1887

Abstract

Coagulase-negative staphylococci (CoNS) are the main causative agents of bacteraemia in infants managed in neonatal intensive care units (NICUs). Intraluminal colonization of long-term central venous catheters by these bacteria and subsequent biofilm formation are the prerequisites of the bloodstream infections acquired in NICUs. The catheter lock technique has been used to treat catheter colonization; however, the optimum choice of antimicrobial agents and their corresponding concentrations and exposure times have not been determined. The effectiveness of catheter lock solutions (CLSs) was assessed by determining the minimal biofilm eradication concentration of antimicrobial agents against CoNS biofilms. Five conventional antibiotics (oxacillin, gentamicin, vancomycin, ciprofloxacin and rifampicin) alone or in combination, as well as ethanol, were evaluated. Ethanol was found to be superior to all of these conventional antibiotics when used as a CLS. A time–kill study and confocal laser scanning microscopy revealed that exposure to 40 % ethanol for 1 h was sufficient to kill CoNS biofilm cells. To our knowledge, this is the first study to provide solid evidence to support the rationale of using ethanol at low concentrations for a short time as a CLS, instead of using conventional antibiotics at high concentrations for a long period to treat catheter-related bloodstream infections.

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2009-04-01
2019-11-19
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References

  1. Ackoundou-N'guessan, C., Heng, A.-E., Guenu, S., Charbonne, F., Traore, O., Deteix, P. & Souweine, B. ( 2006; ). Ethanol lock solution as an adjunct treatment for preventing recurrent catheter-related sepsis – first case report in dialysis setting. Nephrol Dial Transplant 21, 3339–3340.[CrossRef]
    [Google Scholar]
  2. Alam, M., Sultana, M., Nair, G. B., Siddique, A. K., Hasan, N. A., Sack, R. B., Sack, D. A., Ahmed, K. U., Sadique, A. & other authors ( 2007; ). Viable but nonculturable Vibrio cholerae O1 in biofilms in the aquatic environment and their role in cholera transmission. Proc Natl Acad Sci U S A 104, 17801–17806.[CrossRef]
    [Google Scholar]
  3. Allon, M. ( 2003; ). Prophylaxis against dialysis catheter-related bacteremia with a novel antimicrobial lock solution. Clin Infect Dis 36, 1539–1544.[CrossRef]
    [Google Scholar]
  4. Allon, M. ( 2004; ). Dialysis catheter-related bacteremia: treatment and prophylaxis. Am J Kidney Dis 44, 779–791.[CrossRef]
    [Google Scholar]
  5. Bailey, E., Berry, N. & Cheesbrough, J. S. ( 2002; ). Antimicrobial lock therapy for catheter-related bacteraemia among patients on maintenance haemodialysis. J Antimicrob Chemother 50, 615–617.[CrossRef]
    [Google Scholar]
  6. Bastani, B., Minton, J. & Islam, S. ( 2000; ). Insufficient penetration of systemic vancomycin into the PermCath lumen. Nephrol Dial Transplant 15, 1035–1037.[CrossRef]
    [Google Scholar]
  7. Benjamin, D. K., Jr, Miller, W., Garges, H., Benjamin, D. K., McKinney, R. E., Jr, Cotton, M., Fisher, R. G. & Alexander, K. A. ( 2001; ). Bacteremia, central catheters, and neonates: when to pull the line. Pediatrics 107, 1272–1276.[CrossRef]
    [Google Scholar]
  8. Berney, M., Hammes, F., Bosshard, F., Weilenmann, H. U. & Egli, T. ( 2007; ). Assessment and interpretation of bacterial viability by using the LIVE/DEAD BacLight Kit in combination with flow cytometry. Appl Environ Microbiol 73, 3283–3290.[CrossRef]
    [Google Scholar]
  9. Berrington, A. & Gould, F. K. ( 2001; ). Use of antibiotic locks to treat colonized central venous catheters. J Antimicrob Chemother 48, 597–603.[CrossRef]
    [Google Scholar]
  10. Bradford, R., Abdul Manan, R., Daley, A. J., Pearce, C., Ramalingam, A., D'Mello, D., Mueller, Y., Uahwatanasakul, W., Qu, Y. & other authors ( 2006; ). Coagulase-negative staphylococci in very-low-birth-weight infants: inability of genetic markers to distinguish invasive strains from blood culture contaminants. Eur J Clin Microbiol Infect Dis 25, 283–290.[CrossRef]
    [Google Scholar]
  11. Castagnola, E., Moroni, C., Gandullia, P., Oddone, M., Peri, C., Casciaro, R. & De Alessandri, A. ( 2006; ). Catheter lock and systemic infusion of linezolid for treatment of persistent Broviac catheter-related staphylococcal bacteremia. Antimicrob Agents Chemother 50, 1120–1121.[CrossRef]
    [Google Scholar]
  12. Ceri, H., Olson, M. E., Stremick, C., Read, R. R., Morck, D. & Buret, A. ( 1999; ). The Calgary Biofilm Device: new technology for rapid determination of antibiotic susceptibilities of bacterial biofilms. J Clin Microbiol 37, 1771–1776.
    [Google Scholar]
  13. Christensen, G. D., Simpson, W. A., Younger, J. J., Baddour, L. M., Barrett, F. F., Melton, D. M. & Beachey, E. H. ( 1985; ). Adherence of coagulase-negative staphylococci to plastic tissue culture plates: a quantitative model for the adherence of staphylococci to medical devices. J Clin Microbiol 22, 996–1006.
    [Google Scholar]
  14. Curtin, J., Cormican, M., Fleming, G., Keelehan, J. & Colleran, E. ( 2003; ). Linezolid compared with eperezolid, vancomycin, and gentamicin in an in vitro model of antimicrobial lock therapy for Staphylococcus epidermidis central venous catheter-related biofilm infections. Antimicrob Agents Chemother 47, 3145–3148.[CrossRef]
    [Google Scholar]
  15. Deighton, M. A., Capstick, J., Domalewski, E. & van Nguyen, T. ( 2001; ). Methods for studying biofilms produced by Staphylococcus epidermidis. Methods Enzymol 336, 177–195.
    [Google Scholar]
  16. Donlan, R. M. ( 2000; ). Role of biofilms in antimicrobial resistance. ASAIO J 46, S47–S52.[CrossRef]
    [Google Scholar]
  17. Dunne, W. M., Jr, Mason, E. O., Jr & Kaplan, S. L. ( 1993; ). Diffusion of rifampin and vancomycin through a Staphylococcus epidermidis biofilm. Antimicrob Agents Chemother 37, 2522–2526.[CrossRef]
    [Google Scholar]
  18. Edmiston, C. E., Jr, Goheen, M. P., Seabrook, G. R., Johnson, C. P., Lewis, B. D., Brown, K. R. & Towne, J. B. ( 2006; ). Impact of selective antimicrobial agents on staphylococcal adherence to biomedical devices. Am J Surg 192, 344–354.[CrossRef]
    [Google Scholar]
  19. Fernandez-Hidalgo, N., Almirante, B., Calleja, R., Ruiz, I., Planes, A. M., Rodriguez, D., Pigrau, C. & Pahissa, A. ( 2006; ). Antibiotic-lock therapy for long-term intravascular catheter-related bacteraemia: results of an open, non-comparative study. J Antimicrob Chemother 57, 1172–1180.[CrossRef]
    [Google Scholar]
  20. Gagnon, R. F., Richards, G. K. & Subang, R. ( 1993; ). Vancomycin therapy of experimental peritoneal catheter-associated infection (Staphylococcus epidermidis) in a mouse model. Perit Dial Int 13 (Suppl. 2), S310–S312.
    [Google Scholar]
  21. Guedon, C., Nouvellon, M., Lalaude, O. & Lerebours, E. ( 2002; ). Efficacy of antibiotic-lock technique with teicoplanin in Staphylococcus epidermidis catheter-related sepsis during long-term parenteral nutrition. JPEN J Parenter Enteral Nutr 26, 109–113.[CrossRef]
    [Google Scholar]
  22. Hyatt, J. M., Nix, D. E. & Schentag, J. J. ( 1994; ). Pharmacokinetic and pharmacodynamic activities of ciprofloxacin against strains of Streptococcus pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa for which MICs are similar. Antimicrob Agents Chemother 38, 2730–2737.[CrossRef]
    [Google Scholar]
  23. Kite, P., Eastwood, K., Sugden, S. & Percival, S. L. ( 2004; ). Use of in vivo-generated biofilms from hemodialysis catheters to test the efficacy of a novel antimicrobial catheter lock for biofilm eradication in vitro. J Clin Microbiol 42, 3073–3076.[CrossRef]
    [Google Scholar]
  24. Klingenberg, C., Aarag, E., Ronnestad, A., Sollid, J. E., Abrahamsen, T. G., Kjeldsen, G. & Flaegstad, T. ( 2005; ). Coagulase-negative staphylococcal sepsis in neonates. Association between antibiotic resistance, biofilm formation and the host inflammatory response. Pediatr Infect Dis J 24, 817–822.[CrossRef]
    [Google Scholar]
  25. Laird, J., Soutar, R. & Butcher, I. ( 2005; ). Complications of the ethanol-lock technique in the treatment of central venous catheter sepsis. J Infect 51, 338
    [Google Scholar]
  26. Lee, J. Y., Ko, K. S., Peck, K. R., Oh, W. S. & Song, J. H. ( 2006; ). In vitro evaluation of the antibiotic lock technique (ALT) for the treatment of catheter-related infections caused by staphylococci. J Antimicrob Chemother 57, 1110–1115.[CrossRef]
    [Google Scholar]
  27. Lewis, K. ( 2005; ). Persister cells and the riddle of biofilm survival. Biochemistry (Mosc) 70, 267–274.[CrossRef]
    [Google Scholar]
  28. Mermel, L. A., Farr, B. M., Sherertz, R. J., Raad, I. I., O'Grady, N., Harris, J. S. & Craven, D. E. ( 2001; ). Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 32, 1249–1272.[CrossRef]
    [Google Scholar]
  29. Messing, B., Peitra-Cohen, S., Debure, A., Beliah, M. & Bernier, J. J. ( 1988; ). Antibiotic-lock technique: a new approach to optimal therapy for catheter-related sepsis in home-parenteral nutrition patients. JPEN J Parenter Enteral Nutr 12, 185–189.[CrossRef]
    [Google Scholar]
  30. Metcalf, S. C., Chambers, S. T. & Pithie, A. D. ( 2004; ). Use of ethanol locks to prevent recurrent central line sepsis. J Infect 49, 20–22.[CrossRef]
    [Google Scholar]
  31. Monzon, M., Oteiza, C., Leiva, J. & Amorena, B. ( 2001; ). Synergy of different antibiotic combinations in biofilms of Staphylococcus epidermidis. J Antimicrob Chemother 48, 793–801.[CrossRef]
    [Google Scholar]
  32. O'Neill, A. J., Miller, K., Oliva, B. & Chopra, I. ( 2004; ). Comparison of assays for detection of agents causing membrane damage in Staphylococcus aureus. J Antimicrob Chemother 54, 1127–1129.[CrossRef]
    [Google Scholar]
  33. Onland, W., Shin, C. E., Fustar, S., Rushing, T. & Wong, W. Y. ( 2006; ). Ethanol-lock technique for persistent bacteremia of long-term intravascular devices in pediatric patients. Arch Pediatr Adolesc Med 160, 1049–1053.[CrossRef]
    [Google Scholar]
  34. Opilla, M. T., Kirby, D. F. & Edmond, M. B. ( 2007; ). Use of ethanol lock therapy to reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients. JPEN J Parenter Enteral Nutr 31, 302–305.[CrossRef]
    [Google Scholar]
  35. Qin, Z., Lee, B., Yang, L., Zhang, J., Yang, X., Qu, D., Jiang, H. & Molin, S. ( 2007a; ). Antimicrobial activities of YycG histidine kinase inhibitors against Staphylococcus epidermidis biofilms. FEMS Microbiol Lett 273, 149–156.[CrossRef]
    [Google Scholar]
  36. Qin, Z., Yang, X., Yang, L., Jiang, J., Ou, Y., Molin, S. & Qu, D. ( 2007b; ). Formation and properties of in vitro biofilms of ica-negative Staphylococcus epidermidis clinical isolates. J Med Microbiol 56, 83–93.[CrossRef]
    [Google Scholar]
  37. Raad, I., Hanna, H., Dvorak, T., Chaiban, G. & Hachem, R. ( 2007; ). Optimal antimicrobial catheter lock solution, using different combinations of minocycline, EDTA, and 25-percent ethanol, rapidly eradicates organisms embedded in biofilm. Antimicrob Agents Chemother 51, 78–83.[CrossRef]
    [Google Scholar]
  38. Saginur, R., Stdenis, M., Ferris, W., Aaron, S. D., Chan, F., Lee, C. & Ramotar, K. ( 2006; ). Multiple combination bactericidal testing of staphylococcal biofilms from implant-associated infections. Antimicrob Agents Chemother 50, 55–61.[CrossRef]
    [Google Scholar]
  39. Shah, C. B., Mittelman, M. W., Costerton, J. W., Parenteau, S., Pelak, M., Arsenault, R. & Mermel, L. A. ( 2002; ). Antimicrobial activity of a novel catheter lock solution. Antimicrob Agents Chemother 46, 1674–1679.[CrossRef]
    [Google Scholar]
  40. Shama, A., Patole, S. K. & Whitehall, J. S. ( 2002; ). Intravenous rifampicin in neonates with persistent staphylococcal bacteraemia. Acta Paediatr 91, 670–673.[CrossRef]
    [Google Scholar]
  41. Sherertz, R. J., Boger, M. S., Collins, C. A., Mason, L. & Raad, I. I. ( 2006; ). Comparative in vitro efficacies of various catheter lock solutions. Antimicrob Agents Chemother 50, 1865–1868.[CrossRef]
    [Google Scholar]
  42. Sissons, C. H., Wong, L. & Cutress, T. W. ( 1996; ). Inhibition by ethanol of the growth of biofilm and dispersed microcosm dental plaques. Arch Oral Biol 41, 27–34.[CrossRef]
    [Google Scholar]
  43. Spoering, A. L. & Lewis, K. ( 2001; ). Biofilms and planktonic cells of Pseudomonas aeruginosa have similar resistance to killing by antimicrobials. J Bacteriol 183, 6746–6751.[CrossRef]
    [Google Scholar]
  44. Stocks, S. M. ( 2004; ). Mechanism and use of the commercially available viability stain, BacLight. Cytometry A 61, 189–195.
    [Google Scholar]
  45. Stoll, B. J., Hansen, N., Fanaroff, A. A., Wright, L. L., Carlo, W. A., Ehrenkranz, R. A., Lemons, J. A., Donovan, E. F., Stark, A. R. & other authors ( 2002; ). Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics 110, 285–291.[CrossRef]
    [Google Scholar]
  46. van de Wetering, M. D. & van Woensel, J. B. ( 2007; ). Prophylactic antibiotics for preventing early central venous catheter Gram positive infections in oncology patients. Cancer Treat Rev 31, 186–196.
    [Google Scholar]
  47. Villari, P., Sarnataro, C. & Iacuzio, L. ( 2000; ). Molecular epidemiology of Staphylococcus epidermidis in a neonatal intensive care unit over a three-year period. J Clin Microbiol 38, 1740–1746.
    [Google Scholar]
  48. von Eiff, C., Peters, G. & Heilmann, C. ( 2002; ). Pathogenesis of infections due to coagulase-negative staphylococci. Lancet Infect Dis 2, 677–685.[CrossRef]
    [Google Scholar]
  49. Zabinski, R. A., Larsson, A. J., Walker, K. J., Gilliland, S. S. & Rotschafer, J. C. ( 1993; ). Elimination of quinolone antibiotic carryover through use of antibiotic-removal beads. Antimicrob Agents Chemother 37, 1377–1379.[CrossRef]
    [Google Scholar]
  50. Zimmerli, W., Frei, R., Widmer, A. F. & Rajacic, Z. ( 1994; ). Microbiological tests to predict treatment outcome in experimental device-related infections due to Staphylococcus aureus. J Antimicrob Chemother 33, 959–967.[CrossRef]
    [Google Scholar]
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