Hostname: page-component-745bb68f8f-mzp66 Total loading time: 0 Render date: 2025-01-08T10:22:41.607Z Has data issue: false hasContentIssue false
  • English
  • Français

In Vitro and In Vivo Efficacy of Catheters Impregnated With Antiseptics or Antibiotics: Evaluation of the Risk of Bacterial Resistance to the Antimicrobials in the Catheters

Published online by Cambridge University Press:  02 January 2015

Lester A. Sampath ,
Suhas M. Tambe  and
Shanta M. Modak
Lester A. Sampath
Affiliation:
Department of Surgery, College of Physicians and Surgeons, Columbia University, New York City, New York
Suhas M. Tambe
Affiliation:
Department of Surgery, College of Physicians and Surgeons, Columbia University, New York City, New York
Shanta M. Modak*
Affiliation:
Department of Surgery, College of Physicians and Surgeons, Columbia University, New York City, New York
*
Department of Surgery, College of Physicians and Surgeons, Columbia University, 650 West 168th St, New York, NY 10032
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To compare the efficacy of a new antiseptic catheter containing silver sulfadiazine and chlorhexidine on the external surface and chlorhexidine in the lumens to an antibiotic catheter impregnated with minocycline and rifampin on its external and luminal surfaces.

Design:

Experimental trial.

Methods:

Antimicrobial spectrum of catheters was determined by zones of inhibition. Resistance to luminal colonization was tested in vitro by locking catheter lumens with Staphylococcus epidermidis or Staphylococcus aureus culture after 7 days of perfusion. In vitro development of resistance to the antiseptic or antibiotic combination used in catheters was investigated. In vivo efficacy was tested (rat subcutaneous model) by challenge with sensitive or antibiotic-resistant bacteria.

Results:

Antiseptic and antibiotic catheters exhibited broad-spectrum action. However, antibiotic catheters were not effective against Candida species and Pseudomonas aeruginosa. Both catheters prevented luminal colonization. Compared to controls, both test catheters resisted colonization when challenged with S aureus 7 and 14 days' postimplant (P<.05).

Repeated in vitro exposure of S epidermidis culture to the antibiotic and antiseptic combinations led to small increases in the minimum inhibitory concentration (15 times and 2 times, respectively). Unlike the antibiotic catheter, the in vitro and in vivo activity of the antiseptic catheter was unaffected by the resistance profile of the test organism. Antiseptic catheters were more effective than antibiotic catheters in preventing colonization by rifampin-resistant S epidermidis in vivo (P<.05).

Conclusions:

Antiseptic and antibiotic catheters exhibit similar efficacy; however, when challenged with a rifampin-resistant strain, the antibiotic catheter appeared to be more susceptible to colonization than the antiseptic device.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 10 , October 2001 , pp. 640 - 646
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Trooskin, SZ, Donetz, AP, Harvey, RA, Greco, RS. Prevention of catheters sepsis by antibiotic bonding. Surgery 1985;97:547–551.Google ScholarPubMed
2. Solomon, DD, Sherertz, RJ. Antibiotic releasing polymers. J Controlled Release 1987;6:343–352.CrossRefGoogle Scholar
3. Elliot, TS, Tebbs, SE. Intravascular catheters impregnated with benzal-konium chloride. J Antimicrob Chemother 1993;32:905–906.Google Scholar
4. Jansen, B, Jansen, S, Peters, G, Pulverer, G. In vitro efficacy of a central venous catheter (‘Hydrocath’) loaded with teicoplanin to prevent bacterial colonization. J Hosp Infect 1992;22:93–107.CrossRefGoogle ScholarPubMed
5. Modak, SM, Sampath, L. Development and evaluation of a new polyurethane central venous antiseptic catheter: reducing central venous catheter infections. Complications in Surgery 1992;11:23–28.Google Scholar
6. Raad, I, Darouiche, R, Hachem, R, Sacilowski, M, Bodey, GP. The broad-spectrum activity and efficacy of catheters coated with minocycline and rifampin. J Infect Dis 1996;173:418–424.CrossRefGoogle ScholarPubMed
7. Maki, DG, Stoltz, SM, Wheeler, S, Mermel, LA. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized controlled trial. Ann Intern Med 1997;127:257–266.CrossRefGoogle ScholarPubMed
8. Bach, A. Clinical studies on the use of antibiotic-and antiseptic bonded catheters to prevent catheter related infection. Int J Med Microbiol Virol Parasitol 1995;283:208–214.Google ScholarPubMed
9. Veenstra, DL, Saint, S, Saha, S, Lumley, T, Sullivan, SD. Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection: a meta analysis. JAMA 1999;281:261–267.CrossRefGoogle ScholarPubMed
10. Logghe, C, Van Ossel, CH, D'Hoore, W, Ezzedine, H, Wauters, G, Haxhe, JJ. Evaluation of chlorhexidine and silver sulfadiazine impregnated central venous catheters for the prevention of bloodstream infection in leukaemic patients: a randomized controlled trial. J Hosp Infect 1997;37:145–156.CrossRefGoogle ScholarPubMed
11. Pemberton, LB, Ross, V, Cuddy, P, Kremer, H, Fessler, T, McGurk, E. No difference in catheter related sepsis between standard and antiseptic central venous catheters. Arch Surg 1996;131:986–989.CrossRefGoogle ScholarPubMed
12. Ciresi, DL, Albrecht, RM, Volkers, PA, Scholten, DJ. Failure of antiseptic bonding to prevent central venous catheter-related infection and sepsis. Am Surg 1996;62:641–646.Google Scholar
13. Darouiche, RO, Raad, II, Heard, SO, Thornby, JI, Wenker, OC, Gabrielli, A, et al. A comparison of two antimicrobial-impregnated central venous catheters. N Engl J Med 1999;340:1–8.CrossRefGoogle ScholarPubMed
14. Sitges-Serra, A, Linares, J, Garau, J. Catheter sepsis: the clue is in the hub. Surgery 1985;97:355–357.Google ScholarPubMed
15. Salzman, MB, Isenberg, HD, Shapiro, JF, Lipsitz, PJ, Rubin, LG. A prospective study of the catheter hub as the portal of entry for microorganisms causing catheter-related sepsis in neonates. J Infect Dis 1993;167:487–490.CrossRefGoogle ScholarPubMed
16. Salzman, MB, Isenberg, HD, Rubin, LG. Use of disinfectants to reduce microbial contamination of hubs of vascular catheters. J Clin Microbiol 1993;31:475–479.CrossRefGoogle ScholarPubMed
17. Kite, P, Dobbins, BM, Wilcox, MH, Fawley, WN, Kindon, AJ, Thomas, D, et al. Evaluation of a novel endoluminal brush method for in situ diagnosis of catheter related sepsis. J Clin Path 1997;50:278–282.CrossRefGoogle ScholarPubMed
18. Sitges-Serra, A, Girvent, M. Catheter related bloodstream infections. World J Surg 1999;23:589–595.CrossRefGoogle ScholarPubMed
19. Saborio, D, Yaron, I, Sung, RS, Sampath, L, Zakheim, A, Brunnert, SR, et al. Enhanced antimicrobial efficacy of a modified chlorhexidine silver sulfadiazine (CHA AgSD) impregnated large bore-12 Fr-hemodialysis catheter. In: Programs and Abstracts of the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy (Toronto). Washington, DC: American Society for Microbiology; 1997:325. Abstract J-197.Google Scholar
20. Sampath, LA, Chowdhury, N, Caraos, L, Modak, SM. Infection resistance of surface modified catheters with either short-lived or prolonged activity. J Hosp Infect 1995;30:201–210.CrossRefGoogle ScholarPubMed
21. Raad, I, Darouiche, R, Dupuis, J, Abi-Said, D, Gabrielli, A, Hachem, R, et al. Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections: a randomized, double blind trial. Ann Intern Med 1997;127:267–274.CrossRefGoogle ScholarPubMed
22. Sherertz, RJ, Raad, II, Belani, A, Koo, LC, Rand, KH, Pickett, DL, et al. Three-year experience with sonicated vascular catheters cultures in a clinical microbiology laboratory. J Clin Microbiol 1990;28:76–82.CrossRefGoogle Scholar
23. Russell, AD, Day, MJ. Antibiotic and biocide resistance in bacteria. Microbios 1996;85:45–65.Google ScholarPubMed
24. Suller, MTE, Russell, AD. Antibiotic and biocide resistance in methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus. J Hosp Infect 1999;43:281–291.CrossRefGoogle ScholarPubMed
25. Fitzgerald, KA, Davies, A, Russell, AD. Sensitivity and resistance of Escherichia coli and Staphylococcus aureus to chlorhexidine. Lett Appl Microbiol 1991;14:33–36.CrossRefGoogle Scholar
26. Tambe, SM, Sampath, L, Modak, SM. In vitro evaluation of the risk of developing resistance to antiseptics and antibiotics used in medical devices. J Antimicrob Chemother 2001;47:589–598.CrossRefGoogle ScholarPubMed
27. Garrison, JR, Henke, PK, Smith, KR. In vitro and in vivo effects of rifampicin on Staphylococcus aureus graft infections. ASAIO J 1997;43:8–12.CrossRefGoogle Scholar
28. Baiocchi, P, Galie, M, Santini, C, Carfagna, P, Cassone, M, Tarasi, D, et al. In vitro susceptibility of Staphylococcus aureus isolated from blood to currently used antistaphylococcal drugs. J Chemother 1998;10:25–28.CrossRefGoogle ScholarPubMed
28. Alarcon, T, Sanz, JC, Blanco, F, Domingo, D, Lopez-Brea, M. High level mupirocin resistance among Spanish methicillin-resistant Staphylococcus aureus . Eur J Clin Microbiol Infect Dis 1998;17:877–879.CrossRefGoogle ScholarPubMed
29. Speller, DCE, Johnson, AP, James, D, Marples, RR, Charlett, A, George, RC. Resistance to methicillin and other antibiotics in isolates of Staphylococcus aureus from blood and cerebrospinal fluid, England and Wales, 1989-95. Lancet 1997;350:323–325.CrossRefGoogle ScholarPubMed
30. Yzerman, EP, Boelens, HA, Vogel, M, Verbrugh, HA. Efficacy and safety of teicoplanin plus rifampicin in the treatment of bacteremic infections caused by Staphylococcus aureus . J Antimicrob Chemother 1998;42:233–239.CrossRefGoogle Scholar
31. Ito, T, Hiramatsu, K. Acquisition of methicillin resistance and progression of multiantibiotic resistant Staphylococcus aureus . Yonsei Med J 1998;39:526–533.CrossRefGoogle ScholarPubMed
32. Noyon, V, Legallou, F, Richet, H, Dreno, B. The resistance of Propionibacterium acnes and Staphylococcus epidermidis to cyclines. The Research and Study Group on Acne [French]. Ann Dermatol Venerol 1998;125:885–887.Google Scholar
33. Martinez, JL, Baquero, F. Mutation frequencies and antibiotic resistance. Antimicrob Agents Chemother 2000;44:1771–1777.CrossRefGoogle ScholarPubMed