In VitroStudy of Antimicrobial Percutaneous Nephrostomy Catheters for Prevention of Renal Infections.
Percutaneous nephrostomy (PCN) catheters are the primary method for draining ureters obstructed by malignancy and preventing a decline of renal function. However, PCN catheter-related infections, such as pyelonephritis and urosepsis, remain a significant concern. Currently, no antimicrobial PCN catheters are available for preventing infection complications. Vascular catheters impregnated with minocycline-rifampin (M/R) and M/R with chlorhexidine coating (M/R plus CHD) have previously demonstrated antimicrobial activity. Therefore, in this study, we examined whether these combinations could be applied to PCN catheters and effectively inhibit biofilm formation by common uropathogens. Anin vitrobiofilm colonization model was used to assess the antimicrobial efficacy of M/R and M/R-plus-CHD PCN catheters against nine common multidrug-resistant Gram-positive and Gram-negative uropathogens as well asCandida glabrataandCandida albicansExperimental catheters were also assessed for durability of antimicrobial activity for up 3 weeks. PCN catheters coated with M/R plus CHD completely inhibited biofilm formation for up to 3 weeks for all the organisms tested. The reduction in colonization compared to uncoated PCN catheters was significant for all Gram-positive, Gram-negative, and fungal organisms (P< 0.05). M/R-plus-CHD PCN catheters also produced significant reductions in biofilm colonization relative to M/R PCN catheters forEnterobacterspp.,Escherichia coli,Pseudomonas aeruginosa, methicillin-resistantStaphylococcus aureus, vancomycin-resistant enterococci,C. glabrata, andC. albicans(P< 0.05). M/R-plus-CHD PCN catheters proved to be highly efficacious in preventing biofilm colonization when exposed to multidrug-resistant pathogens common in PCN catheter-associated pyelonephritis. M/R-plus-CHD PCN catheters warrant evaluation in a clinical setting to assess their ability to prevent clinically relevant nephrostomy infections.
Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Nylev
N
Vargas-Cruz
Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA rreitzel@mdanderson.org.
Ruth A
RA
Reitzel
Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Joel
J
Rosenblatt
Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Mohamed
M
Jamal
Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Ariel D
AD
Szvalb
Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Anne-Marie
AM
Chaftari
Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Ray
R
Hachem
Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Issam
I
Raad
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D018441:Biofilms / Q000187:drug effects; D002176:Candida albicans / Q000187:drug effects / Q000472:pathogenicity; D041221:Candida glabrata / Q000187:drug effects / Q000472:pathogenicity; D004754:Enterobacter / Q000187:drug effects / Q000472:pathogenicity; D004926:Escherichia coli / Q000187:drug effects / Q000472:pathogenicity; D007674:Kidney Diseases / Q000188:drug therapy* / Q000382:microbiology*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000472:pathogenicity; D000074643:Nephrotomy; D065507:Vancomycin-Resistant Enterococci / Q000187:drug effects / Q000472:pathogenicity
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents
catheter-related infection; nephrostomy; obstructed urethra; percutaneous nephrostomy catheter; pyelonephritis