Potential interactions between vancomycin and meropenem in culture-negative periprosthetic joint infection: an in vitro study

Abstract Background Culture-negative periprosthetic joint infections (CN-PJIs) represent a critical subtype of PJI, and their high prevalence poses substantial challenges for treatment. CN-PJI is commonly managed utilizing antibiotic combinations, however, the interactions between these antibiotics...

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Main Authors: Liqin Yao, Youcai Ma, Rui Liu, Yicheng Li, Xuebin Sun, Tuerhongjiang Wahafu, Li Cao, Wenbo Mu
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Microbiology
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Online Access:https://doi.org/10.1186/s12866-025-03918-4
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author Liqin Yao
Youcai Ma
Rui Liu
Yicheng Li
Xuebin Sun
Tuerhongjiang Wahafu
Li Cao
Wenbo Mu
author_facet Liqin Yao
Youcai Ma
Rui Liu
Yicheng Li
Xuebin Sun
Tuerhongjiang Wahafu
Li Cao
Wenbo Mu
author_sort Liqin Yao
collection DOAJ
description Abstract Background Culture-negative periprosthetic joint infections (CN-PJIs) represent a critical subtype of PJI, and their high prevalence poses substantial challenges for treatment. CN-PJI is commonly managed utilizing antibiotic combinations, however, the interactions between these antibiotics have not been investigated. The aim of study was to investigate the synergistic and antagonistic effects of vancomycin (VAN) and meropenem (MEM), in an in vitro model of CN-PJI. Methods Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC), Minimum Biofilm Inhibitory Concentration (MBIC), and Minimum Biofilm Eradication Concentration (MBEC) were determined for VAN and MEM. Fractional Inhibitory Concentration (FIC) and Fractional Biofilm Eradication Concentration (FBEC) indices were calculated to assess the synergistic or antagonistic effects of VAN in combination with MEM on Staphylococcus aureus (S. aureus), Staphylococcus epidermidis (S. epidermidis), and Escherichia coli (E. coli) incubated alone or in combination. Results In the planktonic bacterial phase, MEM showed higher activity than VAN. Resistance increased when the bacteria were cultured together. The combination of VAN and MEM exhibited an indifferent effect against individual Staphylococci but an antagonistic effect against polymicrobial cultures. In biofilm, MEM demonstrated better antibiofilm activity than VAN, especially against E. coli biofilms. The combination of VAN and MEM showed an indifferent effect against E. coli and S. epidermidis-E. coli biofilms, but an antagonistic effect against S. aureus, S. epidermidis, S. aureus-S. epidermidis, and S. aureus-E. coli biofilms. Conclusion This study provides valuable insights into the effectiveness of VAN and MEM combinations in treating CN-PJIs, highlighting the need for careful consideration when selecting antibiotic treatments for these infections. Clinical trial number Not applicable.
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spelling doaj-art-67f3c1bb6f074c8cb3cb2cf814b021282025-08-20T01:53:19ZengBMCBMC Microbiology1471-21802025-04-012511710.1186/s12866-025-03918-4Potential interactions between vancomycin and meropenem in culture-negative periprosthetic joint infection: an in vitro studyLiqin Yao0Youcai Ma1Rui Liu2Yicheng Li3Xuebin Sun4Tuerhongjiang Wahafu5Li Cao6Wenbo Mu7Orthopedic Center, First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Sports Medicine, First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Orthopaedics, First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Orthopaedics, First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Sports Medicine, First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Orthopaedics, First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Orthopaedics, First Affiliated Hospital of Xinjiang Medical UniversityDepartment of Orthopaedics, First Affiliated Hospital of Xinjiang Medical UniversityAbstract Background Culture-negative periprosthetic joint infections (CN-PJIs) represent a critical subtype of PJI, and their high prevalence poses substantial challenges for treatment. CN-PJI is commonly managed utilizing antibiotic combinations, however, the interactions between these antibiotics have not been investigated. The aim of study was to investigate the synergistic and antagonistic effects of vancomycin (VAN) and meropenem (MEM), in an in vitro model of CN-PJI. Methods Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC), Minimum Biofilm Inhibitory Concentration (MBIC), and Minimum Biofilm Eradication Concentration (MBEC) were determined for VAN and MEM. Fractional Inhibitory Concentration (FIC) and Fractional Biofilm Eradication Concentration (FBEC) indices were calculated to assess the synergistic or antagonistic effects of VAN in combination with MEM on Staphylococcus aureus (S. aureus), Staphylococcus epidermidis (S. epidermidis), and Escherichia coli (E. coli) incubated alone or in combination. Results In the planktonic bacterial phase, MEM showed higher activity than VAN. Resistance increased when the bacteria were cultured together. The combination of VAN and MEM exhibited an indifferent effect against individual Staphylococci but an antagonistic effect against polymicrobial cultures. In biofilm, MEM demonstrated better antibiofilm activity than VAN, especially against E. coli biofilms. The combination of VAN and MEM showed an indifferent effect against E. coli and S. epidermidis-E. coli biofilms, but an antagonistic effect against S. aureus, S. epidermidis, S. aureus-S. epidermidis, and S. aureus-E. coli biofilms. Conclusion This study provides valuable insights into the effectiveness of VAN and MEM combinations in treating CN-PJIs, highlighting the need for careful consideration when selecting antibiotic treatments for these infections. Clinical trial number Not applicable.https://doi.org/10.1186/s12866-025-03918-4VancomycinMeropenemCulture-negative periprosthetic joint infection
spellingShingle Liqin Yao
Youcai Ma
Rui Liu
Yicheng Li
Xuebin Sun
Tuerhongjiang Wahafu
Li Cao
Wenbo Mu
Potential interactions between vancomycin and meropenem in culture-negative periprosthetic joint infection: an in vitro study
BMC Microbiology
Vancomycin
Meropenem
Culture-negative periprosthetic joint infection
title Potential interactions between vancomycin and meropenem in culture-negative periprosthetic joint infection: an in vitro study
title_full Potential interactions between vancomycin and meropenem in culture-negative periprosthetic joint infection: an in vitro study
title_fullStr Potential interactions between vancomycin and meropenem in culture-negative periprosthetic joint infection: an in vitro study
title_full_unstemmed Potential interactions between vancomycin and meropenem in culture-negative periprosthetic joint infection: an in vitro study
title_short Potential interactions between vancomycin and meropenem in culture-negative periprosthetic joint infection: an in vitro study
title_sort potential interactions between vancomycin and meropenem in culture negative periprosthetic joint infection an in vitro study
topic Vancomycin
Meropenem
Culture-negative periprosthetic joint infection
url https://doi.org/10.1186/s12866-025-03918-4
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