An increased concentration of rifampicin bonded to gelatin-sealed Dacron reduces the incidence of subsequent graft infections following a staphylococcal challenge

et al. 2002

Section: Discussionmentioning

confidence: 99%

“…The centerpieces of prophylaxis are asepsis and perioperative administration of systemic antibiotics (3,5). As adjunctive prophylaxis, in the case of vascular grafts, the use of antimicrobials that bind to prosthetic grafts at high concentrations has been proposed (4,6,8,9,15,20,22,24,26).…”

mentioning

confidence: 99%

Efficacy of Quinupristin-Dalfopristin in Preventing Vascular Graft Infection Due to Staphylococcus epidermidis with Intermediate Resistance to Glycopeptides

Giacometti¹,

Cirioni²,

et al. 2002

“…Moreover, the recent emergence of glycopeptide resistance in MR staphylococcal isolates heightens concern about the need for other antibiotics in prophylactic regimens (13,16,20). In the case of vascular surgery, several antimicrobials have been proposed as adjunctive prophylaxis after binding in high concentrations to prosthetic grafts (1,8,18,22,24). Nevertheless, the selection of appropriate antibiotics for this adjunctive prophylaxis is unfortunately hampered by the fact that most agents are already used in systemic treatments and resistant strains might have been previously selected for.…”

Section: Discussionmentioning

confidence: 99%

Mupirocin Prophylaxis against Methicillin-Susceptible, Methicillin-Resistant, or Vancomycin-Intermediate Staphylococcus epidermidis Vascular-Graft Infection

Giacometti

Cirioni

et al. 2000

A rat model was used to investigate the efficacy of mupirocin in the prevention of vascular prosthetic graft infection due to Staphylococcus epidermidis strains with different susceptibility patterns (methicillin susceptible, methicillin resistant, and with intermediate resistance to vancomycin). The effect of mupirocin-soaked Dacron was compared to that of perioperative intraperitoneal prophylaxis with vancomycin. Graft infections were established in the back subcutaneous tissue of adult male Wistar rats by implantation of Dacron prostheses (1 cm 2 ) followed by topical inoculation with 5 ؋ 10 7 CFU of one staphylococcal strain. The study included a control group (no graft contamination), three contaminated groups that did not receive any antibiotic prophylaxis, three contaminated groups that received mupirocin-soaked grafts, three contaminated groups in which perioperative intraperitoneal vancomycin prophylaxis (10 mg/kg of body weight) was administered, and three contaminated groups that received mupirocin-soaked grafts and perioperative intraperitoneal vancomycin prophylaxis (10 mg/kg). The grafts were sterilely removed 7 days after implantation, and the infection was evaluated by using sonication and quantitative agar culture. Data analysis showed the efficacy of mupirocin against all three strains, with growth of the strains in treated rats significantly different than that in the untreated control. In addition, mupirocin was more effective than vancomycin against the strain with intermediate susceptibility to the glycopeptide. Finally, the combination of mupirocin and vancomycin produced complete suppression of the growth of all of the strains.Vascular prosthetic graft infection is a dreaded, serious complication of vascular surgery that frequently results in prolonged hospitalization, organ failure, amputation, and death (2, 3, 23). Staphylococcus epidermidis is among the most common pathogens that cause biomaterial infections (2-4, 18, 23). The centerpiece of prevention is prophylactic systemic antibiotics (4, 17). In addition, in the case of vascular grafts, antimicrobials, bound in high concentrations to prosthetic grafts have been proposed as adjunctive prophylaxis (1,5,6,8,11,12,15). Since the emergence of methicillin-resistant (MR) staphylococci, hglycopeptides have been the only uniformly effective treatment for staphylococcal infections. Vancomycin was introduced in the 1950s, and for almost 3 decades following its introduction, resistance was reported only rarely and appeared to have little clinical significance. Nevertheless, in the 1980s the emergence of vancomycin resistance in coagulase-negative staphylococci, especially S. epidermidis, Staphylococcus hominis, Staphylococcus warneri, Staphylococcus haemolyticus, and Staphylococcus xylous has been described (13,16,20). Mupirocin (pseudomonic acid A), produced by Pseudomonas fluorescens, is a topical antibiotic that is used for the treatment of superficial skin infections due to Staphylococcus aureus and Streptococcus pyogenes and for the erad...

show abstract

“…The centerpiece of therapy is prophylactic systemic antibiotics (3,7). In addition, in the case of vascular grafts, antimicrobials, such as rifampin, bound at high concentrations to prosthetic grafts have been proposed as adjunctive prophylaxis (6,9,15,19,20,22,24,26).…”

mentioning

confidence: 99%

“…By virtue of this binding, the retention of the biologically active molecules is not due to passive entrapment in the plastic tissue but reflects an ionic interaction between the anionic ligands and the cationic compounds. In experimental models, if the antimicrobial agents have an insufficient number of positively charged residues, they are usually bound to the prosthetic graft via a binding compound such as collagen, albumin, fibrin, and tridodecylmethylammonium chloride (6,9,13,15,19,20,24,26). In this study we investigated the in vivo efficacies of two polycationic peptides, ranalexin and buforin II, spontaneously bound to a Dacron graft in preventing S. epidermidis infection of the graft in a rat model.…”

mentioning

confidence: 99%

Polycationic Peptides as Prophylactic Agents against Methicillin-Susceptible or Methicillin-Resistant Staphylococcus epidermidis Vascular Graft Infection

Giacometti

Cirioni

et al. 2000