title: Bacteriophage K antimicrobial-lock technique for treatment of Staphylococcus aureus central venous catheter-related infection: a leporine model efficacy analysis.
abstract: OBJECTIVE
  To determine whether a bacteriophage antimicrobial-lock technique can reduce bacterial colonization and biofilm formation on indwelling central venous catheters in a rabbit model.
  
  
  METHODS
  Cuffed central venous catheters were inserted into the jugular vein of female New Zealand White rabbits under image guidance. Catheters were inoculated for 24 hours with broth culture of methicillin-sensitive Staphylococcus aureus. The inoculum was aspirated, and rabbits were randomly assigned to two equal groups for 24 hours: (i) untreated controls (heparinized saline lock), (ii) bacteriophage antimicrobial-lock (staphylococcal bacteriophage K, propagated titer > 10(8)/mL). Blood cultures were obtained via peripheral veins, and the catheters were removed for quantitative culture and scanning electron microscopy.
  
  
  RESULTS
  Mean colony-forming units (CFU) per cm(2) of the distal catheter segment, as a measure of biofilm, were significantly decreased in experimental animals compared with controls (control, 1.2 × 10(5) CFU/cm(2); experimental, 7.6 × 10(3); P = .016). Scanning electron microscopy demonstrated that biofilms were present on the surface of five of five control catheters but only one of five treated catheters (P = .048). Blood culture results were not significantly different between the groups.
  
  
  CONCLUSIONS
  In a rabbit model, treatment of infected central venous catheters with a bacteriophage antimicrobial-lock technique significantly reduced bacterial colonization and biofilm presence. Our data represent a preliminary step toward use of bacteriophage therapy for prevention and treatment of central venous catheter-associated infection.
authors.affiliation: Department of Radiology, Stanford University Medical Center, 725 Welch Road, Room 1690 MC 5913, Palo Alto, CA 94304. Electronic address: mlungren@gmail.com.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Lungren
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Rodney M
authors.initials: RM
authors.lastname: Donlan
authors.affiliation: Interventional Radiology Translational Research Laboratory, Department of Radiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Ravi
authors.initials: R
authors.lastname: Kankotia
authors.affiliation: Interventional Radiology Translational Research Laboratory, Department of Radiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Ben E
authors.initials: BE
authors.lastname: Paxton
authors.affiliation: Interventional Radiology Translational Research Laboratory, Department of Radiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Irene
authors.initials: I
authors.lastname: Falk
authors.affiliation: Interventional Radiology Translational Research Laboratory, Department of Radiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Diana
authors.initials: D
authors.lastname: Christensen
authors.affiliation: Interventional Radiology Translational Research Laboratory, Department of Radiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Charles Y
authors.initials: CY
authors.lastname: Kim
mesh_terms: D000818:Animals; D001435:Bacteriophages / Q000235:genetics; D018441:Biofilms; D055499:Catheter-Related Infections / Q000382:microbiology / Q000628:therapy*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D062905:Central Venous Catheters / Q000009:adverse effects*; D004195:Disease Models, Animal; D004867:Equipment Design; D005260:Female; D007601:Jugular Veins / Q000382:microbiology*; D011817:Rabbits; D013203:Staphylococcal Infections / Q000382:microbiology / Q000628:therapy*; D013211:Staphylococcus aureus / Q000235:genetics / Q000254:growth & development / Q000821:virology*
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