Abstract
The aim of this study was to evaluate the effectiveness of a moxifloxacin-loaded organic–inorganic sol-gel (A50) by locally preventing the catheter-related bloodstream infection (CRBSI) provoked by Staphylococcus epidermidis (S. epidermidis) and the effect resulting from its hydrolytic degradation on coagulation by using a rabbit in-vivo model. A50 coating can completely inhibit growth and would locally prevent CRBSI provoked by S. epidermidis. None of the coagulation blood parameters showed a significant difference constant over time between the control catheter group and the A50-coated catheter group, despite the visible silica release resulting from physiological A50 sol-gel degradation detected in serum at least during the first week. At pathological level, foreign body reaction was present in both of types of catheter, and it was characterized by the presence of macrophages and foreign body giant cell. However, this reaction was different in each group: the A50-coated catheter group showed a higher inflammation with histiocytes, which were forming granuloma-like aggregates with an amorphous crystalline material inside, accompanied by other inflammatory cells such as plasma cells, lymphocytes and mast cells. In conclusion, A50 coating a venous catheter showed excellent bactericidal anti-biofilm response since it completely inhibited S. epidermidis biofilm development and, far from showing procoagulant effects, showed slightly anticoagulant effects.
Highlights
More than half of hospitalized patients use a peripheral intravenous catheter (PIVC) and over one billion of these devices are used per year around world [1]
The aim of this study was to evaluate the effectiveness of a moxifloxacin-loaded organic–inorganic sol-gel by preventing locally the catheter-related bloodstream infection (CRBSI) caused by Staphylococcus epidermidis and the effect resulting from its hydrolytic degradation on coagulation by using a rabbit in-vivo model
Our results show that A50 coating can completely inhibit the growth and would locally prevent CRBSI provoked by S. epidermidis (Figure 4E), the most common pathogen related to this kind of infection [22], but it would inhibit other bacteria related to this infection, such as other CoN staphylococci, some enterobacteria, and even S. aureus [22]
Summary
More than half of hospitalized patients use a peripheral intravenous catheter (PIVC) and over one billion of these devices are used per year around world [1]. CRBSI is defined as the presence of bacteremia originating from an intravenous catheter. This infection is one of the most frequent, lethal, and costly. The incidence of CoNS, S. aureus and yeasts decreased significantly over time, while Gram-negative bacilli and enterococci remained stable over time in terms of CRSBSI per 1000 admissions [6]. For all these organisms, biofilm development on the surface of indwelling catheters is central to the pathogenesis of this infection [7]
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