title: Inhibitory effect of disodium EDTA upon the growth of Staphylococcus epidermidis in vitro: relation to infection prophylaxis of Hickman catheters.
abstract: Granulocytopenic patients with an intravascular catheter are at increased risk for infection with Staphylococcus epidermidis. During the intervals when the catheters are not being used for infusions, it is customary to maintain patency of the catheter lumen with a solution containing heparin. We show that heparin does not inhibit the growth of S. epidermidis isolated from the catheter of an infected patient. A 20-mg/ml solution of disodium EDTA, a chelating agent which effectively anticoagulates blood at this concentration, was shown to be bactericidal for an initial inoculum of 10(3) CFU of staphylococci per ml in 24 h. Vancomycin, an antibiotic which is often employed to treat Staphylococcus infections, was also bactericidal for initial inocula of 10(3) CFU/ml at doses of 6.7 micrograms/ml, a drug concentration in the therapeutic range. When 10(3) staphylococci per ml were cultured in the presence of catheter segments and disodium EDTA or vancomycin, subcultures of the catheters showed minimal or no growth, respectively. In contrast, when cultured with heparin alone, subcultures showed abundant growth. In view of its low cost, effectiveness as an anticoagulant, and bactericidal activity, EDTA should be studied as a replacement for heparin solutions for the maintenance of intravenous catheters in granulocytopenic patients.
authors.affiliation: Department of Medicine, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire.
authors.forename: J L
authors.initials: JL
authors.lastname: Root
authors.forename: O R
authors.initials: OR
authors.lastname: McIntyre
authors.forename: N J
authors.initials: NJ
authors.lastname: Jacobs
authors.forename: C P
authors.initials: CP
authors.lastname: Daghlian
mesh_terms: D002408:Catheters, Indwelling / Q000009:adverse effects*; D004492:Edetic Acid / Q000494:pharmacology*; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D008826:Microbial Sensitivity Tests; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000254:growth & development; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D014640:Vancomycin; D006493:Heparin; D004492:Edetic Acid