Tavşanda metisiline dirençli Staphylococcus aureus (MRSA)ile oluşturulmuş deneysel menenjit modelinde vankomisin+rifampisin, teikoplanin+rifampisin ve seftarolin+ rifampisin kombinasyonlarının bakteriyolojik etkinliklerinin karşılaştırılması
Project no. 20680 · Status: Kapanmış · 2019
Summary
Aim: The aim of this study was to compare the antibacterial activities of ceftaroline-rifampicin (CR) and vancomycin-rifampicin (VR) combination therapies in an experimental methicillin-resistant S. aureus (MRSA) rabbit meningitis model. In addition, treatment arms’ brain tissues were compared histopathologically in terms of inflammation and apoptosis. Method: Meningitis was induced by direct inoculation of standard MRSA origin (ATCC 43300) strains into the New Zelland rabbits’ cisterna magnae. After 28 h of incubation period, rabbits were divided into three arms: control (C), CR and VR. VR group recieved vancomycin + rifampicin, CR group recieved ceftaroline and rifampicin with the same dose and frequency. After the incubation period, a quantitative CSF culture was performed at T0 and 24th h of treatment. At the end of 24 h therapy, after the euthanasia, complete brain tissues of animals were rapidly removed and histopathologically compared for inflammation and apoptosis. Results: There was no difference in the number of bacteria (calculated as log10) between the three groups before treatment initiation (p:0,506). At the end of 24 h treatment, bacterial count decreased significantly in both treatment groups compared with the control group (C: +3,054±3.817 cfu/mL, CR: -4.411±0.832 cfu/mL, VR: -3,185±3.126 cfu/mL, p: 0.034). However, there was no significant difference between treatment groups (p: 0.541). There was no statistically significant difference between the groups in terms of surviving rabbits at the end of 24 h treatment (p:0.288). Although the rate of neuronal apoptosis in the treatment groups was significantly lower than the control group, there was no significant difference between the treatment groups in this respect (p <0.001, p: 1, respectively). When the groups were compared among themselves in terms of the presence of inflammation via histopathological examination, there was significantly lower inflammation in the CR group compared with the control group (p: 0.032). However, no significant difference was found in the control group versus VR and VR versus CR group. Conclusion: Although complete response and inflammation were in favor of the SR arm, other parameters were similar in both treatment arms. The CR combination has been found to be at least as effective as the VR combination in the treatment of MRSA meningitis.