title: Daptomycin and rifampin alone and in combination prevent vascular graft biofilm formation and emergence of antibiotic resistance in a subcutaneous rat pouch model of staphylococcal infection.
abstract: OBJECTIVE
  To investigate the efficacy of daptomycin and rifampin either alone or in combination in preventing prosthesis biofilm in a rat model of staphylococcal vascular graft infection.
  
  
  METHODS
  Prospective, randomised, controlled animal study.
  
  
  METHODS
  Graft infections were established in the back subcutaneous tissue of adult male Wistar rats by implantation of Dacron prostheses followed by topical inoculation with 2×10(7) colony forming units of Staphylococcus aureus, strain Smith diffuse.
  
  
  METHODS
  The study included a control group, a contaminated group that did not receive any antibiotic prophylaxis and three contaminated groups that received intra-peritoneal daptomycin, rifampin-soaked graft and daptomycin plus rifampin-soaked graft, respectively. Each group included 15 animals. The infection burden was evaluated by using sonication and quantitative agar culture. Moreover, an in vitro antibiotic susceptibility assay for S. aureus biofilms was performed to elucidate the same activity.
  
  
  RESULTS
  When tested alone, daptomycin and rifampin showed good efficacies. Their combination showed efficacies significantly higher than that of each single compound. The in vitro studies showed that minimum inhibitory concentration and minimum bactericidal concentration values for daptomycin were lower in presence of rifampin. Daptomycin prevented the emergence of rifampin resistance.
  
  
  CONCLUSIONS
  Daptomycin is an important candidate for prevention of staphylococcal biofilm-related infection and rifampin could serve as an interesting anti-staphylococcal antibiotic enhancer.
authors.affiliation: Clinic of Infectious Diseases, Università Politecnica delle Marche-Ospedali Riuniti, Ancona, Italy. anconacmi@interfree.it
authors.forename: O
authors.initials: O
authors.lastname: Cirioni
authors.forename: F
authors.initials: F
authors.lastname: Mocchegiani
authors.forename: R
authors.initials: R
authors.lastname: Ghiselli
authors.forename: C
authors.initials: C
authors.lastname: Silvestri
authors.forename: E
authors.initials: E
authors.lastname: Gabrielli
authors.forename: E
authors.initials: E
authors.lastname: Marchionni
authors.forename: F
authors.initials: F
authors.lastname: Orlando
authors.forename: D
authors.initials: D
authors.lastname: Nicolini
authors.forename: A
authors.initials: A
authors.lastname: Risaliti
authors.forename: A
authors.initials: A
authors.lastname: Giacometti
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D018441:Biofilms; D001807:Blood Vessel Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D020099:Coated Materials, Biocompatible; D015169:Colony Count, Microbial; D017576:Daptomycin / Q000008:administration & dosage*; D004195:Disease Models, Animal; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D008297:Male; D008826:Microbial Sensitivity Tests; D011093:Polyethylene Terephthalates; D011446:Prospective Studies; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012293:Rifampin / Q000008:administration & dosage*; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development
chemical_list: D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D011093:Polyethylene Terephthalates; D017576:Daptomycin; D012293:Rifampin