title: Antimicrobial and antibiofilm efficacy of triclosan and DispersinB combination.
abstract: OBJECTIVE
  The objectives of this study were to examine: (i) synergy of the combination of triclosan and DispersinB (DspB); (ii) in vitro efficacy and durability of triclosan + DspB-coated vascular catheters; and (iii) in vivo efficacy of triclosan + DspB-coated catheters compared with chlorhexidine-silver sulfadiazine (CH-SS)-coated and uncoated (control) vascular catheters in preventing colonization by Staphylococcus aureus.
  
  
  METHODS
  We investigated the potential synergistic antimicrobial and antibiofilm activity of triclosan and DspB by biofilm assays. The in vitro antimicrobial efficacy of triclosan + DspB-coated catheters was determined by microbial colonization assays. Antimicrobial durability of the coated catheters was tested by soaking segments in bovine serum for 7 days and determining antimicrobial activity, and by a serial plate transfer method. The in vivo efficacy of triclosan + DspB-coated catheters compared with CH-SS-coated and uncoated catheters was assessed by subcutaneous implantation of segments in a rabbit model of S. aureus infection.
  
  
  RESULTS
  The combination of triclosan and DspB showed synergistic antimicrobial and antibiofilm activity against S. aureus, Staphylococcus epidermidis and Escherichia coli, significantly reduced bacterial colonization (P < 0.05) and generally demonstrated a prolonged superior antimicrobial activity against clinical pathogens compared with CH-SS-coated catheters. Triclosan + DspB-coated and CH-SS-coated catheters exhibited equal in vivo efficacy (P <or= 0.05) in reducing colonization by S. aureus compared with uncoated catheters.
  
  
  CONCLUSIONS
  Catheters coated with the triclosan + DspB combination showed synergistic, broad-spectrum and durable antimicrobial activity. Furthermore, the in vivo efficacy of catheters coated with this unique antimicrobial/antibiofilm composition prompts clinical evaluation of such an innovative approach.
authors.affiliation: Center for Prostheses Infections and Infectious Disease Section, Michael E Debakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA. rdarouiche@aol.com
authors.forename: Rabih O
authors.initials: RO
authors.lastname: Darouiche
authors.forename: Mohammad D
authors.initials: MD
authors.lastname: Mansouri
authors.forename: Purushottam V
authors.initials: PV
authors.lastname: Gawande
authors.forename: Srinivasa
authors.initials: S
authors.lastname: Madhyastha
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects*; D001426:Bacterial Proteins / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects*; D002417:Cattle; D004357:Drug Synergism; D004864:Equipment and Supplies / Q000382:microbiology*; D004926:Escherichia coli; D006026:Glycoside Hydrolases / Q000494:pharmacology*; D011817:Rabbits; D013211:Staphylococcus aureus / Q000187:drug effects; D013212:Staphylococcus epidermidis; D014260:Triclosan / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D014260:Triclosan; D006026:Glycoside Hydrolases; C501330:dispersin B, Actinobacillus actinomycetemcomitans