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Inhibition of Staphylococcus Epidermidis Colonization with Fusidic Acid-Impregnated Catheters

Department of Infectious Diseases and Clinical Microbiology, Kirikkale University School of Medicine, Kirikkale, Turkey,agalarc{at}yahoo.com

Dilek Kilic

Department of Infectious Diseases and Clinical Microbiology, Kirikkale University School of Medicine, Kirikkale, Turkey

Sabahat Ceken

Department of Infectious Diseases and Clinical Microbiology, Kirikkale University School of Medicine, Kirikkale, Turkey

Mehmet Ozdogan

Department of General Surgery, Ataturk Egitim ve Arastirma Hospital, Bilkent, Ankara, Turkey

Erdem Yaar

Department of Physics, Faculty of Arts and Sciences, Kirikkale University, Kirikkale, Turkey

Eylem Özturk

Department of Chemistry, Biochemistry Division, Faculty of Science, Hacettepe University, Ankara, Turkey

Emir Baki Denkba

Department of Chemistry, Biochemistry Division, Faculty of Science, Hacettepe University, Ankara, Turkey

The aim of this study was the preparation and characterization of fusidic acid-impregnated peripheral catheters. In the first part of the study, in vitro drug release studies were performed, and the effect of fusidic acid impregnation on adherence of slime positive Staphylococcus epidermidis to catheters was evaluated as in vitro studies. Fusidic acid-impregnated and naïve catheters were incubated with 10⁸ colony forming unit/mL (cfu/mL) slime positive S. epidermidis during the in vitro experiment. After incubation for 2, 4, 6, 8, 12, 24, 48, and 72 h, the number of colonies were determined in an aliquot and adhered to the catheter. During the in vivo experiment, contaminated naïve and fusidic acid-impregnated catheters (n = 10 rats in both groups) were implanted subcutaneously in the back of the rats. Rats were killed at the end of the seventh day and catheters were removed. Microbiologic assessments from the explanted catheter segments were performed. Fusidic acid impregnation decreased the number of adherent bacteria to the catheters and the number of free bacteria within the liquid medium significantly. There were 3 positive catheter cultures out of 10 in rats implanted with fusidic acid-impregnated catheters, whereas all explanted catheters from naïve group yielded bacterial growth. The mean cfu counts were significantly less in the fusidic acid-impregnated catheter group. In vitro release studies and antibacterial activity studies correlated well. Additionally, morphological evaluations by scanning electron microscopy showed that fewer bacteria were evident on the fusidic acid-impregnated catheters compared with naïve catheters. As a conclusion, catheter impregnation with fusidic acid is effective in preventing colonization in these in vitro and in vivo sets of experiments, with slime-producing S. epidermidis.

Key Words: fusidic acid • impregnation • catheter • Staphylococcus epidermidis • catheter-related infection • drug release.

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