Hydromer-coated catheters to prevent shunt infection?
OBJECTIVE
The authors sought to determine whether Hydromer-coated catheters (HCCs) reduce bacterial adhesion compared with plain silicone, with and without plasma conditioning; to determine whether soaking the catheter in antibiotic solution reduces catheter colonization; and to ascertain their likely efficacy in prevention of shunt infection.


METHODS
Segments of HCCs were soaked in antibiotic solutions and then tested for antimicrobial activity on serial zone plates. All antibiotic agents lost activity within 2 days, except rifampin (9 days). Bacterial adhesion (Staphylococcus epidermidis) to the external surface was measured with and without plasma protein conditioning. Chemiluminescence showed that HCCs significantly reduced adhesion, especially with protein conditioning. Bacterial challenge of the luminal surface of the HCCs under flow conditions showed no difference from plain silicone; this was also the case after soaking in high concentrations of antibiotic agents and was confirmed by scanning electron microscopy. Examination of the inner and outer surfaces of HCCs by laser confocal microscopy disclosed that the outer surface, but not the lumen, was Hydromer coated.


CONCLUSIONS
The findings of this study indicate that HCCs do not impact the major risk factors for infection; therefore, it may be inferred that HCCs cannot be expected to reduce shunt infection significantly.
Bayston
Roger
R
Biomaterials-Related Infection Group, Orthopaedic and Accident Surgery, University Hospital, Nottingham, United Kingdom. roger.bayston@nottingham.ac.uk
Bhundia
Catherine
C
Ashraf
Waheed
W
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001422:Bacterial Adhesion; D002408:Catheters, Indwelling / Q000382:microbiology*; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation / Q000379:methods; D015169:Colony Count, Microbial; D004867:Equipment Design; D006801:Humans; D066298:In Vitro Techniques; D007260:Infusion Pumps; D017953:Isocyanates; D018613:Microscopy, Confocal; D011205:Povidone / Q000031:analogs & derivatives*; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013212:Staphylococcus epidermidis; D013997:Time Factors
D000900:Anti-Bacterial Agents; D017953:Isocyanates; C050067:hydromer; D011205:Povidone