In Vitro Efficacy of Antimicrobial-Treated Drainage Catheters in Preventing Bacterial Colonization in Biological Fluids

Abstract

Device-associated infections, which account for about half of the 2 million annual cases of nosocomial infections in the United States,1 can result in severe complications, impede quality of life, prolong hospital stay, and be fatal.2 Not only is the cost of managing such infections staggering, but recent US Medicare policy changes prohibit reimbursement of hospitals for the cost of managing certain healthcare-acquired complications, including catheter-associated infections.3 Although the protective capacity of surface-modified vascular and urinary catheters has been extensively studied, there is a paucity of information on antimicrobial-coated percutaneously-placed catheters that are used to drain body fluids. Organisms that cause infection of percutaneously-placed drainage catheters can originate from either the patient’s skin or the body fluids that drain through these catheters. Since catheter colonization is a prelude to clinical infection, effective antimicrobial modification of medical devices has the potential of preventing clinical infection.4 However, the activity of antimicrobial-coated drainage catheters has not been previously assessed while placed in body fluids that would simulate clinical scenarios. Since previous studies have demonstrated that central venous catheters impregnated with the combination of minocycline and rifampin (MR) protect against catheter-related bloodstream infection,4 we elected to investigate the in-vitro efficacy of pigtail Fuhrman polyurethane drainage catheters impregnated with MR against both Gram-positive and -negative bacteria in three different body fluids collected from patients.