In vitro activities of N-acetyl cysteine and levofloxacin as a catheter lock therapy against catheter-associated infections.

Autor: Mansouri MD; Baylor College of Medicine, Houston, Texas, USA.; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA., Ramanthan V; Baylor College of Medicine, Houston, Texas, USA.; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA., Mansouri DL; Baylor College of Medicine, Houston, Texas, USA.; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA., Hull RA; Baylor College of Medicine, Houston, Texas, USA.
Jazyk: angličtina
Zdroj: Journal of applied microbiology [J Appl Microbiol] 2022 May; Vol. 132 (5), pp. 3915-3924. Date of Electronic Publication: 2022 Feb 26.
DOI: 10.1111/jam.15490
Abstrakt: Aims: Since management of catheter-associated infections, which are generally biofilm-based, is attempted in certain patients such as older and frail patients by using a catheter lock solution (CLS), we examined the combination of N-acetyl cysteine (NAC), an antibiofilm agent, and levofloxacin, a broad-spectrum antimicrobial agent, for this purpose.
Methods and Results: Intravascular catheters were colonized with methicillin-resistant Staphylococcus epidermidis, levofloxacin-sensitive/methicillin-resistant Staph. aureus, levofloxacin-resistant/methicillin-resistant Staph. aureus, vancomycin-resistant Enterococcus, Escherichia coli, Klebsiella pneumoniae or Pseudomonas aeruginosa and treated with a CLS containing normal saline, NAC, levofloxacin or NAC plus levofloxacin (NACLEV) and then cultured to assess their antimicrobial activities. We also examined antibiofilm and antimicrobial activities of each CLS by scanning electron microscopy (SEM) and the mechanical integrity of catheters exposed to CLS. Treatment of colonized catheters with NACLEV-CLS significantly reduced colonization (p < 0.005) against all pathogens. SEM images also indicate reduction in colonization with NACLEV-CLS with considerable reduction in both visible bacteria and the associated biofilm. Mean tensile strength of catheters exposed to CLS was not significantly different compared to controls (p > 0.05).
Conclusions: These in vitro results suggest that NACLEV-CLS can significantly reduce all bacterial colonization and potentially help salvage infected catheters without affecting the catheter's mechanical integrity.
Significance and Impact of Study: This study presents a novel CLS with a broad spectrum of antimicrobial activity against catheter-associated infections, particularly in long-term catheters.
(© 2022 Society for Applied Microbiology. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)
Databáze: MEDLINE
Externí odkaz: