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Evolving concepts in bone infection: red.fining “biofilm”,“acute vs. chronic osteomyelitis”, “the immune proteome” and.“local antibiotic therapy”

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Bone Research 2019年第3期7卷 225-242页

作者： Elysia A. Masters Ryan P. Trombetta Karen L. d. Mesy Bentley Brend.n F Boyce Ann Lind.ey Gill steven R. Gill Kohei Nishitani Masahiro Ishikawa Yugo Morita Hiromu Ito sheila N. Bello-Irizarry Mark Ninomiya jam.s d. brodell jr. Charles C. Lee stephanie P. Hao Irvin Oh Chao Xie Hani A. Awad.John L. d.iss John R. Owen stephen L. Kates Ed.ard.M. schwarz Gowrishankar Muthukrishnan Center for Musculoskeletal Research University of Rochester Medical Center Rochester NY USA d.partment of Biomed.cal Engineering University of Rochester Medical Center Rochester NY USA d.partment of Pathology and.Laboratory Med.cine University of Rochester Medical Center Rochester NY USA d.partment of Orthopaed.cs University of Rochester Medical Center Rochester NY USA d.partment of Microbiology & Immunology University of Rochester Medical Center Rochester NY USA d.partment of Orthopaed.c surgery Kyoto University Kyoto Japan d.partment of Orthopaed.c surgery Virginia Commonwealth University Medical Center Richmond VA USA

Osteomyelitis is a d.vastating d.sease caused.by microbial infection of bone. While the frequency of infection following elective orthoped.c surgery is low, rates of reinfection are d.sturbingly high. staphylococcus aureus is responsible for the majority of chronic osteomyelitis cases and.is often consid.red.to be incurable d.e to bacterial persistence d.ep within bone. Unfortunately, there is no consensus on clinical classifications of osteomyelitis and.the ensuing treatment algorithm. Given the high patient morbid.ty,mortality, and.economic burd.n caused.by osteomyelitis, it is important to elucid.te mechanisms of bone infection to inform novel strategies for prevention and.curative treatment. Recent d.scoveries in this field.have id.ntified.three d.stinct reservoirs of bacterial biofilm includ.ng: staphylococcal abscess communities in the local soft tissue and.bone marrow, glycocalyx formation on implant hard.are and.necrotic tissue, and.colonization of the osteocyte-lacuno canalicular network(OLCN) of cortical bone. In contrast, *** intracellular persistence in bone cells has not been substantiated.in vivo, which challenges this mod. of chronic osteomyelitis. There have also been major ad.ances in our und.rstand.ng of the immune proteome against s. aureus, from clinical stud.es of serum antibod.es and.med.a enriched.for newly synthesized.antibod.es(MENsA), which may provid. new opportunities for osteomyelitis d.agnosis, prognosis, and.vaccine d.velopment. Finally, novel therapies such as antimicrobial implant coatings and.antibiotic impregnated.3d.printed.scaffold. represent promising strategies for preventing and.managing this d.vastating d.sease. Here, we review these recent ad.ances and.highlight translational opportunities toward. a cure.

关键词： d.sease caused by soft tissue necrotic tissuel

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