Improved Antibiotic-Impregnated Catheters with Extended-Spectrum Activity against Resistant Bacteria and Fungi
Improved Antibiotic-Impregnated Catheters with Extended-Spectrum Activity against Resistant Bacteria and Fungi
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DOI：
10.1128/aac.05836-11
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发表时间：
2012-02-01
影响因子：
4.9
通讯作者：
Hachem, Ray Y.
中科院分区：
文献类型：
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作者：
Raad, Issam;Mohamed, Jamal A.;Hachem, Ray Y.
米诺环素-利福平浸透的中心静脉导管（M/R CVCs）已被证明可有效减少导管相关血流感染（CRBSI），并抑制耐药革兰氏阳性和革兰氏阴性病原体（铜绿假单胞菌和假丝酵母除外）的生物膜粘附。为了扩大抗菌活性的范围，我们开发了一种添加氯己定（CHX-M/R）的新型第二代M/R导管。用CHX-M/R浸渍CVCs和外周插入中心导管（PICCs），并与第一代M/R导管、CHX-银磺胺嘧啶处理的CVCs （CHX/SS-CVCs）、氯己定处理的PICCs和未涂覆的PICCs进行比较。采用生物膜导管定植模型，评估导管对耐甲氧西林金黄色葡萄球菌（MRSA）、耐万古霉素屎肠球菌（VRE）、铜绿假单胞菌、白色念珠菌和光假丝酵母的疗效。CHX-M/ r浸渍CVCs是唯一能在所有时间间隔内完全抑制所有耐药细菌和真菌生物被膜定植的抗菌导管，且显著优于未浸渍CVCs (P值均为
Minocycline-rifampin-impregnated central venous catheters (M/R CVCs) have been shown to be efficacious in reducing catheter-related bloodstream infections (CRBSI) and inhibiting the biofilm adherence of resistant Gram-positive and Gram-negative pathogens, with the exception of Pseudomonas aeruginosa and Candida spp. To expand the spectrum of antimicrobial activity, a novel second-generation M/R catheter was developed by adding chlorhexidine (CHX-M/R). CVCs and peripherally inserted central catheters (PICCs) were impregnated with CHX-M/R and compared with first-generation M/R catheters, CHX-silver sulfadiazine-treated CVCs (CHX/SS-CVCs), chlorhexidine-treated PICCs, and uncoated catheters. A biofilm catheter colonization model was used to assess the efficacy of catheters against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium (VRE), P. aeruginosa, Candida albicans, and Candida glabrata. CHX-M/R-impregnated CVCs were the only antimicrobial catheters that completely inhibited the biofilm colonization of all resistant bacterial and fungal organisms tested at all time intervals, and they were significantly superior to uncoated catheters (all P values were