| 摘要: | 人工關節感染是接受關節置換手術的術後併發症之一，術後發生機率約為2 %，約占25 %的手術失敗總數。當人工關節發生細菌感染後，患者關節局部不舒服且因生物膜緣故通常難以治療、假體難以保存。然而更換全新的假體，不只造成患者身體的負擔也造成二次醫療費用支出。因此本研究開發一種以乳化法包覆靛氰綠(Indocyanine green,ICG)與利福平(Rifampicin) 的聚乳酸甘醇酸(Poly-lactide-co-glycolide, PLGA)的奈米載體(Indocyanine Green-Rifampicin-Encapsulated PLGA Nanoparticles, IRPNPs)，期望能利用奈米載體同時攜帶光敏劑與抗生素，同時發揮兩種功效應用於治療細菌感染。根據分析表示IRPNPs的平均粒徑265.6 nm、表面電位-28.2 mV、ICG與Rifampicin的包覆率分別約為82.2 %、33.5 %。在本研究中我們採用人工關節感染中常見的細菌-耐甲氧西林金黃色葡萄球菌(Methicillin-Resistant Staphylococcus Aureus, MRSA)與凝固酶陰性葡萄球菌(Coagulase-Negative Staphylococci, CoNS)，進行抗菌及破壞生物膜分析，在此研究中，我們提供多孔載體給細菌生長，用以模擬體內細菌感染的環境，後續也將多孔載體應用於in vivo的小鼠異物模型內。在in vitro實驗中，當細菌與多孔載體一同培養時，當葡萄糖存在時能提高細菌生物膜的含量，且珠上細菌隨著時間流逝而逐漸減少。當IRPNPs應用於抗菌及生物膜實驗時，IRPNPs的效果相較於單一光療或是單一抗生素的功效時，皆有一定程度提升，且在後續應用於小鼠異物模型時，也可以獲得與in vitro相似的結果，更是增加我們對IRPNPs對治療細菌感染的信心。;Artificial joint infection is the postoperative complications of joint replacement surgery. The postoperative infection rate is about 2 %, accounting for about 25 % of the total number of surgical failures. The infection area will not only let the patients to feel uncomfortable also hard for treating and difficult to preserve artificial joint. Most of time the patient needs to replacing a new one , which not only causes patient pain but also increases huge secondary medical expenses. This research developed a nano-particles IRPNPs of poly-lactide-co-glycolide (PLGA) encapsulate with indocyanine green (ICG) and rifampicin by emulsion method. IRPNPs can be a carrier to carry both a photosensitizer and an antibiotic, and exert both functions to treat bacterial infections. According to the analysis, the average particle diameter of IRPNPs was 265.6 nm, the surface potential was -28.2 mV, and the encapsulation rate of ICG and Rifampicin are about 82.2 % and 33.5 %.In this study, we used Methicillin-Resistant Staphylococcus Aureus (MRSA) and Coagulase-Negative Staphylococci (CoNS), both are common bacteria cause in artificial joint infections. In this study, we provided porous ceramics for bacterial growth to simulate the environment of bacterial infections in vitro and also in vivo mice foreign body models. In vitro experiments, bacteria were cultured with porous ceramics, the mount of bacterial biofilm was increased when culture medium with glucose, and both the bacteria and biofilms on the beads will decrease with the passage of time. When IRPNPs are used in antibacterial and biofilm experiments, compared with the efficacy of single phototherapy or single antibiotics , the effects of IRPNPs are obvious improved. When it applied into mouse foreign body model the results is similar to in vitro experiments that increase our confidence to apply IRPNPs for treating bacterial infections. |
