title: The prevention of biofilm colonization by multidrug-resistant pathogens that cause ventilator-associated pneumonia with antimicrobial-coated endotracheal tubes.
abstract: Ventilator-associated pneumonia (VAP) continues to be the nosocomial infection associated with the highest mortality in critically ill patients. Since silver-coated endotracheal tubes (ETT) was shown in a multicenter prospective randomized trials to decrease the risk of VAP, we compared the efficacy of two antiseptic agents such as gardine- and gendine-coated ETTs with that of silver-coated ETTs in preventing biofilm. The ETTs were tested for their ability to prevent the biofilm formation of methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Enterobacter cloacae, and Candida albicans. Scanning electron microscopy studies revealed a heavy biofilm on uncoated and silver-coated ETT but not on the gardine-coated ETT. The gardine and gendine ETTs completely inhibited the formation of biofilms by all organisms tested and were more effective in preventing biofilm growth than the silver ETTs (p < 0.001). The gardine- and gendine-coated ETTs were more durable against MRSA than either the silver-coated or uncoated ETTs for up to 2 weeks (p < 0.0001). We have therefore shown that gardine- and gendine-coated ETTs are superior to silver-coated ETTs in preventing biofilm. Future animal and clinical studies are warranted to determine whether the gardine- and gendine-coated ETTs can significantly reduce the risk of VAP.
authors.affiliation: Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, United States. iraad@mdanderson.org
authors.forename: Issam I
authors.initials: II
authors.lastname: Raad
authors.forename: Jamal A
authors.initials: JA
authors.lastname: Mohamed
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Reitzel
authors.forename: Ying
authors.initials: Y
authors.lastname: Jiang
authors.forename: Tanya L
authors.initials: TL
authors.lastname: Dvorak
authors.forename: Mahmoud A
authors.initials: MA
authors.lastname: Ghannoum
authors.forename: Ray Y
authors.initials: RY
authors.lastname: Hachem
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Chaftari
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects / Q000472:pathogenicity; D000890:Anti-Infective Agents / Q000737:chemistry / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects*; D002176:Candida albicans / Q000187:drug effects / Q000472:pathogenicity; D016972:Enterobacter cloacae / Q000187:drug effects / Q000472:pathogenicity; D007442:Intubation, Intratracheal / Q000379:methods*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000472:pathogenicity; D008855:Microscopy, Electron, Scanning; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000472:pathogenicity
chemical_list: D000890:Anti-Infective Agents