Darouiche Rabih O, Mansouri Mohammad D, Gawande Purushottam V, Madhyastha Srinivasa
Center for Prostheses Infections and Infectious Disease Section, Michael E Debakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA.
J Antimicrob Chemother. 2009 Jul;64(1):88-93. doi: 10.1093/jac/dkp158. Epub 2009 May 14.
The objectives of this study were to examine: (i) synergy of the combination of triclosan and DispersinB (DspB); (ii) in vitro efficacy and durability of triclosan + DspB-coated vascular catheters; and (iii) in vivo efficacy of triclosan + DspB-coated catheters compared with chlorhexidine-silver sulfadiazine (CH-SS)-coated and uncoated (control) vascular catheters in preventing colonization by Staphylococcus aureus.
We investigated the potential synergistic antimicrobial and antibiofilm activity of triclosan and DspB by biofilm assays. The in vitro antimicrobial efficacy of triclosan + DspB-coated catheters was determined by microbial colonization assays. Antimicrobial durability of the coated catheters was tested by soaking segments in bovine serum for 7 days and determining antimicrobial activity, and by a serial plate transfer method. The in vivo efficacy of triclosan + DspB-coated catheters compared with CH-SS-coated and uncoated catheters was assessed by subcutaneous implantation of segments in a rabbit model of S. aureus infection.
The combination of triclosan and DspB showed synergistic antimicrobial and antibiofilm activity against S. aureus, Staphylococcus epidermidis and Escherichia coli, significantly reduced bacterial colonization (P < 0.05) and generally demonstrated a prolonged superior antimicrobial activity against clinical pathogens compared with CH-SS-coated catheters. Triclosan + DspB-coated and CH-SS-coated catheters exhibited equal in vivo efficacy (P <or= 0.05) in reducing colonization by S. aureus compared with uncoated catheters.
Catheters coated with the triclosan + DspB combination showed synergistic, broad-spectrum and durable antimicrobial activity. Furthermore, the in vivo efficacy of catheters coated with this unique antimicrobial/antibiofilm composition prompts clinical evaluation of such an innovative approach.
本研究的目的是检验：（i）三氯生和分散素B（DspB）联合使用的协同作用；（ii）三氯生+DspB涂层血管导管的体外有效性和耐久性；以及（iii）与氯己定-磺胺嘧啶银（CH-SS）涂层和未涂层（对照）血管导管相比，三氯生+DspB涂层导管在预防金黄色葡萄球菌定植方面的体内有效性。
我们通过生物膜试验研究了三氯生和DspB潜在的协同抗菌和抗生物膜活性。通过微生物定植试验确定三氯生+DspB涂层导管的体外抗菌效果。通过将导管段浸泡在牛血清中7天并测定抗菌活性，以及采用连续平板转移法来测试涂层导管的抗菌耐久性。通过在金黄色葡萄球菌感染的兔模型中皮下植入导管段，评估三氯生+DspB涂层导管与CH-SS涂层和未涂层导管相比的体内有效性。
三氯生和DspB的联合使用对金黄色葡萄球菌、表皮葡萄球菌和大肠杆菌表现出协同抗菌和抗生物膜活性，显著减少了细菌定植（P<0.05），并且与CH-SS涂层导管相比，通常对临床病原体表现出更长时间的优异抗菌活性。与未涂层导管相比，三氯生+DspB涂层导管和CH-SS涂层导管在减少金黄色葡萄球菌定植方面表现出相同的体内有效性（P≤0.05）。
涂有三氯生+DspB组合的导管表现出协同、广谱和持久的抗菌活性。此外，涂有这种独特抗菌/抗生物膜组合物的导管的体内有效性促使对这种创新方法进行临床评估。
