Abstract
BackgroundThe aim of the study was to investigate the in vivo efficacy of local and systemic antibiotic prophylaxis in the prevention of Staphylococcus (S.) epidermidis graft infection in a rat model and to evaluate the bacterial adherence to frequently used prosthetic graft materials.MethodsGraft infections were established in the subcutaneous tissue of 120 male Wistar rats by implantation of Dacron/ePTFE grafts followed by topical inoculation with 2 × 107 CFUs of clinical isolate of methicillin-resistant S. epidermidis. Each of the graft series included a control group, one contaminated group that did not receive any antibiotic prophylaxis, two contaminated groups that received systemic prophylaxis with teicoplanin or levofloxacin and two contaminated groups that received teicoplanin-soaked or levofloxacin-soaked grafts. The grafts were removed 7 days after implantation and evaluated by quantitative culture.ResultsThere was significant bacterial growth inhibition in the groups given systemic or local prophylaxis (P < 0.05). Methicillin-resistant S. epidermidis had greater affinity to Dacron graft when compared with ePTFE graft in the untreated contaminated groups (P < 0.05).ConclusionThe study demonstrated that the usage of systemic or local prophylaxis and preference of ePTFE graft can be useful in reducing the risk of vascular graft infections caused by staphylococcal strains with high levels of resistance.
Highlights
The aim of the present study was to investigate the in vivo efficacy of local and systemic antibiotic prophylaxis in the prevention of S. epidermidis graft infection in a rat model and to evaluate the bacterial adherence to frequently used prosthetic graft materials
Various studies have demonstrated that systemic antibiotic prophylaxis reduces the incidence of prosthetic vascular graft infections, but not completely prevent them [2224]
The finding that antibiotic-impregnated grafts alone can not prevent prosthetic vascular graft infection is similar to the results found by other groups [11,22]
Summary
The aim of the study was to investigate the in vivo efficacy of local and systemic antibiotic prophylaxis in the prevention of Staphylococcus (S.) epidermidis graft infection in a rat model and to evaluate the bacterial adherence to frequently used prosthetic graft materials. Graft infection often results in prolonged hospitalization, organ failure, amputation and death [4,6,7]. Most commonly contamination occurs at the time of graft insertion and the most frequent source of infection is from staphylococci from the patient's skin [3,4,9]. The most important strategies for the prevention of prosthetic infection are asepsis and the perioperative administration of systemic antibiotics [10,11,12]. In the case of vascular grafts, alternative methods such as antimicrobials bound in high concentrations to prosthetic grafts have been proposed [2,10,11,13]
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