title: Efficacy of minocycline and EDTA lock solution in preventing catheter-related bacteremia, septic phlebitis, and endocarditis in rabbits.
abstract: To determine the efficacy of antibiotic catheter lock solution in preventing catheter-related infections, silicone catheters were tunneled and inserted into the jugular veins of 18 rabbits. The catheters were challenged with an intraluminal injection of 10(5) CFU of slime-producing Staphylococcus epidermidis in 0.1 ml of water. The catheters were maintained on heparin (100 IU/ml) flush for the first 3 days. On day 3, quantitative blood samples for culture were obtained from the catheters and ear veins, which documented catheter-related bacteremia, and the rabbits were randomized to have their catheters flushed as follows: five animals were continued on heparin (100 IU/ml), five animals received vancomycin (3 mg/ml) with heparin (100 IU/ml), and eight animals received 3 mg of minocycline per ml with 30 mg of EDTA per ml (M-EDTA). All animals were killed at day 7. Blood, catheters, jugular veins, and heart valves were cultured quantitatively. Animals maintained on heparin developed catheter-related colonization, bacteremia, septic phlebitis, and endocarditis. Vancomycin-heparin partially prevented catheter colonization, bacteremia, and phlebitis (P = 0.2). M-EDTA completely prevented catheter colonization, catheter-related bacteremia, and phlebitis in all of the animals (P < 0.01). Tricuspid endocarditis was equally prevented by vancomycin-heparin and M-EDTA (P < or = 0.06). In conclusion, the M-EDTA catheter flush solution was highly efficacious in preventing catheter-related colonization, bacteremia, septic phlebitis, and endocarditis in rabbits.
authors.affiliation: Department of Infectious Diseases, Infection Control & Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. iraad@mdanderson.org
authors.forename: Issam
authors.initials: I
authors.lastname: Raad
authors.forename: Ray
authors.initials: R
authors.lastname: Hachem
authors.forename: Robert K
authors.initials: RK
authors.lastname: Tcholakian
authors.forename: Robert
authors.initials: R
authors.lastname: Sherertz
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000517:prevention & control; D002404:Catheterization / Q000009:adverse effects*; D004195:Disease Models, Animal; D004492:Edetic Acid / Q000627:therapeutic use*; D004696:Endocarditis / Q000517:prevention & control; D008297:Male; D008911:Minocycline / Q000627:therapeutic use*; D010689:Phlebitis / Q000517:prevention & control; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D011817:Rabbits
chemical_list: D000900:Anti-Bacterial Agents; D004492:Edetic Acid; D008911:Minocycline