Vancomycin penetration into biofilm covering infected prostheses and effect on bacteria. 1994

R O Darouiche, and A Dhir, and A J Miller, and G C Landon, and I I Raad, and D M Musher
Department of Medicine (Infectious Disease Section), VA Medical Center, Houston, TX 77030.

To evaluate the adequacy of penetration of antibiotics into biofilm, a novel in vitro model for prosthesis-related infection was developed. Sterile stainless steel orthopedic nuts were incubated with slime-producing Staphylococcus epidermidis. Biofilm-covered nuts were exposed to varying concentrations of vancomycin; then biofilms were harvested. Vancomycin levels in biofilm, as measured by fluorescent polarization immunoassay, far exceeded the MIC and MBC of vancomycin for the organism. Bacterial growth in biofilm was inversely related to vancomycin concentration in biofilm, but even extremely high drug concentrations did not eradicate bacteria embedded in biofilm. The MICs and MBCs for bacteria recovered from biofilm did not differ from those for incubating organisms. Thus, failure of glycopeptide antibiotics to cure prosthesis-related infection is not due to poor penetration of drugs into biofilm but likely due to diminished antimicrobial effect on bacteria in the biofilm environment.

UI MeSH Term Description Entries
D008826 Microbial Sensitivity Tests Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses). Bacterial Sensitivity Tests,Drug Sensitivity Assay, Microbial,Minimum Inhibitory Concentration,Antibacterial Susceptibility Breakpoint Determination,Antibiogram,Antimicrobial Susceptibility Breakpoint Determination,Bacterial Sensitivity Test,Breakpoint Determination, Antibacterial Susceptibility,Breakpoint Determination, Antimicrobial Susceptibility,Fungal Drug Sensitivity Tests,Fungus Drug Sensitivity Tests,Sensitivity Test, Bacterial,Sensitivity Tests, Bacterial,Test, Bacterial Sensitivity,Tests, Bacterial Sensitivity,Viral Drug Sensitivity Tests,Virus Drug Sensitivity Tests,Antibiograms,Concentration, Minimum Inhibitory,Concentrations, Minimum Inhibitory,Inhibitory Concentration, Minimum,Inhibitory Concentrations, Minimum,Microbial Sensitivity Test,Minimum Inhibitory Concentrations,Sensitivity Test, Microbial,Sensitivity Tests, Microbial,Test, Microbial Sensitivity,Tests, Microbial Sensitivity
D009779 Occlusive Dressings Material, usually gauze or absorbent cotton, used to cover and protect wounds, to seal them from contact with air or bacteria. (From Dorland, 27th ed) Bandages, Occlusive,Dressings, Occlusive,Dressings, Spray-On,Bandage, Occlusive,Dressing, Occlusive,Dressing, Spray-On,Dressings, Spray On,Occlusive Bandage,Occlusive Bandages,Occlusive Dressing,Spray-On Dressing,Spray-On Dressings
D011091 Polyesters Polymers of organic acids and alcohols, with ester linkages--usually polyethylene terephthalate; can be cured into hard plastic, films or tapes, or fibers which can be woven into fabrics, meshes or velours. Polyester
D003102 Colloids Two-phase systems in which one is uniformly dispersed in another as particles small enough so they cannot be filtered or will not settle out. The dispersing or continuous phase or medium envelops the particles of the discontinuous phase. All three states of matter can form colloids among each other. Hydrocolloids,Colloid,Hydrocolloid
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001705 Bioprosthesis Prosthesis, usually heart valve, composed of biological material and whose durability depends upon the stability of the material after pretreatment, rather than regeneration by host cell ingrowth. Durability is achieved 1, mechanically by the interposition of a cloth, usually polytetrafluoroethylene, between the host and the graft, and 2, chemically by stabilization of the tissue by intermolecular linking, usually with glutaraldehyde, after removal of antigenic components, or the use of reconstituted and restructured biopolymers. Glutaraldehyde-Stabilized Grafts,Heterograft Bioprosthesis,Porcine Xenograft Bioprosthesis,Xenograft Bioprosthesis,Bioprostheses,Bioprostheses, Heterograft,Bioprostheses, Porcine Xenograft,Bioprostheses, Xenograft,Bioprosthesis, Heterograft,Bioprosthesis, Porcine Xenograft,Bioprosthesis, Xenograft,Glutaraldehyde Stabilized Grafts,Glutaraldehyde-Stabilized Graft,Graft, Glutaraldehyde-Stabilized,Grafts, Glutaraldehyde-Stabilized,Heterograft Bioprostheses,Porcine Xenograft Bioprostheses,Xenograft Bioprostheses,Xenograft Bioprostheses, Porcine,Xenograft Bioprosthesis, Porcine
D013212 Staphylococcus epidermidis A species of STAPHYLOCOCCUS that is a spherical, non-motile, gram-positive, chemoorganotrophic, facultative anaerobe. Mainly found on the skin and mucous membrane of warm-blooded animals, it can be primary pathogen or secondary invader.
D014640 Vancomycin Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to RISTOCETIN that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. AB-Vancomycin,Diatracin,VANCO-cell,Vanco Azupharma,Vanco-saar,Vancocin,Vancocin HCl,Vancocine,Vancomicina Abbott,Vancomicina Chiesi,Vancomicina Combino Phar,Vancomicina Norman,Vancomycin Hexal,Vancomycin Hydrochloride,Vancomycin Lilly,Vancomycin Phosphate (1:2),Vancomycin Phosphate (1:2), Decahydrate,Vancomycin Sulfate,Vancomycin-ratiopharm,Vancomycine Dakota,Hydrochloride, Vancomycin,Sulfate, Vancomycin

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