Antibiotics and prevention of microbial colonization of catheters

Abstract

Slime-producing staphylococci frequently colonize catheters, and when they are embedded in biofilm, they become resistant to various antibiotics. In the study that is described, the comparative efficacies of vancomycin, clindamycin, novobiocin, and minocycline, alone or in combination with rifampin, were tested in an in vitro model of colonization. The model consisted of the modified Robbins device with antibiotic-impregnated cement filling the lumen of catheter segments. The synergistic combination of minocycline and rifampin was the most efficacious in preventing bacterial colonization of slime-producing strains of Staphylococcus epidermidis and Staphylococcus aureus to catheter surfaces. A similar trend was observed when the inhibitory activities of polyurethane catheters coated with minocycline and rifampin were compared with the inhibitory activities of catheters coated with other antimicrobial agents. The inhibitory activities of catheters coated with minocycline and rifampin against S. epidermidis, S. aureus, and Enterococcus faecalis strains, for example, were significantly better than those of catheters coated with vancomycin (P < 0.05). The inhibitory activities of catheters coated with minocycline and rifampin against gram-negative bacilli and Candida albicans were comparable to those of catheters coated with ceftazidime and amphotericin B, respectively. We found that the combination of minocycline and rifampin is unique and highly effective in preventing the colonization of catheters with slimeproducing staphylococci and that it also displays a broad-spectrum inhibitory activity against gram-negative bacteria and yeast cells.Catheters are one of the leading causes of nosocomial infections and primary septicemia (16). Catheter-related infections are most commonly caused by coagulase-positive and coagulase-negative staphylococci, particularly slime-producing strains (1, 2). Because methicillin resistance is very prevalent among Staphylococcus epidermidis organisms and is increasing in frequency among Staphylococcus aureus strains, vancomycin remains the frontline intravenous antibiotic for the treatment of catheter-related bacteremia (12).In developing anti-infective catheters coated with antibiotics, one must avoid such potential limitations as the inhibition of antimicrobial activity by the slime material, the emergence of drug resistance, and superinfection by Candida species. In an in vitro susceptibility study of 197 catheter-related staphylococcal isolates collected between 1983 and 1993 at The University of Texas M. D. Anderson Cancer Center, minocycline, novobiocin, and rifampin were shown to have antimicrobial activities equivalent to those of vancomycin and other glycopeptide antibiotics (21). In the current study, we compared the efficacies of vancomycin, clindamycin, minocycline, novobiocin, and rifampin when used alone and in combination for preventing the microbial colonization of catheters. In addition, catheters coated with either amphotericin B, vancomycin, ceftazidime, or minocycline ...

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“…These include device coating with antibiotics which is of two types -active and passive. In the active coating, the release of antimicrobial agents in high fluxes occurs to inhibit the initial adhesion of the bacteria, 25,26,27,28 .…”

Comparison of Tigecycline and Vancomycin Activities in an In Vitro Biofilm Model Generated with Methicillin-Resistant Staphylococcus aureus

“…Kombinasyon tedavisinin direnci azalttığı belirtilmiştir. Bunlardan dolayı rifampisin, MRSA ile oluşan biyofi lm tabakasına karşı kombinasyon tedavisinde diğer antistafi lokokkal antibiyotiklerle birlikte en çok tercih edilen antibiyotik olmuştur 14,22 .…”

Surgical Treatment of Erectile Dysfunction

“…Minocycline and rifampin may help decrease the probability of developing bacterial resistance by inhibition of protein synthesis and inhibition of DNA-dependent RNA polymerase, respectively (Darouiche RO, et al 1999). In-vitro and in-vivo studies have demonstrated the effectiveness of minocycline in retarding the emergence of staphylococcal strains that are resistant to rifampin (Raad et al 1995). Short-term follow-up for this prosthesis enhancement shows statistical improvement in infection reduction for first time implant patients by a single surgeon .…”