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

Los autores desean agradecer la recepción de la subvención de la columna vertebral Biomet de la Sociedad Ortopédica Pediátrica de América del Norte y la subvención KL2 del Instituto de Ciencias Clínicas y Traslacionales de los Institutos Nacionales de Salud, y la subvención de investigación quirúrgica HH Lee como las principales fuentes de financiación para estos experimentos.

Todos los animales fueron manejados en estricta conformidad con las buenas prácticas animales según se define en las regulaciones federales según lo establecido en la Ley de Bienestar Animal (AWA), la Guía de 1996 para el Cuidado y Uso de Animales de Laboratorio, la Política de PHS para el Cuidado y Uso Humanitario de Animales de Laboratorio, así como las políticas y procedimientos de la institución según lo establecido en el Manual de Capacitación para el Cuidado y Uso de Animales. y todo el trabajo con anima...

<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. 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Las infecciones relacionadas con implantes en la columna vertebral presagian malos resultados para los pacientes 1,2,3,4,5. A diferencia de muchas otras áreas del cuerpo, el hardware infectado en la columna vertebral con frecuencia no se puede eliminar debido al riesgo de inestabilidad y compromiso neurológico. Este desafío único en el entorno de bacterias...

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

El propósito de este método es describir un nuevo modelo murino de infección por implante espinal (SII). Este modelo fue diseñado para proporcionar una herramienta económica y precisa para evaluar de manera flexible el efecto de las variables del huésped, el patógeno y/o el implante in vivo. La prueba de posibles terapias y estrategias de tratamiento para las infecciones de implantes espinales en este modelo tiene como objetivo guiar el desarrollo de la investigación antes de su aplicación en modelos animales más grandes y ensayos clínicos.
La infección relacionada con los implantes después de la cirugía de columna vertebral es una complicación devastadora y, por desgracia, ocurre en aproximadamente el 3-8% de los pacientes que se someten a cirugía electiva de columnavertebral 1,2,3,4,5 y hasta el 65% de los pacientes que se someten a cirugía multinivel o de revisión 6. El tratamiento de las infecciones de los implantes espinales a menudo requiere múltiples hospitalizaciones, múltiples cirugías y terapia antibiótica prolongada. Los SII presagian malos resultados para los pacientes, como el compromiso neurológico, la discapacidad y un mayor riesgo de mortalidad. El manejo del SII es extremadamente costoso, con un costo de más de $900,000 por paciente7.
Staphylococcus aureus es el patógeno virulento más común del SII 8,9,10,11. Las bacterias pueden sembrar el hardware directamente durante la cirugía, a través de la herida durante el período postoperatorio o más tarde a través de la diseminación hematógena. En presencia de implantes metálicos, S. aureus forma una biopelícula que protege a las bacterias de la terapia antibiótica y de las células inmunitarias. Si bien la eliminación del hardware infectado puede ayudar a erradicar eficazmente una infección, esto con frecuencia no es factible en la columna vertebral sin causar desestabilización y riesgo de compromiso neurológico12.
En ausencia de la explantación de hardware infectado, se necesitan enfoques novedosos para prevenir, detectar y tratar el SII. Históricamente, ha habido modelos animales limitados de SII para evaluar de manera eficiente la seguridad y eficacia de las nuevas terapias. Los modelos animales anteriores de SII requieren un gran número de animales y la recolección de puntos de datos que requieren eutanasia, incluido el recuento de colonias, la histología y el cultivo13,14,15. Al carecer de un seguimiento longitudinal in vivo, estos modelos solo proporcionan un punto de datos por animal y, por lo tanto, son caros e ineficientes.
Trabajos anteriores que estudiaron un modelo de ratón de infección por artroplastia de rodilla establecieron el valor y la precisión de las imágenes ópticas in vivo no invasivas para monitorizar longitudinalmente la carga de infección16. La detección de la bioluminiscencia permite cuantificar la carga bacteriana a lo largo de un curso de tiempo longitudinal en un solo animal de forma humana, precisa y eficiente. Además, estudios previos han demostrado una alta correlación entre la bioluminiscencia in vivo y las UFC adheridas a implantes17. La capacidad de rastrear la infección a lo largo del tiempo ha llevado a una comprensión más matizada de la infección relacionada con los implantes. Además, el monitoreo de la infección longitudinal de esta manera, ha permitido evaluar con precisión la efectividad de la terapia antibiótica y de los nuevos antimicrobianos16,17,18.
Aprovechando estas herramientas, desarrollamos y validamos un modelo de infección postoperatoria de implantes espinales. En el método presentado, utilizamos un inóculo de S. aureus Xen36 bioluminiscente para establecer un modelo murino in vivo de SII para monitorear longitudinalmente la carga bacteriana16,17,18. Este novedoso modelo proporciona una herramienta valiosa para probar de manera eficiente las posibles estrategias de detección, prevención y tratamiento del SII antes de su aplicación en modelos animales más grandes y ensayos 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

Las infecciones de los implantes de columna vertebral presagian malos resultados, ya que el diagnóstico es difícil y la erradicación quirúrgica está en desacuerdo con la estabilidad mecánica de la columna. El propósito de este método es describir un nuevo modelo de ratón de infección por implante espinal (SII) que se creó para proporcionar una herramienta in vivo económica, rápida y precisa para probar posibles terapias y estrategias de tratamiento para las infecciones de implantes espinales.
En este método, presentamos un modelo de cirugía espinal de abordaje posterior en el que se transfija un alambre k de acero inoxidable en la apófisis espinosa L4 de ratones de tipo salvaje C57BL/6J de 12 semanas de edad y se inocula con 1 x 103 UFC de una cepa bioluminiscente de la bacteria Staphylococcus aureus Xen36. A continuación, se obtienen imágenes longitudinales de la bioluminiscencia de los ratones in vivo en los días postoperatorios 0, 1, 3, 5, 7, 10, 14, 18, 21, 25, 28 y 35. Las señales de imágenes de bioluminiscencia (BLI) de un campo de visión estandarizado se cuantifican para medir la carga bacteriana in vivo.
Para cuantificar las bacterias que se adhieren a los implantes y al tejido periimplantario, se sacrifica a los ratones y se extrae el implante y el tejido blando circundante. Las bacterias se desprenden del implante mediante sonicación, se cultivan durante la noche y luego se cuentan las unidades formadoras de colonias (UFC). Los resultados obtenidos de este método incluyen recuentos bacterianos longitudinales medidos por bioluminiscencia in vivo de S. aureus (flujo máximo medio) y recuentos de UFC después de la eutanasia.
Si bien los modelos animales anteriores de infección instrumentada de la columna vertebral han implicado un análisis invasivo de tejido ex vivo, el modelo de ratón de SII presentado en este artículo aprovecha las imágenes ópticas in vivo no invasivas y en tiempo real de bacterias bioluminiscentes para reemplazar el estudio de tejido estático. Las aplicaciones del modelo son amplias y pueden incluir la utilización de cepas bacterianas bioluminiscentes alternativas, la incorporación de otros tipos de ratones modificados genéticamente para estudiar simultáneamente la respuesta inmunitaria del huésped y la evaluación de las modalidades diagnósticas y terapéuticas actuales o la investigación de nuevas modalidades, como antibióticos o recubrimientos de implantes.

El procedimiento que aquí se presenta se utilizó para evaluar la eficacia de los regímenes antibióticos en un modelo de SII en ratones in vivo. Específicamente, se comparó la eficacia de la terapia combinada con antibióticos con vancomicina y rifampicina con la monoterapia con vancomicina y los controles infectados no tratados.
Antes de la cirugía, los ratones fueron aleatorizados a terapia combinada, monoterapia o control infectado. Se realizó un análisis estadístico de potencia pa...

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In Vivo Mouse Model of Spinal Implant Infection

El protocolo describe un nuevo modelo de ratón in vivo de infección por implante espinal en el que un implante de alambre k de acero inoxidable está infectado con Staphylococcus aureus Xen36 bioluminiscente. La carga bacteriana se monitoriza longitudinalmente con imágenes bioluminiscentes y se confirma con recuentos de unidades formadoras de colonias después de la eutanasia.

Modelo de ratón in vivo de infección por implante espinal

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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