Shah Chirag B, Mittelman Marc W, Costerton J W, Parenteau Stephen, Pelak Michael, Arsenault Richard, Mermel Leonard A
Biolink Corporation, Norwell, Massachusetts, USA.
Antimicrob Agents Chemother. 2002 Jun;46(6):1674-9. doi: 10.1128/AAC.46.6.1674-1679.2002.
Intravascular catheter-associated bloodstream infections significantly increase rates of morbidity and hospital costs. Microbial colonization and development of biofilms, which are known to be recalcitrant to antibiotic therapy, often lead to the loss of otherwise patent vascular access systems. We evaluated a new taurolidine- and citrate-based catheter lock solution (Neutrolin; Biolink Corporation, Norwell, Mass.) for its activity against planktonic microbes, antimicrobial activity in a catheter model, and biofilm eradication activity. In studies of planktonic microbes, after 24 h of contact, 675 mg of taurolidine-citrate solution per liter caused > 99% reductions in the initial counts of Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Entercoccus faecalis. A solution of 13,500 mg/liter was cidal for Candida albicans. Ports and attached catheters inoculated with 50 to 600 CFU of these bloodstream isolates per ml were locked with heparin or the taurolidine-citrate solution. After 72 h, there was no growth in the taurolidine-citrate-treated devices but the heparin-treated devices exhibited growth in the range of 6 x 10(2) to 5 x 10(6) CFU/ml. Biofilms were developed on silicone disks in modified Robbins devices with broth containing 6% serum (initial counts, 10(6) to 10(8) CFU/cm(2)). The axenic biofilms were treated for 24 h with taurolidine-citrate or heparin. Taurolidine-citrate exposure resulted in a median reduction of 4.8 logs, whereas heparin treatment resulted in a median reduction of 1.7 logs (P < 0.01). No significant differences in the effects of the two treatments against P. aeruginosa and C. albicans were observed. These findings suggest that taurolidine-citrate is a promising combination agent for the prevention and treatment of intravascular catheter-related infections.
血管内导管相关血流感染显著增加发病率和医院成本。微生物定植和生物膜形成，已知对抗生素治疗具有顽固性，常导致原本通畅的血管通路系统丧失。我们评估了一种新的基于牛磺罗定和柠檬酸盐的导管封管溶液（Neutrolin；Biolink公司，马萨诸塞州诺韦尔）对浮游微生物的活性、在导管模型中的抗菌活性以及生物膜根除活性。在浮游微生物研究中，接触24小时后，每升含675毫克牛磺罗定 - 柠檬酸盐溶液可使金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌和粪肠球菌的初始菌数减少>99%。每升含13500毫克的溶液对白色念珠菌有杀菌作用。每毫升接种50至600 CFU这些血流分离株的端口和连接导管用肝素或牛磺罗定 - 柠檬酸盐溶液封管。72小时后，牛磺罗定 - 柠檬酸盐处理的装置中无生长，但肝素处理的装置中生长范围为6×10²至5×10⁶ CFU/ml。生物膜在改良的Robbins装置中的硅胶盘上形成，培养液含6%血清（初始菌数，10⁶至10⁸ CFU/cm²）。无菌生物膜用牛磺罗定 - 柠檬酸盐或肝素处理24小时。牛磺罗定 - 柠檬酸盐处理导致菌数中位数减少4.8个对数级，而肝素处理导致菌数中位数减少1.7个对数级（P < 0.01）。两种处理对铜绿假单胞菌和白色念珠菌的效果未观察到显著差异。这些发现表明，牛磺罗定 - 柠檬酸盐是预防和治疗血管内导管相关感染的一种有前景的联合药物。
