Impact of selective antimicrobial agents on staphylococcal adherence to biomedical devices

doi:10.1016/j.amjsurg.2006.04.009

The American Journal of Surgery

Volume 192, Issue 3, September 2006, Pages 344-354

https://doi.org/10.1016/j.amjsurg.2006.04.009 Get rights and content

Abstract

Background

Infection of intravascular or implanted biomedical devices often involves biofilm-forming staphylococci that are recalcitrant to antimicrobial therapy. The present study investigated the activity of 6 antimicrobial agents against biofilm-forming and non–biofilm-forming strains of staphylococci adherent to the surface of selected biomedical devices.

Methods

Five clinical staphylococcal strains were selected for study in (1) antibiotic-lock model (ALM) and (b) vascular graft model (Dacron and expanded polytetrafluoroethylene [ePFTE]) devices. Test strains were inoculated for 30 minutes to stabilize microbial adherence and then exposed to antibiotic; the impact on bacterial adherence was assessed at 1, 2, 4, 7, and 10 days.

Results

Regarding ALM, daptomycin and rifampin were effective at eradicating staphylococcal adherence by day 4 (P < .01); linezolid and gentamicin by day 7 (P < .01); vancomycin by day 7; and ceftriaxone failed to eradicate staphylococcal adherence in 4 of 5 strains by day 10. Regarding ePTFE, daptomycin and linezolid eradicated staphylococcal adherence by day 2 (P < .01); rifampin by day 4 (P < .01); vancomycin and gentamicin by day 7 (P < .01); and ceftriaxone failed to eliminate staphylococcal adherence in 3 of 5 strains by day 10. Regarding Dacron, daptomycin and rifampin eradicated adherent strains by day 4 (P < .01); linezolid by day 7 (P < .01), and vancomycin, gentamicin, and ceftriaxone decreased staphylococcal adherence by 90%, 95%, and 78%, respectively, by day 10.

Comments

Daptomycin, rifampin, and linezolid demonstrated greater efficacy and speed in eradicating microbial adherence of staphylococcal isolates from selected devices compared with vancomycin, gentamicin, or ceftriaxone (P < .01). Further studies are warranted, however, to validate the clinical efficacy of daptomycin and linezolid in the treatment of biomedical device–associated infections.

Section snippets

Staphylococcal strains

Five staphylococcal isolates were selected for testing: S. epidermidis RP-62A, S. epidermidis M187sp11 (polysaccharide/adhesion positive), S. epidermidis M187sn11 (PS/A negative), S. epidermidis Sef141-98, and S. aureus ATCC 25923. RP-62A is a clinical strain derived from a catheter-related blood stream infection and produces a copious exopolysaccharide biofilm [17]. Strains M187sp11 (highly adherent biofilm producer) and M187sn3 (poorly adherent biofilm producer) are mutant strains generated

MIC and MBC findings

MIC and MBC values for the 5 staphylococcal isolates adherent to the silicone (Silastic), ePTFE, and VKD devices are listed in Table 1. MIC values for study strains adherent to silicone against daptomycin, rifampin, and linezolid were similar; however, MIC values increased 2- to 6-fold in the presence of prosthetic graft material with the highest MIC values reported for biofilm-forming and highly adherent (RP-62A and M187sp11) staphylococcal strains to VKD prosthetic graft material. MBC values

Comments

Infections involving indwelling or implanted biomedical devices have a significant clinical and economic impact, requiring increased resource use while adding to patient length of stay [1]. The traditional view has been that intraoperative contamination, originating from normal skin flora of patients or healthcare workers, causes more than half of all surgical-site infections [22]. However, this traditional view has recently come under challenge, suggesting that microbial shedding by members of

Acknowledgments

This study in part was supported by a grant from Cubist Pharmaceutical, Lexington, MA, and the Surgical Microbiology Research Fund, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

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Scientific paperImpact of selective antimicrobial agents on staphylococcal adherence to biomedical devices

Abstract

Background

Methods

Results

Comments

Section snippets

Staphylococcal strains

MIC and MBC findings

Comments

Acknowledgments

J Vasc Interv Radiol

J Vasc Surg

Ann Vasc Surg

J Hosp Infect

J Hosp Infect

Trends Microbiol

Treatment of infections associated with surgical implants

New Engl J Med

Prevention of staphylococcal biofilm-associated infections by the quorum sensing inhibitor RIP

Clin Orthop Relat Res

Catheter infectionsdiagnosis, etiology, treatment and prevention

Nutr Clin Pract

Vascular graft infections

Infections due to infusion therapy

Molecular epidemiology of microbial contamination in the operating room environmentIs there a risk for infections?

Surgery

Prosthetic device infections in surgery

Effects of slime produced by clinical isolates of coagulase-negative staphylococci on activity of various antimicrobial agents

Antimicrob Agents Chemother

Comparative assessment of antibiotic susceptibility of coagulase-negative staphylococci in biofilms versus planktonic culture as assessed by bacterial enumeration or rapid XTT colorimetry

J Antimicrob Chemother

Evidence for the use of the antibiotic lock technique

J Infus Nurs

Sequential analysis of staphylococcal colonization by body surface cultures on patients undergoing vascular surgery

J Clin Microbiol

Adherence of mucin and non-mucin producing staphylococci to preclotted and albumin-coated velour knitted vascular grafts

Surgery

Scientific paper
Impact of selective antimicrobial agents on staphylococcal adherence to biomedical devices