Bioburden after Staphylococcus aureus inoculation in type 1 diabetic rats undergoing internal fixation.
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SUMMARY: Fracture stabilization in the diabetic patient is associated with higher complication rates, particularly infection and impaired wound healing, which can lead to major tissue damage, osteomyelitis, and higher amputation rates. With an increasing prevalence of diabetes and an aging population, the risks of infection of internal fixation devices are expected to grow. Although numerous retrospective clinical studies have identified a relationship between diabetes and infection, currently there are few animal models that have been used to investigate postoperative surgical-site infections associated with internal fixator implantation and diabetes. The authors therefore refined the protocol for inducing hyperglycemia and compared the bacterial burden in controls to pharmacologically induced type 1 diabetic rats after undergoing internal fracture plate fixation and Staphylococcus aureus surgical-site inoculation. Using an initial series of streptozotocin doses, followed by optional additional doses to reach a target blood glucose range of 300 to 600 mg/dl, the authors reliably induced diabetes in 100 percent of the rats (n = 16), in which a narrow hyperglycemic range was maintained 14 days after onset of diabetes (mean ± SEM, 466 ± 16 mg/dl; coefficient of variation, 0.15). With respect to their primary endpoint, the authors quantified a significantly higher infectious burden in inoculated diabetic animals (median, 3.2 × 10 colony-forming units/mg dry tissue) compared with inoculated nondiabetic animals (7.2 × 10 colony-forming units/mg dry tissue). These data support the authors' hypothesis that uncontrolled diabetes adversely affects the immune system's ability to clear Staphylococcus aureus associated with internal hardware.
Colony Count, Microbial
Diabetes Mellitus, Experimental
Diabetes Mellitus, Type 1
Fracture Fixation, Internal
Surgical Wound Infection
Published Version (Please cite this version)10.1097/PRS.0000000000000434
Publication InfoBrown, Nga L; Rose, Michael B; Blueschke, Gert; Cho, Eugenia H; Schoenfisch, Mark H; Erdmann, Detlev; & Klitzman, Bruce (2014). Bioburden after Staphylococcus aureus inoculation in type 1 diabetic rats undergoing internal fixation. Plast Reconstr Surg, 134(3). pp. 412e-419e. 10.1097/PRS.0000000000000434. Retrieved from https://hdl.handle.net/10161/10339.
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Professor of Surgery
Associate Professor of Surgery
Our overriding interests are in the fields of tissue engineering, wound healing, biosensors, and long term improvement of medical device implantation. My basic research interests are in the area of physiological mechanisms of optimizing substrate transport to tissue. This broad topic covers studies on a whole animal, whole organ, hemorheological, microvascular, cellular, ultrastructural, and molecular level. The current projects include: 1) control of blood flow and flow distribu
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