Comparative In Vitro Efficacies and Antimicrobial Durabilities of Novel Antimicrobial Central Venous Catheters

Hanna, Hend; Bahna, Paul; Reitzel, Ruth; Dvorak, Tanya; Chaiban, Gassan; Hachem, Ray; Raad, Issam

doi:10.1128/aac.01622-05

Cited by 62 publications

(31 citation statements)

References 50 publications

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“…However, some existing antimicrobial-treated catheters designed to prevent catheter colonization may have partial clinical efficacy, particularly against drug-resistant pathogens, and limited durability of antimicrobial activity (8,(10)(11)(12)(13) partly due to their inability to control biofilm formation and combat biofilm-nested microorganisms, which can have MICs of up to 1,000 times higher than their MICs against their free-floating planktonic counterparts (8,(14)(15)(16).…”

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confidence: 99%

In Vitro Activity and Durability of a Combination of an Antibiofilm and an Antibiotic against Vascular Catheter Colonization

Mansouri

Hull

Stager

et al. 2013

Antimicrob Agents Chemother

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bCatheter-associated infections can cause severe complications and even death. Effective antimicrobial modification of catheters that can prevent device colonization has the potential of preventing clinical infection. We studied in vitro the antimicrobial activities of central venous catheters impregnated with N-acetylcysteine (NAC), an antibiofilm agent, and a broad-spectrum antibiotic against a range of important clinical pathogens. NAC-levofloxacin-impregnated (NACLEV) catheters were also evaluated for their antiadherence activity. NACLEV catheters produced the most active and durable antimicrobial effect against both Grampositive and Gram-negative isolates and significantly reduced colonization (P < 0.0001) by all tested pathogens compared to control catheters. These in vitro results suggest that this antimicrobial combination can potentially be used to combat catheter colonization and catheter-associated infection. Intravascular catheters are essential in managing critically ill patients. However, vascular catheter-associated infections could result in dire consequences leading to excessive morbidity and mortality, longer hospital stays, and higher health care costs, with an average treatment cost of $25,000 per episode (1-5).Catheter-associated infections are generally initiated by microbial colonization of the catheter surface and formation of a superficial biofilm layer (6). Cell surface proteins and polysaccharide production by bacterial cells reportedly contribute to the formation of biofilm that can then protect pathogens by impeding both the penetration of antibiotics and the function of phagocytic immune cells, thus hindering the ability to combat colonizing pathogens (7-9).Impregnation or coating of catheters with antimicrobial agents has commonly been used to prevent bacterial colonization of vascular catheters (8). However, some existing antimicrobial-treated catheters designed to prevent catheter colonization may have partial clinical efficacy, particularly against drug-resistant pathogens, and limited durability of antimicrobial activity (8, 10-13) partly due to their inability to control biofilm formation and combat biofilm-nested microorganisms, which can have MICs of up to 1,000 times higher than their MICs against their free-floating planktonic counterparts (8,(14)(15)(16).N-acetylcysteine (NAC), a commonly used inhalation mucolytic therapy for chronic bronchitis and an FDA-approved intravenous injection for the treatment of acetaminophen toxicity (17), has favorable pharmacokinetics when used in hemodialysis patients (18). NAC also adversely affects bacterial growth and polysaccharide production and disrupts disulfide bonds in mucus, reducing the viscosity of secretions. These properties may contribute to the prevention and disruption of biofilm around different polymeric and metallic surfaces (9,(19)(20)(21). Not only does NAC diminish the formation of biofilm by common pathogens (19,22,23), it also possesses some in vitro intrinsic antimicrobial activity against both Gram-positive and Gr...

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confidence: 99%

In Vitro Activity and Durability of a Combination of an Antibiofilm and an Antibiotic against Vascular Catheter Colonization

Mansouri

Hull

Stager

et al. 2013

Antimicrob Agents Chemother

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“…Moreover, the use of tap water or sodium chloride solution can substitute the use of antiseptics like chlorhexidine and gentian violet in reducing the adherence of Candida albicans to the catheters [10,13]. Also, the effectiveness of sodium chloride solution (0.9%) in this study highlights the significant use of this solution instead of antimicrobial coated central venous catheter, as well as its effect is comparable to the irrigation with antimicrobials [14]. The effect of certain concentrations of sodium chloride solutions may be related to the interaction of chloride solution with the materials of catheter.…”

Section: Discussionmentioning

confidence: 69%

A Novel Approach to Overcome Adherence Property of Candida albicans

Saadaldin¹

2011

JNUS

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The study is aimed to introduce a procedure that mimic the adherence of microorganisms to the plastic tube and to assess the suitable solution to irrigate these microorganisms. Candida albicans broth was inoculated into a 30 cm plastic tube for a certain period of time to allow the adherence of microorganism to the inner surface of tube. Tubes were irrigated with distilled water, tap water or different concentrations of sodium chloride (0.1-0.9%). The results showed that the percentage of Candida albicans which adhered to the inner surface of tube ranged between 0.27% and 30% of the initial inoculum. Tap water was superior than distilled water in removing the adherent Candida. Sodium chloride in concentrations 0.3%, 0.6% and 0.9% completely removed the attached Candida while the other concentrations showed inconsistent results. It concludes that irrigation with water or certain sodium chloride concentrations, which interfere with the fluidity of Candida albicans, is the simple and best method to eliminate the adherent microorganisms.

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“…These gendine-coated devices showed antimicrobial efficacy and durability against a wide range of bacteria and fungi (14,(17)(18)(19). Further, gendine-coated urinary catheters prevented urinary tract infection with E. coli in a rabbit model (15).…”

Section: Resultsmentioning

confidence: 99%

“…Our team previously developed gendine-coated medical devices, such as central venous catheters (CVC), urinary catheters, endotracheal tubes, and gloves made of different types of polymers (14,(17)(18)(19). These gendine-coated devices showed antimicrobial efficacy and durability against a wide range of bacteria and fungi (14,(17)(18)(19).…”

Section: Resultsmentioning

confidence: 99%

Development of Gendine-Coated Cannula for Continuous Subcutaneous Insulin Infusion for Extended Use

Mohamed

Garoge

Rosenblatt

et al. 2015

Antimicrob Agents Chemother

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Continuous subcutaneous insulin infusion (CSII) using pumps is a widely used method for insulin therapy in patients with diabetes mellitus. Among the major factors that usually lead to the discontinuation of CSII are CSII set-related issues, including infection at the infusion site. The American Diabetic Association currently recommends rotating sites every 2 to 3 days. This recommendation adds cost and creates inconvenience. Therefore, in order to prevent infections and extend the duration between insertion site changes, we developed a Teflon cannula coated with a combination of gentian violet and chlorhexidine (gendine) and tested its antimicrobial efficacy against different pathogens. The cannulas were coated with gendine on the exterior surface and dried. The efficacy and durability of gendine-coated cannulas were determined against methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, methicillin-susceptible S. aureus, Streptococcus pyogenes, vancomycin-resistant enterococci, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, and Candida glabrata using a biofilm colonization method. The cytotoxicity of gendine was assessed against mouse fibroblast cell lines. The gendine-coated cannulas showed complete prevention of biofilm colonization of all organisms tested for up to 2 weeks (P < 0.0001) compared to that with the uncoated control. A gendine-coated catheter against mouse fibroblast cells was shown to be noncytotoxic. Our in vitro results show that a novel gendine cannula is highly effective in completely inhibiting the biofilm of multidrug-resistant pathogens for up to 2 weeks and may have potential clinical applications, such as prolonged use, cost reduction, and lower infection rate. C ontinuous subcutaneous insulin infusion (CSII), a universally approved method, is used by an increasing number of both children and adults with diabetes (1). Technical advancements in insulin pump fabrication and the use of rapid-acting insulin analogs in recent years have increased the safety and efficacy of CSII to successfully attain normoglycemia (2). It is estimated that Ͼ500,000 patients worldwide are currently using CSII (3). Among the major factors that usually lead to the discontinuation of CSII therapy are CSII set-related issues, such as those related to the inconvenience of CSII therapy, which includes the need for frequent set changes, mechanical issues with infusion sets, skin problems at the site associated with pain and skin irritation from needle sticks, and infection at the infusion site (4-6). The use of CSII pumps by diabetic cancer patients while undergoing chemotherapy might improve their glycemic control and therapeutic outcomes; however, this frequently immunosuppressed and immunocompromised population has heightened susceptibility to infections (7,8).The American Diabetic Association (ADA) recommends changing the infusion set catheter at least every 3 days. Longer use of CSII is associated with microbial colonization and may consequently lead to infection. These recomme...

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Comparative In Vitro Efficacies and Antimicrobial Durabilities of Novel Antimicrobial Central Venous Catheters

Cited by 62 publications

References 50 publications

In Vitro Activity and Durability of a Combination of an Antibiofilm and an Antibiotic against Vascular Catheter Colonization

In Vitro Activity and Durability of a Combination of an Antibiofilm and an Antibiotic against Vascular Catheter Colonization

A Novel Approach to Overcome Adherence Property of Candida albicans

Development of Gendine-Coated Cannula for Continuous Subcutaneous Insulin Infusion for Extended Use

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