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Thomas Kalteis

Publications and source records attributed to Thomas Kalteis.

5 recordsLinked to original sources

Treatment of implant-associated infections with moxifloxacin: an animal study.

The efficacy of moxifloxacin in the treatment of an implant-associated infection by Staphylococcus aureus was compared with vancomycin in an animal study. The femoral medullary cavity of 36 Wistar rats was contaminated with S. aureus (ATCC 29213) and a metal device was implanted. After treatment for 14 days with moxifloxacin (2 x 10 mg/kg/day) or vancomycin (2 x 15 mg/kg/day), the bacterial counts (colony-forming units) in the periprosthetic bone, the soft tissue and the implant-associated biofilm were measured. Compared with the control group, moxifloxacin achieved a highly significant decrease in the microbial counts in the bone and soft tissue and in the biofilm (P<0.001). Moreover, the efficacy of moxifloxacin was significantly greater than that of vancomycin (P<0.01). Vancomycin did not reduce the microbial count significantly compared with the control group (P>0.05). The results justify further investigations of the treatment of implant-associated infections due to S. aureus with moxifloxacin.

Animals↗

Moxifloxacin superior to vancomycin for treatment of bone infections--a study in rats.

BACKGROUND: Increasing resistance rates towards conventional antibiotics necessitate investigations of the efficacy of newly developed antibiotics. Thus, in a rat study, we compared the efficacy of moxifloxacin and vancomycin in the treatment of a local Staphylococcus aureus bone infection. METHOD: The femoral medullary cavities of 36 Wistar rats were contaminated with 100 muL of an oxacillin-sensitive Staphylococcus aureus strain (ATCC 29213) at 10(8) cfu/mL. On the seventh day, antibiotic treatment with moxifloxacin (10 mg/kg twice daily i.p.) or vancomycin (15 mg/kg twice daily i.p.) was commenced in 12 animals each. 12 control animals were left untreated. After 21 days, the infected femurs were explanted and the bacterial counts (cfu/g) were determined. RESULTS: In the control group, a median of 3.42 x 10(6) cfu/g (LQ/UQ 1.09 x 10(6)/ 1.55 x 10(7)) was cultured, with a median of 2.53 x 10(6) cfu/g (LQ/UQ 1.95 x 10(6)/ 4.25 x 10(6)) in the vancomycin group and a median of 2.49 x 10(5) cfu/g (LQ/UQ 2.84 x 10(4)/ 3.75 x 10(5)) in the moxifloxacin group. The bacterial count was reduced by treatment with moxifloxacin both in comparison with the control group (p < 0.001), and in comparison with treatment with vancomycin (p < 0.001). There was no statistically significant difference between the vancomycin group and the control group (p = 0.53). INTERPRETATION: In contrast to vancomycin, moxifloxacin proved to be an effective antibiotic for the treatment of bone infections due to Staphylococcus aureus in our animal model.

Animals↗

Position of the acetabular cup -- accuracy of radiographic calculation compared to CT-based measurement.

OBJECTIVE: A variety of mathematical and trigonometric methods has been described for determining the position of the acetabular cups from conventional radiographs. However, these formulae are subject to unduly large inaccuracies. The aim of the study was to compare the reliability and the accuracy of radiological and CT-based determination of acetabular cup position. MATERIALS AND METHODS: The positions of acetabular cups of 31 patients were calculated in conventional plain radiographs of the hip using the method described by Widmer. Further, in all patients computed tomograms of the pelvis were performed and the cup position was measured with the aid of a CT-based computer-assisted navigation software. As reference values inclination and anteversion of the cups were calculated in 3D reconstructions of the pelvis with the aid of an image processing software. RESULTS: The radiological measurement as well as the CT-based method showed good intra- and inter-observer reliability and no significant difference in the calculation of the inclination (p=0.409). However, CT-based determination of anteversion was significantly more exact than radiological measurement (p<0.001). The calculation of the cup anteversion from the X-rays showed serious deviations from the reference method and a substantial error range (X-ray: mean deviation +1.74 degrees, range -16.6 degrees to +29.8 degrees , S.D. +/-9.32 degrees; CT-based: mean deviation -0.74 degrees, range -6.6 degrees to +5.3 degrees, S.D. +/-2.87). CONCLUSION: For any clinical problem or for clinical studies in which acetabular positions of acetabular cups have to be exactly determined, CT-based measuring methods are obviously the method of choice. Evaluations based only on conventional plain X-rays and calculation of the acetabular cup position using the formula described by Widmer must be regarded as unreliable, particularly, because of problems in measuring the anteversion.

Acetabulum↗

Arthroscopic and histologic findings in Morquio's syndrome.

Mucopolysaccharidosis type IV A/B (Morquio's syndrome) is one of a heterogeneous group of lysosomal storage diseases characterized by accumulation of keratan sulfate in cells of connective tissue. From early childhood, the major orthopaedic manifestations are shortening of the trunk, spondylepiphyseal dysplasia, odontoid hypoplasia, upper cervical instability, lower-limb alignment problems, and degenerative joint disease. Most of the rare published case reports describe those characteristic clinical deformities of the skeleton. Our literature search showed that these striking arthroscopic findings have not been made public to date. We report a typical case of mucopolysaccharidosis type IV. We show and, in particular, correlate the arthroscopic with the histologic findings. In particular, the comparison between arthroscopy and light microscopy showed a remarkable extensive delamination of the chondral layer from subchondral bone of both knee joints. These findings should encourage further research, especially of the osteochondral borderline.

Adult↗

Contaminant seeding in bone by different irrigation methods: an experimental study.

OBJECTIVE: This study was designed to investigate the effectiveness of using various devices and manual procedures for cleansing bacterially contaminated bone tissue and to assess the risk of iatrogenic bacterial seeding in deep bone layers. METHODS: In an in vitro model, human femoral heads were contaminated with Escherichia coli and then cleansed with pulsatile high-pressure lavage, pulsatile low-pressure lavage, manual rinsing with bulb syringe lavage, or manual rinsing with combined brush cleaning. The numbers of bacteria that remained or those that were introduced by the rinsing procedures were quantitatively determined at depths of 0 to 1 cm, 1 to 2 cm, and 2 to 3 cm. RESULTS: Both pulsatile high-pressure lavage and brush cleaning were more effective than pulsatile low-pressure lavage and bulb syringe lavage for the purpose of surface cleansing. The differences were highly significant (P < 0.001). There was no significant difference in the decontaminating effect between pulsatile high-pressure lavage and brush cleaning (P = 0.24). The bacterial contamination attributable to the cleansing procedure, as measured at tissue depths of 1 to 2 cm and 2 to 3 cm, was significantly higher after pulsatile high-pressure lavage and after pulsatile low-pressure lavage than it was after bulb syringe lavage or brush cleaning (P < 0.001). CONCLUSION: In this in vitro investigation of cancellous bone, the brush cleansing was just as effective for getting rid of bacterial contamination as pulsatile high-pressure lavage, and carries a significantly lesser risk of iatrogenic bacterial seeding into deeper tissue layers. In the light of these promising results obtained by the cleansing of cancellous bone contaminated with bacteria, it would be desirable to perform supplementary in vitro and in vivo investigations into brush cleansing.

Aged↗