Efficacy of Antiseptic Impregnation of Aortic Endografts with Rifampicin Compared to Silver Against In vitro Contamination with Four Bacteria That Frequently Cause Vascular Graft Infections

Overview

Journal JVS Vasc Sci

Specialty Cardiology & Vascular Diseases

Date 2021 Oct 7

PMID 34617047

Citations 3

Authors

Susanne Honig

Philipp Seeger

Holger Rohde

Tilo Kolbel

Eike Sebastian Debus

Holger Diener

Affiliations

Soon will be listed here.

Abstract

Objective: This in vitro study investigates the antimicrobial efficacy of impregnation of commercially available aortic endografts (EG) with rifampicin (RIF) and nanocolloidal silver.

Methods: Endografts were flushed with 50 mL of RIF 600 mg, 70 mL of a silver-based aqueous solution (AG), or 50 mL of phosphate-buffered saline (PBS) over 15 minutes. Endografts were then retrieved from the sheath and cut in 1 × 1 cm sized graft units (n = 80 of each impregnation), which were then incubated for 1 hour separately with inoculates containing 10 or 10 bacteria per milliliter (bact/mL) of each of the following bacteria: multisensitive , and . After sonication of the graft units, bacterial counts were measured by plating out twice the sonication solution on Mueller-Hinton plates.

Results: RIF showed a statistically significant decrease of colony forming units per milliliter for all four bacterial strains in both concentrations compared with PBS and AG, except for 10 bact/mL of . AG showed a significant decrease of colony forming units per milliliter compared with PBS only for 10 bact/mL of and was statistically significantly inferior to RIF for all four bacterial strains in both concentrations with the exception of at a concentration of 10 bact/mL.

Conclusions: This in vitro study demonstrated infectivity resistance of aortic EG after flushing with RIF. Moreover, the feasibility of flushing aortic EG with a new silver-based agent could be demonstrated, but without statistically significant antimicrobial efficacy compared with native EG.

Citing Articles

Which Gelatin and Antibiotic Should Be Chosen to Seal a Woven Vascular Graft?.

Zhuravleva I, Shadanov A, Surovtseva M, Vaver A, Samoylova L, Vladimirov S Int J Mol Sci. 2024; 25(2).

PMID: 38256039 PMC: 10816219. DOI: 10.3390/ijms25020965.

Aortic Endograft Infection: Diagnosis and Management.

Kim Y Vasc Specialist Int. 2023; 39:26.

PMID: 37732343 PMC: 10512004. DOI: 10.5758/vsi.230071.

Use of a Silver-Impregnated Vascular Graft: Single-Center Experience.

Molacek J, Treska V, Houdek K, Opatrny V, Certik B, Baxa J Antibiotics (Basel). 2022; 11(3).

PMID: 35326849 PMC: 8944627. DOI: 10.3390/antibiotics11030386.

References

Jung W, Koo H, Kim K, Shin S, Kim S, Park Y . Antibacterial activity and mechanism of action of the silver ion in Staphylococcus aureus and Escherichia coli. Appl Environ Microbiol. 2008; 74(7):2171-8. PMC: 2292600. DOI: 10.1128/AEM.02001-07. View

Goeau-Brissonniere O, Javerliat I, Koskas F, Coggia M, Pechere J . Rifampin-bonded vascular grafts and postoperative infections. Ann Vasc Surg. 2010; 25(1):134-42. DOI: 10.1016/j.avsg.2010.09.002. View

Smeds M, Duncan A, Harlander-Locke M, Lawrence P, Lyden S, Fatima J . Treatment and outcomes of aortic endograft infection. J Vasc Surg. 2016; 63(2):332-40. DOI: 10.1016/j.jvs.2015.08.113. View

Argyriou C, Georgiadis G, Lazarides M, Georgakarakos E, Antoniou G . Endograft Infection After Endovascular Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-analysis. J Endovasc Ther. 2017; 24(5):688-697. DOI: 10.1177/1526602817722018. View

Vogel T, Symons R, Flum D . The incidence and factors associated with graft infection after aortic aneurysm repair. J Vasc Surg. 2008; 47(2):264-9. DOI: 10.1016/j.jvs.2007.10.030. View

Pupka A, Skora J, Janczak D, Plonek T, Marczak J, Szydelko T . In situ revascularisation with silver-coated polyester prostheses and arterial homografts in patients with aortic graft infection--a prospective, comparative, single-centre study. Eur J Vasc Endovasc Surg. 2010; 41(1):61-7. DOI: 10.1016/j.ejvs.2010.10.005. View

Wanhainen A, Verzini F, Van Herzeele I, Allaire E, Bown M, Cohnert T . Editor's Choice - European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2018; 57(1):8-93. DOI: 10.1016/j.ejvs.2018.09.020. View

Bosman W, van der Burg B, Schuttevaer H, Thoma S, Hedeman Joosten P . Infections of intravascular bare metal stents: a case report and review of literature. Eur J Vasc Endovasc Surg. 2013; 47(1):87-99. DOI: 10.1016/j.ejvs.2013.10.006. View

Batt M, Feugier P, Camou F, Coffy A, Senneville E, Caillon J . A Meta-Analysis of Outcomes After In Situ Reconstructions for Aortic Graft Infection. Angiology. 2017; 69(5):370-379. DOI: 10.1177/0003319717710114. View

10.

Zegelman M, Guenther G, Waliszewski M, Pukacki F, Stanisic M, Piquet P . Results from the International Silver Graft Registry for high-risk patients treated with a metallic-silver impregnated vascular graft. Vascular. 2013; 21(3):137-47. DOI: 10.1177/1708538113478773. View

11.

Chaufour X, Gaudric J, Goueffic Y, Khodja R, Feugier P, Malikov S . A multicenter experience with infected abdominal aortic endograft explantation. J Vasc Surg. 2016; 65(2):372-380. DOI: 10.1016/j.jvs.2016.07.126. View

12.

Delva J, Deglise S, Berard X, Dubuisson V, Delva F, Stecken L . In-situ revascularisation for secondary aorto-enteric fistulae: the success of silver-coated Dacron is closely linked to a suitable bowel repair. Eur J Vasc Endovasc Surg. 2012; 44(4):417-24. DOI: 10.1016/j.ejvs.2012.04.004. View

13.

Koshiko S, Sasajima T, Muraki S, Azuma N, Yamazaki K, Chiba K . Limitations in the use of rifampicin-gelatin grafts against virulent organisms. J Vasc Surg. 2002; 35(4):779-85. DOI: 10.1067/mva.2002.121850. View

14.

Ricco J . InterGard silver bifurcated graft: features and results of a multicenter clinical study. J Vasc Surg. 2006; 44(2):339-46. DOI: 10.1016/j.jvs.2006.03.046. View

15.

Bisdas T, Beckmann E, Marsch G, Burgwitz K, Wilhelmi M, Kuehn C . Prevention of vascular graft infections with antibiotic graft impregnation prior to implantation: in vitro comparison between daptomycin, rifampin and nebacetin. Eur J Vasc Endovasc Surg. 2012; 43(4):448-56. DOI: 10.1016/j.ejvs.2011.12.029. View

16.

Kahlberg A, Grandi A, Loschi D, Vermassen F, Moreels N, Chakfe N . A systematic review of infected descending thoracic aortic grafts and endografts. J Vasc Surg. 2019; 69(6):1941-1951.e1. DOI: 10.1016/j.jvs.2018.10.108. View

17.

Bandyk D, Novotney M, Back M, Johnson B, Schmacht D . Expanded application of in situ replacement for prosthetic graft infection. J Vasc Surg. 2001; 34(3):411-9; discussion 419-20. DOI: 10.1067/mva.2001.117147. View

18.

Oderich G, Bower T, Hofer J, Kalra M, Duncan A, Wilson J . In situ rifampin-soaked grafts with omental coverage and antibiotic suppression are durable with low reinfection rates in patients with aortic graft enteric erosion or fistula. J Vasc Surg. 2010; 53(1):99-106, 107.e1-7. DOI: 10.1016/j.jvs.2010.08.018. View

19.

Behrendt C, Wipper S, Debus S, von Kodolitsch Y, Puschel K, Kammal M . Primary aorto-enteric fistula as a rare cause of massive gastrointestinal haemorrhage. Vasa. 2017; 46(6):425-430. DOI: 10.1024/0301-1526/a000646. View

20.

Bandyk D, Novotney M, Johnson B, Back M, Roth S . Use of rifampin-soaked gelatin-sealed polyester grafts for in situ treatment of primary aortic and vascular prosthetic infections. J Surg Res. 2000; 95(1):44-9. DOI: 10.1006/jsre.2000.6035. View