Vancomycin-based tracers guiding in situ visualization of bacteria on osteosynthesis devices and surgical debridement

Gerbren B Spoelstra; Philip H Elsinga; Jan Maarten van Dijl; Johannes H van Snick; Ben L Feringa; Andor W J M Glaudemans; Bas Keizers; Schelto Kruijff; Wiktor Szymanski; Marleen van Oosten; Frank F A IJpma

doi:10.1007/s00259-025-07249-4

Vancomycin-based tracers guiding in situ visualization of bacteria on osteosynthesis devices and surgical debridement

Gerbren B Spoelstra, Philip H Elsinga, Jan Maarten van Dijl, Johannes H van Snick, Ben L Feringa, Andor W J M Glaudemans, Bas Keizers, Schelto Kruijff, Wiktor Szymanski, Marleen van Oosten, Frank F A IJpma^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

PURPOSE: Bacterial infections associated with musculoskeletal injuries are challenging to detect and distinguish from sterile inflammation. Here we present the combined first-time application of a bacteria-targeted positron emission tomography (PET) tracer and a near-infrared fluorescent tracer to detect infected osteosynthesis implants and guide surgical treatment.

METHODS: To this end, osteosynthesis plates covered with bacterial biofilm and pre-incubated with [ 18F]PQ-VE1-vancomycin for PET imaging and/or vancomycin-IRDye800CW for optical imaging were fixed to post-mortem human tibiae and femora. PET/CT and fluorescence imaging were used to quantify the bacterial load before and after surgical debridement.

RESULTS: Pre-debridement, PET imaging showed a significant 2.2-fold higher tracer uptake on biofilm-covered plates compared to plates without biofilm (p < 0.001). Post-debridement, the PET signal was marginal, demonstrating effective biofilm removal. Fluorescence-guided surgery enabled real-time visualization and removal of bacterial biofilms.

CONCLUSION: Combined preoperative PET and intraoperative fluorescence imaging with vancomycin-based tracers allows noninvasive detection and real-time infection management, as demonstrated by these preliminary findings.

Original language	English
Journal	European Journal of Nuclear Medicine and Molecular Imaging
DOIs	https://doi.org/10.1007/s00259-025-07249-4
Publication status	E-pub ahead of print - 2-Apr-2025

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Spoelstra, G. B., Elsinga, P. H., van Dijl, J. M., van Snick, J. H., Feringa, B. L., Glaudemans, A. W. J. M., Keizers, B., Kruijff, S., Szymanski, W., van Oosten, M., & IJpma, F. F. A. (2025). Vancomycin-based tracers guiding in situ visualization of bacteria on osteosynthesis devices and surgical debridement. European Journal of Nuclear Medicine and Molecular Imaging. Advance online publication. https://doi.org/10.1007/s00259-025-07249-4

@article{31400aafa05f41cda03a158823627ba5,

title = "Vancomycin-based tracers guiding in situ visualization of bacteria on osteosynthesis devices and surgical debridement",

abstract = "PURPOSE: Bacterial infections associated with musculoskeletal injuries are challenging to detect and distinguish from sterile inflammation. Here we present the combined first-time application of a bacteria-targeted positron emission tomography (PET) tracer and a near-infrared fluorescent tracer to detect infected osteosynthesis implants and guide surgical treatment.METHODS: To this end, osteosynthesis plates covered with bacterial biofilm and pre-incubated with [ 18F]PQ-VE1-vancomycin for PET imaging and/or vancomycin-IRDye800CW for optical imaging were fixed to post-mortem human tibiae and femora. PET/CT and fluorescence imaging were used to quantify the bacterial load before and after surgical debridement. RESULTS: Pre-debridement, PET imaging showed a significant 2.2-fold higher tracer uptake on biofilm-covered plates compared to plates without biofilm (p < 0.001). Post-debridement, the PET signal was marginal, demonstrating effective biofilm removal. Fluorescence-guided surgery enabled real-time visualization and removal of bacterial biofilms.CONCLUSION: Combined preoperative PET and intraoperative fluorescence imaging with vancomycin-based tracers allows noninvasive detection and real-time infection management, as demonstrated by these preliminary findings.",

author = "Spoelstra, {Gerbren B} and Elsinga, {Philip H} and {van Dijl}, {Jan Maarten} and {van Snick}, {Johannes H} and Feringa, {Ben L} and Glaudemans, {Andor W J M} and Bas Keizers and Schelto Kruijff and Wiktor Szymanski and {van Oosten}, Marleen and IJpma, {Frank F A}",

note = "{\textcopyright} 2025. The Author(s).",

year = "2025",

month = apr,

day = "2",

doi = "10.1007/s00259-025-07249-4",

language = "English",

journal = "European Journal of Nuclear Medicine and Molecular Imaging",

issn = "1619-7070",

publisher = "Springer",

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Spoelstra, GB , Elsinga, PH , van Dijl, JM , van Snick, JH , Feringa, BL , Glaudemans, AWJM , Keizers, B , Kruijff, S , Szymanski, W, van Oosten, M & IJpma, FFA 2025, 'Vancomycin-based tracers guiding in situ visualization of bacteria on osteosynthesis devices and surgical debridement', European Journal of Nuclear Medicine and Molecular Imaging. https://doi.org/10.1007/s00259-025-07249-4

TY - JOUR

T1 - Vancomycin-based tracers guiding in situ visualization of bacteria on osteosynthesis devices and surgical debridement

AU - Spoelstra, Gerbren B

AU - Elsinga, Philip H

AU - van Dijl, Jan Maarten

AU - van Snick, Johannes H

AU - Feringa, Ben L

AU - Glaudemans, Andor W J M

AU - Keizers, Bas

AU - Kruijff, Schelto

AU - Szymanski, Wiktor

AU - van Oosten, Marleen

AU - IJpma, Frank F A

PY - 2025/4/2

Y1 - 2025/4/2

N2 - PURPOSE: Bacterial infections associated with musculoskeletal injuries are challenging to detect and distinguish from sterile inflammation. Here we present the combined first-time application of a bacteria-targeted positron emission tomography (PET) tracer and a near-infrared fluorescent tracer to detect infected osteosynthesis implants and guide surgical treatment.METHODS: To this end, osteosynthesis plates covered with bacterial biofilm and pre-incubated with [ 18F]PQ-VE1-vancomycin for PET imaging and/or vancomycin-IRDye800CW for optical imaging were fixed to post-mortem human tibiae and femora. PET/CT and fluorescence imaging were used to quantify the bacterial load before and after surgical debridement. RESULTS: Pre-debridement, PET imaging showed a significant 2.2-fold higher tracer uptake on biofilm-covered plates compared to plates without biofilm (p < 0.001). Post-debridement, the PET signal was marginal, demonstrating effective biofilm removal. Fluorescence-guided surgery enabled real-time visualization and removal of bacterial biofilms.CONCLUSION: Combined preoperative PET and intraoperative fluorescence imaging with vancomycin-based tracers allows noninvasive detection and real-time infection management, as demonstrated by these preliminary findings.

AB - PURPOSE: Bacterial infections associated with musculoskeletal injuries are challenging to detect and distinguish from sterile inflammation. Here we present the combined first-time application of a bacteria-targeted positron emission tomography (PET) tracer and a near-infrared fluorescent tracer to detect infected osteosynthesis implants and guide surgical treatment.METHODS: To this end, osteosynthesis plates covered with bacterial biofilm and pre-incubated with [ 18F]PQ-VE1-vancomycin for PET imaging and/or vancomycin-IRDye800CW for optical imaging were fixed to post-mortem human tibiae and femora. PET/CT and fluorescence imaging were used to quantify the bacterial load before and after surgical debridement. RESULTS: Pre-debridement, PET imaging showed a significant 2.2-fold higher tracer uptake on biofilm-covered plates compared to plates without biofilm (p < 0.001). Post-debridement, the PET signal was marginal, demonstrating effective biofilm removal. Fluorescence-guided surgery enabled real-time visualization and removal of bacterial biofilms.CONCLUSION: Combined preoperative PET and intraoperative fluorescence imaging with vancomycin-based tracers allows noninvasive detection and real-time infection management, as demonstrated by these preliminary findings.

U2 - 10.1007/s00259-025-07249-4

DO - 10.1007/s00259-025-07249-4

M3 - Article

C2 - 40172692

SN - 1619-7070

JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

ER -

Vancomycin-based tracers guiding in situ visualization of bacteria on osteosynthesis devices and surgical debridement

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