Rifampin and Triclosan but not silver is effective in preventing bacterial infection of vascular dacron graft material.
OBJECTIVE
To evaluate the efficacy of silver- or Triclosan-coated prosthetic material compared to Rifampin bonded Dacron concerning their resistance to infection following subcutaneous implantation and contamination with Staphylococcus aureus.


METHODS
Animal experimental study in mice.


METHODS
Thirty-six C3H/HcN mice (Charles River Lab., Sulzfeld, Germany) with a weight between 24 and 27 g were randomised into six groups counting six animals each. Group I: control, gel-sealed dacron graft, group II: gel-sealed dacron graft and local contamination, group III: Intergard-Silver-prosthesis and contamination, group IV: silver/gel-sealed dacron prosthesis (test graft) and contamination, group V: Rifampin-bonded gel-sealed graft and contamination, group VI: Triclosan/collagen-coated dacron graft and contamination. Dacron graft material 0.8x1 cm was subcutaneously implanted in mice. Local contamination with 2x10(7)/0.2 ml S. aureus ATCC 25923 was carried out in groups II to VI. On day 14 the animals were killed and the grafts were explanted. The microscopic, histologic and microbiological evaluation of the graft material and the perigraft tissue was performed.


RESULTS
In control group I no case of infection was detected. In group II, 6 of 6 animals showed infection. In group III (Intergard-Silver) and group IV (silver/gel-test graft) were 6 of 6, in group V (Rifampin) only 1 of 6 grafts and in group VI (Triclosan) 4 of 6 grafts were infected. The difference between the low rate of infection in group V (Rifampin) in comparison to the completely infected groups III and IV (Silver) as well as the control group II was significant. Treatment of grafts with Triclosan could prevent infection only in 1/3 of the cases in group IV.


CONCLUSIONS
Silver coating failed to prevent graft infection material. A potential antimicrobial property was evident for Triclosan whereas Rifampin-bonded grafts exhibit a significantly reduced infection rate. Thus, silver-coated vascular grafts cannot ensure protection from vascular graft infection.
Hernández-Richter
T
T
Chirurgische Klinik und Poliklinik, Ludwig Maximilians-University, Munich, Germany.
Schardey
H M
HM
Wittmann
F
F
Mayr
S
S
Schmitt-Sody
M
M
Blasenbreu
S
S
Heiss
M M
MM
Gabka
C
C
Angele
M K
MK
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D020099:Coated Materials, Biocompatible; D008297:Male; D051379:Mice; D008809:Mice, Inbred C3H; D011093:Polyethylene Terephthalates; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D012293:Rifampin / Q000008:administration & dosage*; D012834:Silver / Q000008:administration & dosage*; D013203:Staphylococcal Infections / Q000517:prevention & control*; D014260:Triclosan / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D020099:Coated Materials, Biocompatible; D011093:Polyethylene Terephthalates; D012834:Silver; D014260:Triclosan; D012293:Rifampin