Local treatment of Dacron patch graft contaminated with Staphylococcus aureus with antibiotic-releasing porous apatite ceramic: an experimental study in the rabbit.
OBJECTIVE
The purpose of this study was to investigate whether or not infection of prosthetic vascular graft could be prevented with the placement of antibiotic-loaded porous apatite ceramic on the graft with bacterial contamination.


METHODS
Teicoplanin as an antibiotic was loaded into a beta-tricalcium phosphate (TCP) block of porous apatite ceramic. The activity of teicoplanin released from teicoplanin-loaded TCP was examined for 40 days at 2-day intervals. In an in vivo study, the graft was patched in the abdominal aorta of a rabbit. Two different doses of Staphylococcus aureus were applied (n = 13). Teicoplanin-loaded TCP was placed around the graft infected with S aureus (n = 6). The graft, the tissue around it, and the arterial blood were collected and cultivated 4 weeks after operation.


RESULTS
The activity of teicoplanin in the replaced saline solution was maintained for at least 40 days. Because graft infection was established in all rabbits with a dose of 2 x 10(7) colony forming units, this dose was used as the dose of S aureus in this study. Fifty-seven percent of the subjects died from the infection. When teicoplanin-loaded TCP was placed around the graft contaminated with S aureus, no rabbits died. Bacterial cultures of the graft and of tissues around it were negative in all rabbits killed 4 weeks after operation. This infection was prevented with teicoplanin-loaded TCP in all rabbits.


CONCLUSIONS
Teicoplanin-loaded TCP may be useful in avoiding Dacron graft infection with S aureus in rabbits.
Sago
Tetsu
T
First Department of Surgery, Gifu University School of Medicine, Gifu 500-8705, Japan. gekaol@town.shirotori.gifu.jp
Mori
Yoshio
Y
Takagi
Hisato
H
Iwata
Hisashi
H
Murase
Katsutoshi
K
Kawamura
Yoshiaki
Y
Hirose
Hajime
H
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001031:Apatites; D001807:Blood Vessel Prosthesis; D002516:Ceramics; D004866:Equipment Contamination / Q000517:prevention & control*; D008297:Male; D010328:Patch Tests; D011093:Polyethylene Terephthalates; D016459:Prosthesis-Related Infections / Q000517:prevention & control; D011817:Rabbits; D013203:Staphylococcal Infections / Q000517:prevention & control; D013211:Staphylococcus aureus; D017334:Teicoplanin / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D001031:Apatites; D011093:Polyethylene Terephthalates; D017334:Teicoplanin