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Activity of ethanol and daptomycin lock on biofilm generated by an in vitro dynamic model using real subcutaneous injection ports

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Abstract

Vancomycin lock solution (LS) is recommended for the conservative treatment of subcutaneous injection port (SIP)-related infections, but may be associated with failure. We used an in vitro dynamic model of biofilm formation in an SIP, based on a continuous flow circulating via a real SIP, to assess the effectiveness of vancomycin (5 mg/ml), daptomycin (5 mg/ml) and ethanol 40 % LS in eradicating a pre-established Staphylococcus epidermidis biofilm. Heparin, Ringer’s lactate and enoxaparin sodium LS were used as controls. The logarithmic reductions of colony-forming units (CFU) were compared by Student’s t-test. After 24 h of exposure, the vancomycin LS did not exert a greater bactericidal effect than the heparin LS control (mean logarithmic reduction: 2.27 ± 0.58 vs. 1.34 ± 0.22, respectively, p = 0.3). The mean logarithmic reduction was greater with daptomycin LS (5.45 ± 0.14 vs. 0.39 ± 0.12, p < 0.01) and ethanol LS (6.79 ± 1.03 vs. 1.43 ± 0.54, p = 0.02). Bacterial revival after exposure to 24 h of LS was assessed. The mean viable bacteria count was significantly higher for vancomycin LS (9.36 ± 0.10 log10CFU) and daptomycin LS (9.16 ± 0.02 log10CFU) than for ethanol LS (2.95 ± 1.65 log10CFU). Ethanol appeared to be the most attractive option to treat SIP-related infection, but its poor ability to entirely disrupt the biofilm structure may require its use in association with a dispersal agent to avoid renewal of the biofilm.

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Acknowledgements

Damien Balestrino, Nicolas Charbonnel [Clermont Université, UMR CNRS 6023 Laboratoire Microorganismes: Génome Environnement (LMGE), Université d’Auvergne, CHU Clermont Ferrand, 63003 Clermont-Ferrand, France], Henri Laurichesse, Jean Beytout, Violaine Corbin (Service des Maladies Infectieuses, Pôle REUNNHIR, CHU Clermont-Ferrand, Clermont-Ferrand, France), Bertrand Souweine, Alexandre Lautrette, Natacha Mrozek (Réanimation Médicale, Pôle REUNNHIR, CHU Clermont-Ferrand, Clermont-Ferrand, France), Christelle Blavignac (CICS platform, Clermont University, electron microscopy).

This research was supported, in part, by an unrestricted, investigator-initiated grant from Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, MA 02421, USA. We thank Bard Access Systems, Salt Lake City, UT, USA, for providing the titanium central venous pressure port (TICVP) and Jeffrey Watts for reviewing the manuscript (Université Clermont 1, Faculté de Médecine de Clermont Ferrand, 63003 Clermont-Ferrand, France).

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The authors declare that they have no conflict of interest.

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  1. LMGE «Laboratoire Micro-organismes: Génome et Environnement»—UMR CNRS 6023—Clermont Université, Université Blaise Pascal et Université d’Auvergne, CHU Clermont Ferrand, 63003, Clermont-Ferrand, France

    C. Aumeran, P. Guyot, M. Boisnoir, C. Robin-Hennequin, M. Vidal, C. Forestier, O. Traore & O. Lesens

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  1. C. Aumeran
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  2. P. Guyot
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  3. M. Boisnoir
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  8. O. Lesens
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Clermont-Ferrand Biofilm Study Group

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Correspondence to O. Lesens.

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Aumeran, C., Guyot, P., Boisnoir, M. et al. Activity of ethanol and daptomycin lock on biofilm generated by an in vitro dynamic model using real subcutaneous injection ports. Eur J Clin Microbiol Infect Dis 32, 199–206 (2013). https://doi.org/10.1007/s10096-012-1732-5

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  • DOI: https://doi.org/10.1007/s10096-012-1732-5

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