title: Anti-adherence activity and antimicrobial durability of anti-infective-coated catheters against multidrug-resistant bacteria.
abstract: OBJECTIVE
  To investigate the anti-adherence and antimicrobial durability of anti-infective catheters against multidrug-resistant (MDR) Staphylococcus aureus (resistant to vancomycin, rifampicin and methicillin) and MDR Gram-negative bacteria (Stenotrophomonas maltophilia, Acinetobacter baumannii/calcoaceticus and Enterobacter agglomerans) that are often associated with catheter-related bloodstream infections (CRBSIs).
  
  
  METHODS
  Catheters impregnated with minocycline and rifampicin (M/R) or with silver-platinum and carbon (SPC) or with chlorhexidine and silver sulfadiazine (CHX/SS) were compared with non-coated catheters. Adherence of organisms was tested by using an established biofilm colonization model. All isolates were rifampicin-resistant. Antimicrobial durability was tested by soaking 1 cm segments of the catheter in serum and determining zones of inhibition against the tested organisms at weekly intervals.
  
  
  RESULTS
  The M/R catheters showed significantly superior anti-adherence activity and more prolonged antimicrobial durability when compared with CHX/SS-central venous catheter (CVC), SPC-CVC and uncoated control catheters against MDR and vancomycin-resistant S. aureus (MDR VRSA) (all P values < or = 0.02), MDR S. maltophilia (all P values < 0.005) and MDR A. baumannii/calcoaceticus (all P values < 0.002), respectively. M/R-CVC and CHX/SS-CVC had comparable anti-adherence and antimicrobial durability against MDR E. agglomerans, and these two were superior to SPC-CVC and the uncoated control catheters (all P values < 0.001).
  
  
  CONCLUSIONS
  M/R-CVC demonstrated superior anti-adherence activity and more prolonged antimicrobial durability when compared with other approved anti-infective catheters against MDR VRSA and/or MDR Gram-negative bacteria that are often associated with CRBSIs. This finding could explain their efficacy and better performance in clinical studies.
authors.affiliation: The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. iraad@mdanderson.org
authors.forename: I
authors.initials: I
authors.lastname: Raad
authors.forename: R
authors.initials: R
authors.lastname: Reitzel
authors.forename: Y
authors.initials: Y
authors.lastname: Jiang
authors.forename: R F
authors.initials: RF
authors.lastname: Chemaly
authors.forename: T
authors.initials: T
authors.lastname: Dvorak
authors.forename: R
authors.initials: R
authors.lastname: Hachem
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology*; D001422:Bacterial Adhesion / Q000187:drug effects*; D002404:Catheterization; D024901:Drug Resistance, Multiple, Bacterial; D004864:Equipment and Supplies / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D017053:Infection Control / Q000379:methods*; D013211:Staphylococcus aureus / Q000187:drug effects*
chemical_list: D000890:Anti-Infective Agents