Vancomycin-impregnated polymethylmethacrylate beads for methicillin-resistant Staphylococcus aureus (MRSA) infection: report of two cases

J Orthop Sci. 1998;3(3):163-8. doi: 10.1007/s007760050037.

Abstract

Two patients with methicillin-resistant Staphylococcus aureus (MRSA) infection were treated with vancomycin (VCM)-impregnated polymethylmethacrylate (PMMA) beads. One patient, who had a history of polycystic kidney and diabetes mellitus, who was receiving hemodialysis due because of non-functional kidney, underwent resection of an intermediate grade chondrosarcoma in the pelvis. MRSA infection developed and curettage of the lesion was performed, but MRSA infection recurred. During the second revision surgery, VCM-impregnated PMMA beads were implanted. MRSA infection has not recurred for 16 months since the implantation of the VCM beads. The second patient had a history of total hip arthroplasty (THA) performed because of coxarthrosis. After the initial surgery, MRSA infection developed, recurring after the second revision surgery for THA. After curettage following removal of the prosthesis, VCM beads were implanted with a spacer composed of VCM-PMMA and a Luque rod. Infection did not recur and THA revision was performed 3 months after the VCM beads implantation. Fifteen months after the last revision surgery, infection has not recurred.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Arthroplasty, Replacement, Hip / adverse effects
  • Bone Neoplasms / surgery
  • Chondrosarcoma / surgery
  • Drug Implants
  • Female
  • Humans
  • Male
  • Methicillin / pharmacology
  • Methicillin Resistance*
  • Microspheres
  • Middle Aged
  • Osteomyelitis / diagnostic imaging
  • Osteomyelitis / drug therapy
  • Osteomyelitis / microbiology
  • Penicillins / pharmacology
  • Polymethyl Methacrylate
  • Radiography
  • Recurrence
  • Staphylococcal Infections / diagnostic imaging
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / isolation & purification
  • Surgical Wound Infection / diagnostic imaging
  • Surgical Wound Infection / drug therapy*
  • Surgical Wound Infection / microbiology
  • Vancomycin / administration & dosage*

Substances

  • Anti-Bacterial Agents
  • Drug Implants
  • Penicillins
  • Vancomycin
  • Polymethyl Methacrylate
  • Methicillin