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Abstract

Purpose . To develop a new in vitro model of prosthetic vascular graft infection (PVGI) and evaluate antimicrobial and biofilm-disrupting efficacy of 0.1% octenidine dihydrochloride, 10% povidone-iodine and 0.02% chlorhexidine digluconate against biofilm-producing Staphylococcus aureus ( S. aureus ).

Methodology . The effect of antiseptics on the microscopic integrity and antimicrobial effect on S. aureus biofilms was tested by growing biofilms on glass coverslips, in the modified Lubbock chronic wound pathogenic biofilm (LCWPB) model and on the surface of vascular grafts using qualitive and quantitative methods as well as by scanning electron microscopy (SEM).

Results . Chlorhexidine worked best on destroying the integrity of S. aureus biofilms (P=0.002). In the LCWPB model, octenidine and povidone-iodine eradicated all S. aureus colonies (from 1.79 × 10  c.f.u. ml to 0). In the newly developed PVGI model, the grafts were successfully colonized with biofilms as seen in SEM images. All antiseptics demonstrated significant antimicrobial efficacy, decreasing colony counts by seven orders of magnitude (P=0.002). Octenidine was superior to povidone-iodine (P=0.009) and chlorhexidine (P=0.041).

Conclusion . We implemented an innovative in vitro model on S. aureus biofilms grown in different settings, including a clinically challenging situation of PVGI. The strongest antimicrobial activity against S. aureus biofilms, grown on prosthetic vascular grafts, was showed by 0.1% octenidine dihydrochloride. We suggest that combinational therapy of antiseptics between chlorhexidine with either povidone-iodine or octenidine dihydrochloride should be tested in further experiments. Despite the need of further studies, our findings of these in vitro experiments will assist the management of vascular graft infection in clinical cases.

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2019-02-08
2024-03-29
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References

  1. Revest M, Camou F, Senneville E, Caillon J, Laurent F et al. Medical treatment of prosthetic vascular graft infections: review of the literature and proposals of a Working Group. Int J Antimicrob Agents 2015; 46:254–265 [View Article]
    [Google Scholar]
  2. FitzGerald SF, Kelly C, Humphreys H. Diagnosis and treatment of prosthetic aortic graft infections: confusion and inconsistency in the absence of evidence or consensus. J Antimicrob Chemother 2005; 56:996–999 [View Article]
    [Google Scholar]
  3. Seeger JM. Management of patients with prosthetic vascular graft infection. Am Surg 2000; 66:166–177
    [Google Scholar]
  4. Erb S, Sidler JA, Elzi L, Gurke L, Battegay M et al. Surgical and antimicrobial treatment of prosthetic vascular graft infections at different surgical sites: a retrospective study of treatment outcomes. PLoS One 2014; 9:e112947 [View Article]
    [Google Scholar]
  5. Gilbert V, Kelly T, Grossi R. Source control and graft preservation using negative pressure wound therapy with antibiotic instillation: a case report. Cureus 2016; 8:e855 [View Article]
    [Google Scholar]
  6. Arciola CR, Campoccia D, Montanaro L. Implant infections: adhesion, biofilm formation and immune evasion. Nat Rev Microbiol 2018; 16:397–409 [View Article]
    [Google Scholar]
  7. Valentine RJ. Diagnosis and management of aortic graft infection. Semin Vasc Surg 2001; 14:292–301 [View Article]
    [Google Scholar]
  8. Homer-Vanniasinkam S. Surgical site and vascular infections: treatment and prophylaxis. Int J Infect Dis 2007; 11:S17–S22 [View Article]
    [Google Scholar]
  9. Dongari-Bagtzoglou A. Pathogenesis of mucosal biofilm infections: challenges and progress. Expert Rev Anti Infect Ther 2008; 6:201–208 [View Article]
    [Google Scholar]
  10. Jones CJ, Newsom D, Kelly B, Irie Y, Jennings LK et al. ChIP-Seq and RNA-seq reveal an AmrZ-mediated mechanism for cyclic di-GMP synthesis and biofilm development by Pseudomonas aeruginosa. PLoS Pathog 2014; 10:e1003984 [View Article]
    [Google Scholar]
  11. Balaban N, Cirioni O, Giacometti A, Ghiselli R, Braunstein JB et al. Treatment of Staphylococcus aureus biofilm infection by the quorum-sensing inhibitor RIP. Antimicrob Agents Chemother 2007; 51:2226–2229 [View Article]
    [Google Scholar]
  12. Tote K, Horemans T, Berghe DV, Maes L, Cos P. Inhibitory effect of biocides on the viable masses and matrices of Staphylococcus aureus and Pseudomonas aeruginosa biofilms. Appl Environ Microbiol 2010; 76:3135–3142 [View Article]
    [Google Scholar]
  13. Stewart PS, Franklin MJ. Physiological heterogeneity in biofilms. Nat Rev Micro 2008; 6:199–210 [View Article]
    [Google Scholar]
  14. Richards JJ, Melander C. Controlling bacterial biofilms. ChemBioChem 2009; 10:2287–2294 [View Article]
    [Google Scholar]
  15. Rewatkar AR, Wadher BJ. Staphylococcus aureus and Pseudomonas aeruginosa- biofilm formation methods. J Pharm Biol Sci 2013; 8:36–40 [View Article]
    [Google Scholar]
  16. Darwish SF, Asfour HA. Investigation of biofilm forming ability in staphylococci causing bovine mastitis using phenotypic and genotypic assays. ScientificWorldJournal 2013; 2013:378492 [View Article]
    [Google Scholar]
  17. Freeman DJ, Falkiner FR, Keane CT. New method for detecting slime production by coagulase negative staphylococci. J Clin Pathol 1989; 42:872–874 [View Article]
    [Google Scholar]
  18. Metzler A. Honors Research Thesis: Department of Animal Science The Ohio State University; 2016
    [Google Scholar]
  19. Sun Y, Dowd SE, Smith E, Rhoads DD, Wolcott RD. In vitro multispecies Lubbock chronic wound biofilm model. Wound Repair Regen 2008; 16:805–813 [View Article]
    [Google Scholar]
  20. Lewis K. Persister cells, dormancy and infectious disease. Nat Rev Microbiol 2007; 5:48–56 [View Article]
    [Google Scholar]
  21. Smith K, Hunter IS. Efficacy of common hospital biocides with biofilms of multi-drug resistant clinical isolates. J Med Microbiol 2008; 57:966–973 [View Article]
    [Google Scholar]
  22. Fraise AP. European norms for disinfection testing. J Hosp Infect 2008; 70:8–10 [View Article]
    [Google Scholar]
  23. Herscu G, Wilson SE. Prosthetic infection: lessons from treatment of the infected vascular graft. Surg Clin North Am 2009; 89:391–401 viii [View Article]
    [Google Scholar]
  24. Daeschlein G. Antimicrobial and antiseptic strategies in wound management. Int Wound J 2013; 10:9–14 [View Article]
    [Google Scholar]
  25. Trautner BW, Darouiche RO. Catheter-associated infections: pathogenesis affects prevention. Arch Intern Med 2004; 164:842–850
    [Google Scholar]
  26. Zhao G, Hochwalt PC, Usui ML, Underwood RA, Singh PK et al. Delayed wound healing in diabetic (db/db) mice with Pseudomonas aeruginosa biofilm challenge: a model for the study of chronic wounds. Wound Repair Regen 2010; 18:467–477 [View Article]
    [Google Scholar]
  27. Clutterbuck AL, Woods EJ, Knottenbelt DC, Clegg PD, Cochrane CA et al. Biofilms and their relevance to veterinary medicine. Vet Microbiol 2007; 121:1–17 [View Article]
    [Google Scholar]
  28. Nagpal A, Sohail MR. Prosthetic vascular graft infections: a contemporary approach to diagnosis and management. Curr Infect Dis Rep 2011; 13:317–323 [View Article]
    [Google Scholar]
  29. Hasse B, Husmann L, Zinkernagel A, Weber R, Lachat M et al. Vascular graft infections. Swiss Med Wkly 2013; 143:w13754
    [Google Scholar]
  30. Sousa JV, Antunes L, Mendes C, Marinho A, Gonçalves A et al. Prosthetic vascular graft infections: a center experience. Angiol Cir Vasc 2014; 10:52–57 [View Article]
    [Google Scholar]
  31. Chen L, Wen YM. The role of bacterial biofilm in persistent infections and control strategies. Int J Oral Sci 2011; 3:66–73 [View Article]
    [Google Scholar]
  32. McKean SC, Rose JJ, Dressler DD, Brotman DJ, Ginsberg JS. Principles and practice of hospital medicine, Ch. 196. Intravascular Catheter-Related Infections: Management and Prevention McGraw-Hill Education; 2011 www.accessmedicine.com
    [Google Scholar]
  33. Russell AD, Day MJ. Antibacterial activity of chlorhexidine. J Hosp Infect 1993; 25:229–238 [View Article]
    [Google Scholar]
  34. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999; 12:147–179 [View Article]
    [Google Scholar]
  35. Johani K, Malone M, Jensen SO, Dickson HG, Gosbell IB et al. Evaluation of short exposure times of antimicrobial wound solutions against microbial biofilms: from in vitro to in vivo. J Antimicrob Chemother 2018; 73:494–502 [View Article]
    [Google Scholar]
  36. Amalaradjou M, Venkitanarayanan K. Antibiofilm effect of Octenidine hydrochloride on Staphylococcus aureus, MRSA and VRSA. Pathogens 2014; 3:404–416 [View Article]
    [Google Scholar]
  37. Hoekstra MJ, Westgate SJ, Mueller S. Povidone-iodine ointment demonstrates in vitro efficacy against biofilm formation. Int Wound J 2017; 14:172–179 [View Article]
    [Google Scholar]
  38. Liu JX, Werner JA, Buza JA, Kirsch T, Zuckerman JD et al. Povidone-iodine solutions inhibit cell migration and survival of osteoblasts, fibroblasts, and myoblasts. Spine 2017; 42:1757–1762 [View Article]
    [Google Scholar]
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