Antimicrobial Percutaneous Nephrostomy Catheters for the prevention of Renal Infections: In vitro studies.

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Antimicrobial Percutaneous Nephrostomy Catheters for the prevention of Renal Infections: In vitro studies.

Antimicrob Agents Chemother. 2017 Mar 20;:

Authors: Vargas-Cruz N, Reitzel RA, Rosenblatt J, Jamal M, Szvalb AD, Chaftari AM, Hachem R, Raad I

Abstract
Purpose - Percutaneous nephrostomy (PCN) catheters are the primary method for draining ureters obstructed by malignancy and preventing a decline of the renal function. However, PCN-related infections such as pyelonephritis and urosepsis remain a significant concern. Currently no antimicrobial PCNs are available for preventing infectious complications. Vascular catheters impregnated with Minocycline/Rifampin (M/R) and M/R with Chlorhexidine coating (M/R+CHD) have previously demonstrated antimicrobial activity. Therefore, in this study we examined whether these combinations could be applied to PCNs and effectively inhibit biofilm formation of common uropathogens.Methods - An in vitro biofilm colonization model was used to assess the antimicrobial efficacy of M/R and M/R +CHD PCNs against nine common multi-drug resistant Gram-positive, Gram-negative, and yeast uropathogens. Experimental catheters were also assessed for durability of antimicrobial activity for up 3 weeks.Results - PCNs coated with M/R+CHD completely inhibited biofilm formation for up to 3 weeks for all organisms tested. The reduction in colonization compared to uncoated PCNs was significant for all Gram-positive, Gram-negative, and fungal organisms (p < 0.05). M/R + CHD PCNs also gave significant reductions in biofilm colonization relative to M/R PCNs for Enterobacter sp., Eschericia coli, Pseudomonas aeruginosa, methicillin resistant Staphylococcus aureus, Vancomycin-resistant Enterococci, Candida glabrata and Candida albicans (p< 0.05).Conclusion - M/R+CHD PCNs proved to be highly efficacious in preventing biofilm colonization when exposed to multi-drug resistant pathogens common to PCN-associated pyelonephritis. M/R+CHD PCNs warrant evaluation in a clinical setting to assess their ability to prevent clinically relevant nephrostomy infections.

PMID: 28320713 [PubMed - as supplied by publisher]

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