Short-Term Glycemic Control Is Effective in Reducing Surgical Site Infection in Diabetic Rats
BACKGROUND:Patients and animals with diabetes exhibit enhanced vulnerability to bacterial surgical infections. Despite multiple retrospective studies demonstrating the benefits associated with glycemic control in reducing bacterial infection after cardiac surgery, there are fewer guidelines on the u...
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| Veröffentlicht in: | Anesthesia and analgesia 2015-06, Vol.120 (6), p.1289-1296 |
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| container_title | Anesthesia and analgesia |
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| creator | Kroin, Jeffrey S. Buvanendran, Asokumar Li, Jinyuan Moric, Mario Im, Hee-Jeong Tuman, Kenneth J. Shafikhani, Sasha H. |
| description | BACKGROUND:Patients and animals with diabetes exhibit enhanced vulnerability to bacterial surgical infections. Despite multiple retrospective studies demonstrating the benefits associated with glycemic control in reducing bacterial infection after cardiac surgery, there are fewer guidelines on the use of glycemic control for noncardiac surgeries. In the current study, we investigated whether long-term (begun 2 weeks before surgery) or immediate (just before surgery) glycemic controls, continued postoperatively, can reduce surgical site infection in type 1 diabetic–induced rats.
METHODS:Rats were injected with streptozotocin to induce type 1 diabetes. Four groups of animals underwent surgery and thigh muscle Staphylococcus aureus bacteria challenge (1 × 10 colony forming units) at the time of surgery. Group 1 diabetic rats received insulin treatment just before surgery and continued until the end of study (short-term glycemic control group). Group 2 diabetic rats received insulin treatment 2 weeks before surgery and continued until the end of study (long-term glycemic control). Group 3 diabetic rats received no insulin treatment (no glycemic control group). Group 4 nondiabetic rats served as a healthy control group. Rats were euthanized at 3 or 6 days after surgery. Blood glucose and muscle bacterial burden were measured at 3 or 6 days after surgery.
RESULTS:Glycemic control was achieved in both long- and short-term insulin-treated diabetic rats. Compared with untreated diabetic rats, the bacterial burden in muscle was significantly lower in both groups of glycemic controlled diabetic rats at 3 (all P < 0.003) and 6 (all P < 0.0001) days after surgery.
CONCLUSIONS:A short-term glycemic control regimen, initiated just before surgery and bacterial exposure, was as effective in reducing surgical site infection as a long-term glycemic control in type 1 diabetic rats. These data suggest that immediately implementing glycemic control in type 1 diabetic surgical patients before undergoing noncardiac surgery may decrease the risk of infection. |
| doi_str_mv | 10.1213/ANE.0000000000000650 |
| format | Article |
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METHODS:Rats were injected with streptozotocin to induce type 1 diabetes. Four groups of animals underwent surgery and thigh muscle Staphylococcus aureus bacteria challenge (1 × 10 colony forming units) at the time of surgery. Group 1 diabetic rats received insulin treatment just before surgery and continued until the end of study (short-term glycemic control group). Group 2 diabetic rats received insulin treatment 2 weeks before surgery and continued until the end of study (long-term glycemic control). Group 3 diabetic rats received no insulin treatment (no glycemic control group). Group 4 nondiabetic rats served as a healthy control group. Rats were euthanized at 3 or 6 days after surgery. Blood glucose and muscle bacterial burden were measured at 3 or 6 days after surgery.
RESULTS:Glycemic control was achieved in both long- and short-term insulin-treated diabetic rats. Compared with untreated diabetic rats, the bacterial burden in muscle was significantly lower in both groups of glycemic controlled diabetic rats at 3 (all P < 0.003) and 6 (all P < 0.0001) days after surgery.
CONCLUSIONS:A short-term glycemic control regimen, initiated just before surgery and bacterial exposure, was as effective in reducing surgical site infection as a long-term glycemic control in type 1 diabetic rats. These data suggest that immediately implementing glycemic control in type 1 diabetic surgical patients before undergoing noncardiac surgery may decrease the risk of infection.</description><identifier>ISSN: 0003-2999</identifier><identifier>EISSN: 1526-7598</identifier><identifier>DOI: 10.1213/ANE.0000000000000650</identifier><identifier>PMID: 25695673</identifier><language>eng</language><publisher>United States: International Anesthesia Research Society</publisher><subject>Animals ; Biomarkers - blood ; Blood Glucose - drug effects ; Blood Glucose - metabolism ; Diabetes Mellitus, Experimental - blood ; Diabetes Mellitus, Experimental - chemically induced ; Diabetes Mellitus, Experimental - complications ; Diabetes Mellitus, Experimental - drug therapy ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 1 - chemically induced ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - drug therapy ; Drug Administration Schedule ; Hypoglycemic Agents - administration & dosage ; Insulin - administration & dosage ; Male ; Muscle, Skeletal - microbiology ; Rats, Sprague-Dawley ; Staphylococcal Infections - microbiology ; Staphylococcal Infections - prevention & control ; Streptozocin ; Surgical Wound Infection - microbiology ; Surgical Wound Infection - prevention & control ; Time Factors</subject><ispartof>Anesthesia and analgesia, 2015-06, Vol.120 (6), p.1289-1296</ispartof><rights>International Anesthesia Research Society</rights><rights>2015 International Anesthesia Research Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5130-4d34bf97ca8f5dc7a798804428cff94bb77df392acb6f4e7b6ec3937ef176b243</citedby><cites>FETCH-LOGICAL-c5130-4d34bf97ca8f5dc7a798804428cff94bb77df392acb6f4e7b6ec3937ef176b243</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00000539-201506000-00018$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>314,780,784,4607,27923,27924,65232</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25695673$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kroin, Jeffrey S.</creatorcontrib><creatorcontrib>Buvanendran, Asokumar</creatorcontrib><creatorcontrib>Li, Jinyuan</creatorcontrib><creatorcontrib>Moric, Mario</creatorcontrib><creatorcontrib>Im, Hee-Jeong</creatorcontrib><creatorcontrib>Tuman, Kenneth J.</creatorcontrib><creatorcontrib>Shafikhani, Sasha H.</creatorcontrib><title>Short-Term Glycemic Control Is Effective in Reducing Surgical Site Infection in Diabetic Rats</title><title>Anesthesia and analgesia</title><addtitle>Anesth Analg</addtitle><description>BACKGROUND:Patients and animals with diabetes exhibit enhanced vulnerability to bacterial surgical infections. Despite multiple retrospective studies demonstrating the benefits associated with glycemic control in reducing bacterial infection after cardiac surgery, there are fewer guidelines on the use of glycemic control for noncardiac surgeries. In the current study, we investigated whether long-term (begun 2 weeks before surgery) or immediate (just before surgery) glycemic controls, continued postoperatively, can reduce surgical site infection in type 1 diabetic–induced rats.
METHODS:Rats were injected with streptozotocin to induce type 1 diabetes. Four groups of animals underwent surgery and thigh muscle Staphylococcus aureus bacteria challenge (1 × 10 colony forming units) at the time of surgery. Group 1 diabetic rats received insulin treatment just before surgery and continued until the end of study (short-term glycemic control group). Group 2 diabetic rats received insulin treatment 2 weeks before surgery and continued until the end of study (long-term glycemic control). Group 3 diabetic rats received no insulin treatment (no glycemic control group). Group 4 nondiabetic rats served as a healthy control group. Rats were euthanized at 3 or 6 days after surgery. Blood glucose and muscle bacterial burden were measured at 3 or 6 days after surgery.
RESULTS:Glycemic control was achieved in both long- and short-term insulin-treated diabetic rats. Compared with untreated diabetic rats, the bacterial burden in muscle was significantly lower in both groups of glycemic controlled diabetic rats at 3 (all P < 0.003) and 6 (all P < 0.0001) days after surgery.
CONCLUSIONS:A short-term glycemic control regimen, initiated just before surgery and bacterial exposure, was as effective in reducing surgical site infection as a long-term glycemic control in type 1 diabetic rats. These data suggest that immediately implementing glycemic control in type 1 diabetic surgical patients before undergoing noncardiac surgery may decrease the risk of infection.</description><subject>Animals</subject><subject>Biomarkers - blood</subject><subject>Blood Glucose - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>Diabetes Mellitus, Experimental - blood</subject><subject>Diabetes Mellitus, Experimental - chemically induced</subject><subject>Diabetes Mellitus, Experimental - complications</subject><subject>Diabetes Mellitus, Experimental - drug therapy</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - chemically induced</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Drug Administration Schedule</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Insulin - administration & dosage</subject><subject>Male</subject><subject>Muscle, Skeletal - microbiology</subject><subject>Rats, Sprague-Dawley</subject><subject>Staphylococcal Infections - microbiology</subject><subject>Staphylococcal Infections - prevention & control</subject><subject>Streptozocin</subject><subject>Surgical Wound Infection - microbiology</subject><subject>Surgical Wound Infection - prevention & control</subject><subject>Time Factors</subject><issn>0003-2999</issn><issn>1526-7598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1v1DAQhi0EotvCP0DIRy5p_RV_HKtlaVeqitQtRxQ5zrhrcJJiO63678l2C0Ic2rmMZvS870jvIPSBkmPKKD85vVwdk39L1uQVWtCayUrVRr9Gi3nJK2aMOUCHOf-YR0q0fIsOWC1NLRVfoO-b7ZhKdQ2px2fxwUEfHF6OQ0ljxOuMV96DK-EOcBjwFXSTC8MN3kzpJjgb8SYUwOvhkRmHHfM52BbKbHJlS36H3ngbM7x_6kfo25fV9fK8uvh6tl6eXlSuppxUouOi9UY5q33dOWWV0ZoIwbTz3oi2Varz3DDrWukFqFaC44Yr8FTJlgl-hD7tfW_T-GuCXJo-ZAcx2gHGKTdUaiaYVFTNqNijLo05J_DNbQq9TQ8NJc0u2GYOtvk_2Fn28enC1PbQ_RX9SXIG9B64H2OBlH_G6R5SswUby_Ylb_GM9BGruakYoTWR81DtHqn5bwuZk6Q</recordid><startdate>201506</startdate><enddate>201506</enddate><creator>Kroin, Jeffrey S.</creator><creator>Buvanendran, Asokumar</creator><creator>Li, Jinyuan</creator><creator>Moric, Mario</creator><creator>Im, Hee-Jeong</creator><creator>Tuman, Kenneth J.</creator><creator>Shafikhani, Sasha H.</creator><general>International Anesthesia Research Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201506</creationdate><title>Short-Term Glycemic Control Is Effective in Reducing Surgical Site Infection in Diabetic Rats</title><author>Kroin, Jeffrey S. ; Buvanendran, Asokumar ; Li, Jinyuan ; Moric, Mario ; Im, Hee-Jeong ; Tuman, Kenneth J. ; Shafikhani, Sasha H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5130-4d34bf97ca8f5dc7a798804428cff94bb77df392acb6f4e7b6ec3937ef176b243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Animals</topic><topic>Biomarkers - blood</topic><topic>Blood Glucose - drug effects</topic><topic>Blood Glucose - metabolism</topic><topic>Diabetes Mellitus, Experimental - blood</topic><topic>Diabetes Mellitus, Experimental - chemically induced</topic><topic>Diabetes Mellitus, Experimental - complications</topic><topic>Diabetes Mellitus, Experimental - drug therapy</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Diabetes Mellitus, Type 1 - chemically induced</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Drug Administration Schedule</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Insulin - administration & dosage</topic><topic>Male</topic><topic>Muscle, Skeletal - microbiology</topic><topic>Rats, Sprague-Dawley</topic><topic>Staphylococcal Infections - microbiology</topic><topic>Staphylococcal Infections - prevention & control</topic><topic>Streptozocin</topic><topic>Surgical Wound Infection - microbiology</topic><topic>Surgical Wound Infection - prevention & control</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kroin, Jeffrey S.</creatorcontrib><creatorcontrib>Buvanendran, Asokumar</creatorcontrib><creatorcontrib>Li, Jinyuan</creatorcontrib><creatorcontrib>Moric, Mario</creatorcontrib><creatorcontrib>Im, Hee-Jeong</creatorcontrib><creatorcontrib>Tuman, Kenneth J.</creatorcontrib><creatorcontrib>Shafikhani, Sasha H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anesthesia and analgesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kroin, Jeffrey S.</au><au>Buvanendran, Asokumar</au><au>Li, Jinyuan</au><au>Moric, Mario</au><au>Im, Hee-Jeong</au><au>Tuman, Kenneth J.</au><au>Shafikhani, Sasha H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Short-Term Glycemic Control Is Effective in Reducing Surgical Site Infection in Diabetic Rats</atitle><jtitle>Anesthesia and analgesia</jtitle><addtitle>Anesth Analg</addtitle><date>2015-06</date><risdate>2015</risdate><volume>120</volume><issue>6</issue><spage>1289</spage><epage>1296</epage><pages>1289-1296</pages><issn>0003-2999</issn><eissn>1526-7598</eissn><abstract>BACKGROUND:Patients and animals with diabetes exhibit enhanced vulnerability to bacterial surgical infections. Despite multiple retrospective studies demonstrating the benefits associated with glycemic control in reducing bacterial infection after cardiac surgery, there are fewer guidelines on the use of glycemic control for noncardiac surgeries. In the current study, we investigated whether long-term (begun 2 weeks before surgery) or immediate (just before surgery) glycemic controls, continued postoperatively, can reduce surgical site infection in type 1 diabetic–induced rats.
METHODS:Rats were injected with streptozotocin to induce type 1 diabetes. Four groups of animals underwent surgery and thigh muscle Staphylococcus aureus bacteria challenge (1 × 10 colony forming units) at the time of surgery. Group 1 diabetic rats received insulin treatment just before surgery and continued until the end of study (short-term glycemic control group). Group 2 diabetic rats received insulin treatment 2 weeks before surgery and continued until the end of study (long-term glycemic control). Group 3 diabetic rats received no insulin treatment (no glycemic control group). Group 4 nondiabetic rats served as a healthy control group. Rats were euthanized at 3 or 6 days after surgery. Blood glucose and muscle bacterial burden were measured at 3 or 6 days after surgery.
RESULTS:Glycemic control was achieved in both long- and short-term insulin-treated diabetic rats. Compared with untreated diabetic rats, the bacterial burden in muscle was significantly lower in both groups of glycemic controlled diabetic rats at 3 (all P < 0.003) and 6 (all P < 0.0001) days after surgery.
CONCLUSIONS:A short-term glycemic control regimen, initiated just before surgery and bacterial exposure, was as effective in reducing surgical site infection as a long-term glycemic control in type 1 diabetic rats. These data suggest that immediately implementing glycemic control in type 1 diabetic surgical patients before undergoing noncardiac surgery may decrease the risk of infection.</abstract><cop>United States</cop><pub>International Anesthesia Research Society</pub><pmid>25695673</pmid><doi>10.1213/ANE.0000000000000650</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Animals Biomarkers - blood Blood Glucose - drug effects Blood Glucose - metabolism Diabetes Mellitus, Experimental - blood Diabetes Mellitus, Experimental - chemically induced Diabetes Mellitus, Experimental - complications Diabetes Mellitus, Experimental - drug therapy Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - chemically induced Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - drug therapy Drug Administration Schedule Hypoglycemic Agents - administration & dosage Insulin - administration & dosage Male Muscle, Skeletal - microbiology Rats, Sprague-Dawley Staphylococcal Infections - microbiology Staphylococcal Infections - prevention & control Streptozocin Surgical Wound Infection - microbiology Surgical Wound Infection - prevention & control Time Factors |
| title | Short-Term Glycemic Control Is Effective in Reducing Surgical Site Infection in Diabetic Rats |
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