European Journal of Molecular & Clinical Medicine

Infected nonunion of long bones is a chronic and debilitating disorder. The problems in treating them are infection, instability, and deformity. Traditionally, it is managed by two- stage procedure for controlling the infection first and then treating the nonunion. Effectiveness of antibiotic impregnated cement coated intramedullary nail as a single stage treatment modality  for treating infection and achieving stability at the same time has been described in the literature currently..
Materials and Methods: Fifteen patients (above 18 years of age) with infected non-union of femur and tibia were selected and surgically treated with antibiotic cement coated iln. Antibiotic cement nail was prepared using endotracheal tube method. Antibiotics used are vancomycin 4 mg . Functional results were evaluated with regard to control of infection, bony union, and complications.
Results: Infection was controlled in 85% of the patients. With Average period of follow-up of 12 months bony union was achieved in 10 of 15 (66%) patients with antibiotic cement nailing as the only procedure with average time of union of 32 weeks. Remaining 5 patients required additional procedures like bone grafting or exchange nailing and these were done in two patients, with union of fracture. Recurrence of infection occurred in two cases. Complications encountered were difficult nail removal in two cases, broken nail in one case, and bent nail in one case.
Conclusion: Antibiotic cement impregnated nailing is a simple, economical and effective single stage procedure with better patient compliance for the management of infected nonunion of long bones. Instruments are easily available and performed at any orthopaedic center.

A vascular catheter may be saved if an intraluminal antibiotic lock treatment is used in the case of catheter-related bloodstream infections. These recently developed antibiotics were compared to the older antibiotics vancomycin and minocycline against methicillin-resistant Staphylococcus aureus (MRSA) embedded in biofilms in this in vitro study. We examined the emergence of MRSA after four hours of daily catheter lock therapy that was resistant to these antibiotics alone and with rifampin. Compared to linezolid, vancomycin, and the negative control, minocycline, daptomycin, and tigecycline are more effective at inhibiting MRSA in biofilms after the first day of exposure (P 0.001), with minocycline being the most active and daptomycin and tigecycline having weak activity, similar to the negative control. Among the antibiotics tested, daptomycin was the fastest in eliminating MRSA from biofilm after three days of exposure for 4-hour periods, followed by minocycline and tigecycline, which were faster than linezolid, rifampin, and vancomycin (P 0.001). After five days of exposure to MRSA continuously for four hours each day, rifampin alone was least effective at eradicating MRSA from biofilms because it promoted rifampin-resistant MRSA growth. It has been found that when rifampin is combined with additional antibiotics, the combination is far more effective at eliminating MRSA colonization than any single antibiotic alone. Daptomycin, minocycline, and tigecycline lock therapy also needs to be researched, as should the potential for rifampin's antistaphylococcal activity as a single agent, but not as a combined solution.

Background: Staphylococcus aureus infections are one of the major infections in hospitals and the drug-resistant strain of S. aureus caused mortality and morbidity throughout the globe. In this study, we evaluated the S. aureus infection and their drug sensitivity patterns at Medicine department for 5 years.
Methods: The patients admitted at medicine word were participated in this study. All clinical samples were taken for bacteriological study. After identification of bacteria, the drug sensitivity patterns were carried out by disc diffusion methods.
Results: A total of 944 S. aureus isolates were analyzed. High sensitivity of S. aureus was observed for quinupristin/dalfopristin (100%), tigecycline (98.2), imipenem (98%), nitrofurantoin (97.6%), linezolid (97.3%), teicoplanin (97.1%) and vancomycin (95.1%). High resistance was recorded against penicillin G (91.9%), trimethoprim/sulfamethoxazole (56.9%) and tetracycline (33.2%). MRSA prevalence among the patients at IMS and SUM Hospital, Bhubaneswar was 27.8%. Highest proportion (80%) of MRSA was in burns unit.
Conclusions: Both MRSA and MSSA were highly susceptible to quinupristin/dalfopristin, tigecycline, linezolid, nitrofurantoin, ampicillin/sulbactam and vancomycin and showed high resistance to commonly used antibiotics such as gentamycin, erythromycin, levofloxacin and tetracycline. A majority of isolates were from pus specimen (68%).