Impact of selective antimicrobial agents on staphylococcal adherence to biomedical devices

• Published in: The American journal of surgery 2006-09, Vol.192 (3), p.344-354
• Main Authors: Edmiston, Charles E., Goheen, Michael P., Seabrook, Gary R., Johnson, Christopher P., Lewis, Brian D., Brown, Kellie R., Towne, Jonathan B.
• Format: Article
• Language: English
• Subjects: Acetamides - pharmacology; Anti-Bacterial Agents - pharmacology; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimicrobial agents; Biofilm; Biofilms; Biofilms - drug effects; Biofilms - growth & development; Biological and medical sciences; Biomedical device–related infections; Blood Vessel Prosthesis; Ceftriaxone - pharmacology; Daptomycin; Daptomycin - pharmacology; General aspects; Gentamicins - pharmacology; Hospitals; Linezolid; Medical sciences; Microbial Sensitivity Tests; Microbiology; Mortality; Nosocomial infections; Oxazolidinones - pharmacology; Patients; Pharmacology. Drug treatments; Protein synthesis; Proteins; Rifampin - pharmacology; Staphylococcal adherence; Staphylococcus - drug effects; Staphylococcus - growth & development; Studies; Vancomycin - pharmacology
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2006.04.009

Infection of intravascular or implanted biomedical devices often involves biofilm-forming staphylococci that are recalcitrant to antimicrobial therapy. The present study investigated the activity of 6 antimicrobial agents against biofilm-forming and non–biofilm-forming strains of staphylococci adherent to the surface of selected biomedical devices. Five clinical staphylococcal strains were selected for study in (1) antibiotic-lock model (ALM) and (b) vascular graft model (Dacron and expanded polytetrafluoroethylene [ePFTE]) devices. Test strains were inoculated for 30 minutes to stabilize microbial adherence and then exposed to antibiotic; the impact on bacterial adherence was assessed at 1, 2, 4, 7, and 10 days. Regarding ALM, daptomycin and rifampin were effective at eradicating staphylococcal adherence by day 4 ( P < .01); linezolid and gentamicin by day 7 ( P < .01); vancomycin by day 7; and ceftriaxone failed to eradicate staphylococcal adherence in 4 of 5 strains by day 10. Regarding ePTFE, daptomycin and linezolid eradicated staphylococcal adherence by day 2 ( P < .01); rifampin by day 4 ( P < .01); vancomycin and gentamicin by day 7 ( P < .01); and ceftriaxone failed to eliminate staphylococcal adherence in 3 of 5 strains by day 10. Regarding Dacron, daptomycin and rifampin eradicated adherent strains by day 4 ( P < .01); linezolid by day 7 ( P < .01), and vancomycin, gentamicin, and ceftriaxone decreased staphylococcal adherence by 90%, 95%, and 78%, respectively, by day 10. Daptomycin, rifampin, and linezolid demonstrated greater efficacy and speed in eradicating microbial adherence of staphylococcal isolates from selected devices compared with vancomycin, gentamicin, or ceftriaxone ( P < .01). Further studies are warranted, however, to validate the clinical efficacy of daptomycin and linezolid in the treatment of biomedical device–associated infections.