo+mouse+model+of+bacteraemia.">Activity of telavancin against heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) in vitro and in an in vivo mouse model of bacteraemia.</a> Journal of Antimicrobial Chemotherapy. 65 (4), 725-728 (2010).</li><li>Crandon, J. L., Kuti, J. L., Nicolau, D. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparative+efficacies+of+human+simulated+exposures+of+telavancin+and+vancomycin+against+methicillin-resistant+Staphylococcus+aureus+with+a+range+of+vancomycin+MICs+in+a+murine+pneumonia+model.">Comparative efficacies of human simulated exposures of telavancin and vancomycin against methicillin-resistant Staphylococcus aureus with a range of vancomycin MICs in a murine pneumonia model.</a> Antimicrobial Agents and Chemotherapy. 54 (12), 5115-5119 (2010).</li><li>Reyes, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+of+telavancin+in+a+murine+model+of+bacteraemia+induced+by+methicillin-resistant+Staphylococcus+aureus.">Efficacy of telavancin in a murine model of bacteraemia induced by methicillin-resistant Staphylococcus aureus.</a> Journal of Antimicrobial Chemotherapy. 58 (2), 462-465 (2006).</li><li>Sakoulas, G., Eliopoulos, G. M., Alder, J., Eliopoulos, C. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+of+daptomycin+in+experimental+endocarditis+due+to+methicillin-resistant+Staphylococcus+aureus.">Efficacy of daptomycin in experimental endocarditis due to methicillin-resistant Staphylococcus aureus.</a> Antimicrobial Agents and Chemotherapy. 47 (5), 1714-1718 (2003).</li><li>Hu, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Combinatory+antibiotic+therapy+increases+rate+of+bacterial+kill+but+not+final+outcome+in+a+novel+mouse+model+of+Staphylococcus+aureus+spinal+implant+infection.">Combinatory antibiotic therapy increases rate of bacterial kill but not final outcome in a novel mouse model of Staphylococcus aureus spinal implant infection.</a> PLoS One. 12 (2), 0173019 (2017).</li><li>Poelstra, K. A., Barekzi, N. A., Grainger, D. W., Gristina, A. G., Schuler, T. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+novel+spinal+implant+infection+model+in+rabbits.">A novel spinal implant infection model in rabbits.</a> Spine. 25 (4), 406-410 (2000).</li></ol>

Infecções relacionadas ao implante na coluna vertebral pressagiam maus resultados para os pacientes 1,2,3,4,5. Ao contrário de muitas outras áreas do corpo, o hardware infectado na coluna frequentemente não pode ser removido devido ao risco de instabilidade e comprometimento neurológico. Esse desafio único no cenário de bactérias do biofilme resistent...

An erratum was issued for:&#160;<a href="https://www.jove.com/t/60560">In vivo Mouse Model of Spinal Implant Infection</a>. The Authors section was updated from:
Benjamin V. Kelley1 
Stephen D. Zoller1 
Danielle Greig1 
Kellyn Hori1 
Nicolas Cevallos1 
Chad Ishmael1 
Peter Hsiue1 
Rishi Trikha1 
Troy Sekimura2 
Thomas Olson2 
Ameen Chaudry2 
Michael M. Le2 
Anthony A. Scaduto1 
Kevin P. Francis1 
Nicholas M. Bernthal1 
1Department of Orthopaedic Surgery, University of California Los Angeles 
2David Geffen School of Medicine, University of California Los Angeles
to:
Benjamin V. Kelley1 
Christopher Hamad1 
Stephen D. Zoller1 
Danielle Greig1 
Zeinab Mamouei1 
Rene Chun1 
Kellyn Hori1 
Nicolas Cevallos1 
Chad Ishmael1 
Peter Hsiue1 
Rishi Trikha1 
Troy Sekimura2 
Brandon Gettleman3 
Autreen Golzar2 
Adrian Lin2 
Thomas Olson2 
Ameen Chaudry2 
Michael M. Le2 
Anthony A. Scaduto1 
Kevin P. Francis1 
Nicholas M. Bernthal1 
1Department of Orthopaedic Surgery, University of California Los Angeles 
2David Geffen School of Medicine, University of California Los Angeles 
3University of South Carolina School of Medicine, University of South Carolina

An erratum was issued for:&#160;<a href="https://www.jove.com/t/60560">In vivo Mouse Model of Spinal Implant Infection</a>. The Authors section was updated.

Erratum: In vivo Mouse Model of Spinal Implant Infection

O objetivo deste método é descrever um novo modelo de infecção de implante espinhal (LIP) em camundongos. Esse modelo foi projetado para fornecer uma ferramenta barata e precisa para avaliar de forma flexível o efeito de variáveis do hospedeiro, patógeno e/ou implante in vivo. Testar potenciais estratégias terapêuticas e de tratamento para infecções de implantes espinhais neste modelo visa orientar o desenvolvimento de pesquisas antes da aplicação em modelos animais maiores e ensaios clínicos.
A infecção relacionada ao implante após cirurgia de coluna é uma complicação devastadora e, infelizmente, ocorre em aproximadamente 3% a 8% dos pacientes submetidos à cirurgia eletiva da colunavertebral 1,2,3,4,5 e em até 65% dos pacientes submetidos à cirurgia multinível ou de revisão6. O tratamento de infecções de implantes espinhais geralmente requer várias hospitalizações, múltiplas cirurgias e antibioticoterapia prolongada. As SIIs pressagiam resultados ruins para os pacientes, incluindo comprometimento neurológico, incapacidade e aumento do risco de mortalidade. O manejo da LIF é extremamente caro, custando mais de US$ 900.000 por paciente7.
Staphylococcus aureus é o patógeno virulento mais comum da LIF8,9,10,11. As bactérias podem semear o hardware diretamente durante a cirurgia, através da ferida durante o período pós-operatório, ou mais tarde via disseminação hematogênica. Na presença de implantes metálicos, o S. aureus forma biofilme que protege as bactérias da antibioticoterapia e das células imunes. Embora a remoção de hardware infectado possa ajudar efetivamente a erradicar uma infecção, isso frequentemente não é viável na coluna vertebral sem causar desestabilização e risco de comprometimento neurológico12.
Na ausência de explantio de hardware infectado, novas abordagens são necessárias para prevenir, detectar e tratar SII. Historicamente, há modelos animais limitados de SII para avaliar eficientemente a segurança e eficácia de novas terapias. Modelos animais anteriores de LIF requerem grande número de animais e coleta de pontos de dados que requerem eutanásia, incluindo contagem de colônias, histologia e cultura13,14,15. Na falta de monitoramento longitudinal in vivo, esses modelos fornecem apenas um ponto de dados por animal e, portanto, são caros e ineficientes.
Trabalhos anteriores estudando um modelo de infecção por artroplastia de joelho em camundongos estabeleceram o valor e a acurácia da imagem óptica in vivo não invasiva para monitorar longitudinalmente a carga de infecção16. A detecção de bioluminescência permite que a carga bacteriana seja quantificada ao longo de um curso longitudinal de tempo em um único animal de forma humana, precisa e eficiente. Além disso, estudos prévios demonstraram alta correlação entre bioluminescência in vivo e UFCs aderentes a implantes17. A capacidade de rastrear a infecção ao longo do tempo, levou a uma compreensão mais sutil da infecção relacionada ao implante. Além disso, monitorar a infecção longitudinal dessa forma permitiu avaliar com precisão a efetividade da antibioticoterapia e de novos antimicrobianos16,17,18.
Aproveitando essas ferramentas, desenvolvemos e validamos um modelo de infecção pós-operatória de implante espinhal. No método apresentado, utilizamos um inóculo de S. aureus Xen36 bioluminescente para estabelecer um modelo in vivo de SII em camundongos para monitorar longitudinalmente a carga bacteriana16,17,18. Este novo modelo fornece uma ferramenta valiosa para testar eficientemente potenciais estratégias de detecção, prevenção e tratamento para SII antes de sua aplicação em modelos animais maiores e ensaios clínicos.

<table>
	<tbody>
		<tr>
			<td>Analytical Balance ME104</td>
			<td>Mettler Toledo</td>
			<td>30029067</td>
			<td>120 g capacity, 0.1 mg readability, backlit LCD, internal adjustment, metal base</td>
		</tr>
		<tr>
			<td>BD Bacto Tryptic Soy Broth</td>
			<td>Becton Dickinson (BD)</td>
			<td>BD 211825</td>
			<td>BD Bacto Tryptic Soy Broth (Soybean-Casein Digest Medium)</td>
		</tr>
		<tr>
			<td>Biomate 3S UV-VIS Spectrophotometer</td>
			<td>Thermo Scientific</td>
			<td>840-208300</td>
			<td>Spectrophotometer; Thermo Scientific; BioMate 3S; Six-position cell holder; Spectral bandwidth: 1.8nm; Long-life xenon lamp; Store up to 40 test methods; 16L x 13W x 9 in. H; 19 lb.; 100/240V US line cord</td>
		</tr>
		<tr>
			<td>Bioshield 720+ swinging bucket rotor</td>
			<td>Thermo Scientific</td>
			<td>75003183</td>
			<td>Rotor, Swinging bucket; Thermo Scientific; BIOShield 720 high speed; Capacity: 4 x 180mL (0.72L); Angle: 90 deg. ; Max. speed/RCF: 6300rpm/7188 x g; Max. radius: 16.2cm</td>
		</tr>
		<tr>
			<td>Branson Ultrasonics 2510R-MTH (Sonicator)</td>
			<td>Branson Ultrasonics</td>
			<td>CPX952217R</td>
			<td>*similar model, our model is discontinued* Branson Ultrasonics MH Series Heated Ultrasonic Cleaning Bath, 120V, 0.75 gal</td>
		</tr>
		<tr>
			<td>Bullet Blender Storm Homogenizer</td>
			<td>Next Advance</td>
			<td>BBY24M</td>
			<td>The Bullet Blender Storm is the most powerful member of the Bullet Blender family. Homogenize up to 24 of your toughest samples (mouse femur, skin, cartilage, tumor, etc.) in just minutes. Air cooling&#8482; minimizes sample heat up. Uses 1.5ml screw-cap RINO&#174; tubes or snap-cap Eppendorf&#174; Safe-lock&#8482; tubes.</td>
		</tr>
		<tr>
			<td>Germinator 500</td>
			<td>Electron Microscopy Sciences</td>
			<td>66118-10</td>
			<td>The Germinator 500 is designed to decontaminate metal micro-dissecting instruments only. It is to be 
			used exclusively for research purposes. The Germinator 500 should not be used as a substitute for 
			traditional methods of terminal sterilization. Effective sterilization cannot be assured due to lack of routine 
			sterilization-efficacy monitoring methods for glass bead sterilization. The Germinator 500 has been 
			designed and built to pass the Validation of Dry Sterilizer Spore Suspension Test: USP XXIII, Part 1211.</td>
		</tr>
		<tr>
			<td>Heracell 150i CO2 Incubator</td>
			<td>Thermo Scientific</td>
			<td>51026282</td>
			<td>Single 150L</td>
		</tr>
		<tr>
			<td>IVIS Lumina X5 Imaging System</td>
			<td>Perkin Elmer</td>
			<td>CLS148590</td>
			<td>The IVIS Lumina X5 high-throughput 2D optical imaging system combines high-sensitivity bioluminescence and fluorescence with high-resolution x-ray into a compact system that fits on your benchtop. With an expanded 5 mouse field of view for 2D optical imaging plus our unique line of accessories to accelerate setup and labeling, it has never been easier or faster to get robust data&#8212;and answers&#8212;on anatomical and molecular aspects of disease.</td>
		</tr>
		<tr>
			<td>MAXQ 4450 Digtial Incubating Bench Shaker</td>
			<td>Thermo Scientific</td>
			<td>SHKE4450</td>
			<td>Shaker, Incubated; Thermo Scientific; Digital; MaxQ 4450; Speed 15 to 500rpm +/-1rpm; 5 deg. C above ambient to 80 deg. C; 120V 50/60Hz</td>
		</tr>
		<tr>
			<td>PBS, Phosphate Buffered Saline</td>
			<td>Fisher Bioreagents</td>
			<td>BP24384</td>
			<td>PBS, Phosphate Buffered Saline, 1X Solution, pH 7.4</td>
		</tr>
		<tr>
			<td>Sorvall Legend Micro 21 Centrifuge, Ventilated</td>
			<td>Thermo Scientific</td>
			<td>75002436</td>
			<td>24 x 1.5/2.0mL rotor with ClickSeal biocontainment lid</td>
		</tr>
		<tr>
			<td>SORVALL LEGEND X1R 120V Centrifuge</td>
			<td>Thermo Scientific</td>
			<td>75004261</td>
			<td>Centrifuge, Benchtop; Thermo Scientific; Sorvall Legend X1R (Refrigerated), 1L capacity; Max. Speed/RCF 15,200rpm/25,830 x g; CFC-free cooling -10C to +40C; 120V 60Hz</td>
		</tr>
		<tr>
			<td>Staphylococcus aureus - Xen36</td>
			<td>Perkin Elmer</td>
			<td>119243</td>
			<td>Staphylococcus aureus - Xen36 bioluminescent pathogenic bacteria for in vivo and in vitro drug discovery. This product was derived from a parental strain from the American Type Culture Collection, used under license. Staph. aureus-Xen36 possesses a stable copy of the Photorhabdus luminescens lux operon on the native plasmid.</td>
		</tr>
		<tr>
			<td>TUTTNAUER AUTOCLAVE 2540E 120V</td>
			<td>Heidolph Tuttnauer</td>
			<td>23210401</td>
			<td>Sterilizer, Benchtop; Heidolph; Tuttnauer; Model 2540E; Self-contained design with refillable reservoir controls water purity for sterilization; 120V 50/60Hz; 1400w. With electronic controls</td>
		</tr>
		<tr>
			<td>Tween 80</td>
			<td>Fisher Bioreagents</td>
			<td>BP338-500</td>
			<td>Tween 80, Fisher BioReagents, Non-ionic detergent for selective protein extraction</td>
		</tr>
		<tr>
			<td>Vortex mixer VX-200</td>
			<td>Labnet Internation</td>
			<td>S0200</td>
			<td>120V touch or continuous mixer, 230V: 0 - 2,850 rpm,120V: 0 - 3,400 rpm</td>
		</tr>
		<tr>
			<td>0.9% Sodium Chloride</td>
			<td>Pfizer Injectables/Hospira</td>
			<td>00409-4888-10</td>
			<td>0.9% Sodium Chloride Injection, USP</td>
		</tr>
	</tbody>
</table>

in vivo mouse model of spinal implant infection

As infecções por implantes na coluna vertebral pressagiam resultados ruins, pois o diagnóstico é desafiador e a erradicação cirúrgica está em desacordo com a estabilidade mecânica da coluna vertebral. O objetivo deste método é descrever um novo modelo de camundongo de infecção por implante espinhal (SII) que foi criado para fornecer uma ferramenta in vivo barata, rápida e precisa para testar potenciais estratégias terapêuticas e de tratamento para infecções de implantes espinhais.
Neste método, apresentamos um modelo de cirurgia espinhal por abordagem posterior, no qual um fio k de aço inoxidável é transfixado no processo espinhoso L4 de camundongos selvagens C57BL/6J com 12 semanas de idade e inoculado com 1 x 103 UFC de uma cepa bioluminescente da bactéria Staphylococcus aureus Xen36. Os camundongos são então fotografados longitudinalmente para bioluminescência in vivo nos dias de pós-operatório 0, 1, 3, 5, 7, 10, 14, 18, 21, 25, 28 e 35. Sinais de imagem de bioluminescência (BLI) de um campo de visão padronizado são quantificados para medir a carga bacteriana in vivo.
Para quantificar as bactérias aderidas aos implantes e ao tecido peri-implantar, camundongos são eutanasiados e o implante e o tecido mole circundante são colhidos. As bactérias são destacadas do implante por sonicação, cultivadas durante a noite e, em seguida, as unidades formadoras de colônias (UFCs) são contadas. Os resultados obtidos a partir deste método incluem contagens bacterianas longitudinais medidas pela bioluminescência de S. aureus in vivo (fluxo máximo médio) e contagens de UFC após eutanásia.
Enquanto modelos animais anteriores de infecção instrumentada da coluna vertebral envolveram análise invasiva ex vivo de tecido, o modelo de SII em camundongos apresentado neste artigo aproveita imagens ópticas in vivo não invasivas e em tempo real de bactérias bioluminescentes para substituir o estudo de tecido estático. As aplicações do modelo são amplas e podem incluir a utilização de cepas bacterianas bioluminescentes alternativas, a incorporação de outros tipos de camundongos geneticamente modificados para estudar contemporaneamente a resposta imune do hospedeiro e avaliar as atuais ou investigar novas modalidades diagnósticas e terapêuticas, como antibióticos ou revestimentos de implantes.

O procedimento aqui apresentado foi utilizado para avaliar a eficácia de esquemas de antibióticos em um modelo in vivo de SII em camundongos. Especificamente, a eficácia da antibioticoterapia combinada vancomicina e rifampicina foi comparada à vancomicina em monoterapia e controles infectados não tratados.
Antes da cirurgia, os camundongos foram randomizados para terapia combinada, monoterapia ou controle infectado. Uma análise de poder estatístico foi realizada para calcular o tamanho ...

Watch this Scientific Journal Video about In Vivo Mouse Model of Spinal Implant Infection at JoVE.com

In Vivo Mouse Model of Spinal Implant Infection

O protocolo descreve um novo modelo in vivo de infecção de implante espinhal em camundongos, onde um implante de fio k de aço inoxidável é infectado com Staphylococcus aureus Xen36 bioluminescente. A carga bacteriana é monitorada longitudinalmente com imagens bioluminescentes e confirmada com contagens de unidades formadoras de colônias após a eutanásia.

Modelo in vivo de infecção de implante espinhal em camundongos

Spine implant infections portend poor outcomes as diagnosis is challenging and surgical eradication is at odds with mechanical spinal stability. The ...

Postoperative infection is a devastating complication of spinal surgery. This mouse model of spinal implant infection allows researchers to study the effect of host, implant, and therapeutic factors on infection. This technique quantifies real-time longitudinal bacterial burden, humanely and efficiently, in-vivo.Using a frozen stock of S.aureus zen 36, streak the bacteria onto Luria broth plates containing 200 micrograms per milliliter of kanamycin and incubate for 12 to 16 hours at 37 degrees Celsius. At the end of the incubation, individually culture single colonies from the S.aureus zen 36 culture in tryptic soy broth containing 200 micrograms per milliliter kanamycin for 12 to 16 hours at 37 degrees Celsius and 200 revolutions per minute. The next day, dilute the culture in fresh broth at a one to 50 ratio and culture the bacteria for an additional two hours to allow the isolation of mid-logarithmic phase bacteria.At the end of the incubation, pellet the bacterial cells by centrifugation and wash the cells three times in one milliliter of fresh PBS per wash. After the last wash, measure the absorbance at 600 nanometers. The ideal optical density is 0.750.Then, re-suspend the bacteria at a one times 10 to the third colony forming units per two microliters of PBS concentration. Use clippers to remove hair from the sacrum and upper thoracic spine of the 12 week old male C-57 black six mouse. Deliver pain medicine via subcutaneous injection immediately before skin preparation and repeat in three days.Sterilize the surgical site using three alternating Betadine and alcohol wipes. After the third wipe, place the mouse in the prone position on a sterile surgical bed and maximally flex the hips. Before making an incision, confirm a lack of response to toe pinch.Palpate for the iliac crest to approximately the lumbar four vertebrae body and use a number 15 surgical scalpel blade to make a longitudinal, two centimeter skin incision. Palpate the spinous process to confirm the midline and continue the incision down to the bone. Dissect sub-periosteally on the right side of the L-4 spinous process, extending laterally to the transverse process, and pass an open absorbable braided suture size 5.0 cephalad and caudad to the L-4 body through the fascia.Using a 25-gauge spinal needle, ream the spinous process of L-4 and insert a 0.1 millimeter diameter, one centimeter long, L-shaped surgical grade stainless steel implant along the lamina, with the long arm laying cephalad. Inoculate the implant with one times 10 to the third colony forming units per two microliters of bioluminescent S.aureus zen 36, taking care to ensure that all of the solution contacts the implant. Immediately tie the suture to ensure containment of the inoculum to the implant, and use a second absorbable suture to close the skin in a running fashion.Place the mouse on a heating pad with monitoring until full recovery. Obtain postoperative radiographs to confirm the appropriate placement of the implant. To measure the bacterial burden, on the appropriate day post-infection, use clippers to remove any regrown hair from the sacrum to the upper thoracic spine and place the mouse onto a bioluminescent imaging platform.Using large bending settings with a 13 centimeter field of view, capture the bioluminescent signal for five minutes. Then, use bioluminescent imaging software to isolate a standard ovoid region of interest to quantify the mean and maximum total flux of the bioluminescence. At the appropriate experimental endpoint, after preparing the mouse as demonstrated for the surgical procedure, use a number 15 scalpel blade to sharply incise the old incision and use sterile scissors to bluntly dissect to the L-4 spinous process.When the implant can be identified, use a needle driver to gently twist and remove the implant from its position, and use sterile forceps and scissors to harvest approximately one gram of spinous process bone and soft tissue immediately surrounding the surgical implant. Place the tissue in one milliliter of PBS in a pre-weighed small conical rhino tube containing four sharp homogenizing beads and place the implant in 250 microliters of 0.3%TWEEN 80 in triptych soy broth. Weigh the tube of tissue and use a homogenizer to homogenize the sample.Vortex the implants at medium strength for two minutes, then sonicate them for 10 minutes. Dilute the implant in tissue samples one to 10, one to 101, one to 1000, and plate them on triptych soy broth plates containing 1%agar. Place the plates in an incubator at 37 degrees Celsius overnight.The following day, count the colony forming units from the implant and surrounding tissue cultures. Infected control mice demonstrate BLI signals that peak on post-infection day 10 and remain above one times 10 to the fifth photons per second per square centimeter per teridian until sacrifice, successfully modeling a chronic spinal implant infection. Mice treated with vancomycin monotherapy exhibit a significantly lower BLI signal compared to infected controls, with a two-fold reduction from post infections day 10 through 21.After post-infection day 21, there is no significant difference in BLI between the monotherapy and infected control groups. Mice treated with vancomycin-rifampin combination therapy have an even lower BLI signal that is 20 fold lower than infected controls on post-infection day 10. This significant reduction persists until post infection day 28, after which no significant difference in BLI is observed between any of the groups.Implants and surrounding tissue harvested and processed on day 35 revealed no significant differences in colony-forming units between infected control, monotherapy, and combination therapy groups. Following this procedure, the host immune response may also be studied such as by utilizing mice with fluorescently-labeled neutrophils. The development of this efficient mouse model has allowed us to identify effective novel treatments for spinal implant infection.

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