title: In-vitro and in-vivo activity of antimicrobial-coated prosthetic heart valve sewing cuffs.
abstract: OBJECTIVE
  Prosthetic valve endocarditis (PVE) is a relatively uncommon but very serious condition. As bacterial colonization of the prosthetic heart valve sewing cuff can be a prelude to the clinical occurrence of PVE, antimicrobial coating of the sewing cuff may be beneficial. The study aims were to examine the antimicrobial activity in vitro and anti-infective efficacy in vivo of prosthetic heart valve sewing cuffs coated with minocycline and rifampin.
  
  
  METHODS
  Zones of inhibition by antimicrobial-coated sewing cuffs were assessed in vitro against Staphylococcus epidermidis, S. aureus, Enterococcus faecalis, Pseudomonas aeruginosa and Candida albicans. The ability of subcutaneously implanted devices coated with minocycline and rifampin to resist colonization and infection by P. aeruginosa was also examined in a rabbit model.
  
  
  RESULTS
  Antimicrobial-coated sewing cuffs produced zones of inhibition against all tested organisms. Coated devices were significantly less likely than uncoated devices to become colonized (2/24; 8% versus 20/24; 83%; p <0.001) or to cause device-related infection (0/24; 0% versus 18/24; 75%; p <0.001) and device-related abscess (0/24; 0% versus 10/24; 42%; p <0.001) due to P. aeruginosa.
  
  
  CONCLUSIONS
  Prosthetic heart valve sewing cuffs coated with minocycline and rifampin provide broad-spectrum antimicrobial activity in vitro, and are anti-infective in vivo against P. aeruginosa. These results encourage the clinical evaluation of these sewing cuffs.
authors.affiliation: Center for Prostheses Infection, Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Rabih O
authors.initials: RO
authors.lastname: Darouiche
authors.forename: Mohammad D
authors.initials: MD
authors.lastname: Mansouri
authors.forename: Ricardo
authors.initials: R
authors.lastname: Meade
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods*; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage; D020099:Coated Materials, Biocompatible; D004359:Drug Therapy, Combination; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D066298:In Vitro Techniques; D008911:Minocycline / Q000008:administration & dosage*; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D011552:Pseudomonas Infections / Q000517:prevention & control; D011817:Rabbits; D012293:Rifampin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D020099:Coated Materials, Biocompatible; D008911:Minocycline; D012293:Rifampin