title: In Vitro Approach for Identification of the Most Effective Agents for Antimicrobial Lock Therapy in the Treatment of Intravascular Catheter-Related Infections Caused by Staphylococcus aureus.
abstract: Infection of intravascular catheters by Staphylococcus aureus is a significant risk factor within the health care setting. To treat these infections and attempt salvage of an intravascular catheter, antimicrobial lock solutions (ALSs) are being increasingly used. However, the most effective ALSs against these biofilm-mediated infections have yet to be determined, and clinical practice varies greatly. The purpose of this study was to evaluate and compare the efficacies of antibiotics and antiseptics in current clinical use against biofilms produced by reference and clinical isolates of S. aureus Static and flow biofilm assays were developed using newly described in vivo-relevant conditions to examine the effect of each agent on S. aureus within the biofilm matrix. The antibiotics daptomycin, tigecycline, and rifampin and the antiseptics ethanol and Taurolock inactivated established S. aureus biofilms, while other commonly used antistaphylococcal antibiotics and antiseptic agents were less effective. These findings were confirmed by live/dead staining of S. aureus biofilms formed and treated within a flow cell model. The results from this study demonstrate the most effective clinically used agents and their concentrations which should be used within an ALS to treat S. aureus-mediated intravascular catheter-related infections.
authors.affiliation: Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: S
authors.initials: S
authors.lastname: Hogan
authors.affiliation: Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Zapotoczna
authors.affiliation: Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: N T
authors.initials: NT
authors.lastname: Stevens
authors.affiliation: Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland Department of Microbiology, Beaumont Hospital, Dublin, Ireland.
authors.forename: H
authors.initials: H
authors.lastname: Humphreys
authors.affiliation: Microbiology, School of Natural Sciences, National University of Ireland, Galway, Ireland.
authors.forename: J P
authors.initials: JP
authors.lastname: O'Gara
authors.affiliation: Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland Department of Microbiology, Connolly Hospital, Dublin, Ireland eoneill@rcsi.ie.
authors.forename: E
authors.initials: E
authors.lastname: O'Neill
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects; D055499:Catheter-Related Infections / Q000382:microbiology*; D017576:Daptomycin / Q000494:pharmacology; D000431:Ethanol / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000031:analogs & derivatives / Q000494:pharmacology; D012293:Rifampin / Q000494:pharmacology; D013211:Staphylococcus aureus; D000078304:Tigecycline
chemical_list: D000890:Anti-Infective Agents; D000431:Ethanol; D000078304:Tigecycline; D008911:Minocycline; D017576:Daptomycin; D012293:Rifampin