1 Vilnius University Faculty of Medicine, M. K. Ciurlionio str. 21, Vilnius, Lithuania.
2 Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
J Med Microbiol. 2019 Mar;68(3):432-439. doi: 10.1099/jmm.0.000939. Epub 2019 Feb 8.
To develop a new in vitro model of prosthetic vascular graft infection (PVGI) and evaluate antimicrobial and biofilm-disrupting efficacy of 0.1% octenidine dihydrochloride, 10% povidone-iodine and 0.02% chlorhexidine digluconate against biofilm-producing Staphylococcus aureus (S. aureus).
The effect of antiseptics on the microscopic integrity and antimicrobial effect on S. aureus biofilms was tested by growing biofilms on glass coverslips, in the modified Lubbock chronic wound pathogenic biofilm (LCWPB) model and on the surface of vascular grafts using qualitive and quantitative methods as well as by scanning electron microscopy (SEM).
Chlorhexidine worked best on destroying the integrity of S. aureus biofilms (P=0.002). In the LCWPB model, octenidine and povidone-iodine eradicated all S. aureus colonies (from 1.79 × 10 c.f.u. ml to 0). In the newly developed PVGI model, the grafts were successfully colonized with biofilms as seen in SEM images. All antiseptics demonstrated significant antimicrobial efficacy, decreasing colony counts by seven orders of magnitude (P=0.002). Octenidine was superior to povidone-iodine (P=0.009) and chlorhexidine (P=0.041).
We implemented an innovative in vitro model on S. aureus biofilms grown in different settings, including a clinically challenging situation of PVGI. The strongest antimicrobial activity against S. aureus biofilms, grown on prosthetic vascular grafts, was showed by 0.1% octenidine dihydrochloride. We suggest that combinational therapy of antiseptics between chlorhexidine with either povidone-iodine or octenidine dihydrochloride should be tested in further experiments. Despite the need of further studies, our findings of these in vitro experiments will assist the management of vascular graft infection in clinical cases.
开发一种新的人工血管移植物感染（PVGI）体外模型，并评估 0.1%盐酸奥替尼啶、10%聚维酮碘和 0.02%葡萄糖酸氯己定对产生物膜金黄色葡萄球菌（S. aureus）的抗菌和生物膜破坏效果。
通过在改良的 Lubbock 慢性伤口致病生物膜（LCWPB）模型中以及在血管移植物表面使用定性和定量方法以及扫描电子显微镜（SEM）生长生物膜，测试防腐剂对生物膜微观完整性的影响以及对 S. aureus 生物膜的抗菌效果。
氯己定在破坏 S. aureus 生物膜的完整性方面效果最好（P=0.002）。在 LCWPB 模型中，奥替尼啶和聚维酮碘根除了所有 S. aureus 菌落（从 1.79×10 c.f.u. ml 降至 0）。在新开发的 PVGI 模型中，SEM 图像显示移植物成功定植了生物膜。所有防腐剂均表现出显著的抗菌功效，使菌落计数减少了 7 个数量级（P=0.002）。奥替尼啶优于聚维酮碘（P=0.009）和氯己定（P=0.041）。
我们在不同环境中（包括 PVGI 这一具有挑战性的临床情况）对 S. aureus 生物膜实施了一种创新的体外模型。对人工血管移植物上生长的 S. aureus 生物膜显示出最强抗菌活性的是 0.1%盐酸奥替尼啶。我们建议在进一步的实验中测试氯己定与聚维酮碘或盐酸奥替尼啶之间的防腐剂联合治疗。尽管需要进一步研究，但我们的这些体外实验结果将有助于指导临床病例中血管移植物感染的治疗。
