Combination of Bacteriophages and Antibiotics for Prevention of Vascular Graft Infections—An In Vitro Study

Abstract

(1) Background: Implant-associated bacterial infections are usually hard to treat conservatively due to the resistance and tolerance of the pathogens to conventional antimicrobial therapy. Bacterial colonization of vascular grafts may lead to life-threatening conditions such as sepsis. The objective of this study is to evaluate whether conventional antibiotics and bacteriophages can reliably prevent the bacterial colonization of vascular grafts. (2) Methods: Gram-positive and Gram-negative bacterial infections were simulated on samples of woven PET gelatin-impregnated grafts using Staphylococcus aureus and Escherichia coli strains, respectively. The ability to prevent colonization was evaluated for a mixture of broad-spectrum antibiotics, for strictly lytic species-specific bacteriophage strains, and for a combination of both. All the antimicrobial agents were conventionally tested in order to prove the sensitivity of the used bacterial strains. Furthermore, the substances were used in a liquid form or in combination with a fibrin glue. (3) Results: Despite their strictly lytic nature, the application of bacteriophages alone was not enough to protect the graft samples from both bacteria. The singular application of antibiotics, both with and without fibrin glue, showed a protective effect against S. aureus (0 CFU/cm2), but was not sufficient against E. coli without fibrin glue (M = 7.18 × 104 CFU/cm2). In contrast, the application of a combination of antibiotics and phages showed complete eradication of both bacteria after a single inoculation. The fibrin glue hydrogel provided an increased protection against repetitive exposure to S. aureus (p = 0.05). (4) Conclusions: The application of antibacterial combinations of antibiotics and bacteriophages is an effective approach to the prevention of bacteria-induced vascular graft infections in clinical settings.

The Potential of Bacteriophage-Antibiotic Combination Therapy in Treating Infections with Multidrug-Resistant Bacteria

“…Current therapeutic efforts targeted at microbes need to factor in their adaptive feature if rapid microbe-rendered obsoletion of these efforts is to be circumvented. In line with this, we “add our voice” to calls for the advances made in phage therapy to be combined with the relative efficacy of antibiotics to create a synergy that may be robust enough to foil, or mitigate at worst, survival induction in microbes [ 40 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ].…”

Antibacterial copper‐filled TiO2 coating of cardiovascular implants to prevent infective endocarditis—A pilot study

“…These include antibiotic-loaded coatings, non-antibiotic organic coated antimicrobial agents, and adhesion-resistant coatings, all of which show promise in the existing literature. 23 A prominent pathophysiological hallmark of PVE is biofilm formation, where bacterial adhesion to the prosthetic valve surfaces plays a pivotal role. 24 Biofilms are complex communities of microorganisms 25 encased in a self-produced extracellular matrix, 26 rendering them highly resistant to host defenses and conventional antibiotics.…”