Iranian Journal of Veterinary Surgery

Iranian Journal of Veterinary Surgery

Efficacy of Cefepime and Vancomycin in Prevention of Dacron and ePTFE Vascular Grafts Infected with Staphylococcus aureus: A Rat Subcutaneous Model

Document Type : Original Article

Authors
Parya Naserzadeh 1
Saeed Azizi 1
Amir Tukmachi 2
1 Department of Surgery and Diagnostic Imaging, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
2 Department of Microbiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
10.30500/ivsa.2021.264705.1241
Abstract
The objective of the present study was to evaluate systemic and local effects of cefepime alone and/or in combination with vancomycin in the prevention of experimentally implanted Dacron and ePTFE vascular grafts infected with Staphylococcus aureus in rat. Ninety healthy adult male Wistar rats were divided into two groups of 45 animals each. Then, each group was subdivided into nine subgroups of 5 animals each. Following anesthesia, in each rat one cm2, sterile Dacron or ePTFE graft was implanted aseptically into dorso-lumbar subcutaneous pocket. The grafts were infected by inoculation of one ml of (5 × 107 CFU/ml) Staphylococcus aureus suspension. The rats received vancomycin or cefepime locally, intraperitoneally, or in combinations. The grafts were removed seven days after implantation and evaluated by quantitative culture. Combinations of cefepime with vancomycin resulted in enhanced efficiency of antibiotics in bacterial growth inhibition. Local vancomycin was more effective than local cefepime in the reduction of graft contamination. A combination of intraperitoneal vancomycin, as well as local cefepime, was more effective than a combination of intraperitoneal cefepime as well as intraperitoneal vancomycin in the Dacron group. Local vancomycin-intraperitoneal cefepime combination could be suggested to prevent Dacron and ePTFE vascular graft infected with Staphylococcus aureus. Local treatment alone, vancomycin for Dacron graft and cefepime for ePTFE graft, and intraperitoneal treatment alone, vancomycin for ePTFE graft, could also be suggested.
Keywords
Vascular graft infection
Dacron graft
ePTFE graft
Cefepime
Vancomycin
Rat
Subjects
  1. Darouiche RO. Treatment of infections associated with surgical implants. The New England Journal of Medicine, 2004; 350: 1422–1429.
  2. Bergamini TM, Corpus RA, Peyton JC, Cheadle WG. The natural history of bacterial biofilm graft infection. Journal of Surgical Research, 1994; 56: 393-396.
  3. Von Eiff C, Heilmann GP. New aspects in the molecular basis of polymer-associated infections due to staphylococci. European Journal of Clinical Microbiology & Infectious Diseases, 1999; 18: 843–846.
  4. Seeger JM, Pretus HA, Welborn MB, Ozaki CK, Flynn TC, Huber TS. Long-term outcome after treatment of aortic graft infection with staged extraanatomic bypass grafting and aortic graft removal. Journal of Vascular Surgery, 2000; 32(3): 451-461.
  5. Soetevent C, Klemm PL, Stalenhoef AF, Bredie SJ. Vascular graft infection in aortoiliac and aortofemoral bypass surgery: clinical presentation, diagnostic strategies and results of surgical treatment. The Netherlands Journal of Medicine, 2004; 62(11): 446-452.
  6. Nagpal A, Sohail MR. Prosthetic Vascular Graft Infection: A Contemporary Approach to Diagnosis and Management, Current Infectious Disease Reports, 2011; 13, 317–323.
  7. Wipke-Tevis D. Vascular infections: medical and surgical therapies. Journal of Cardiovascular Nursing, 1999; 13: 70–81.
  8. Bergamini TM, Peyton JC, Cheadle WG. Prophylactic antibiotics prevent bacterial biofilm graft infection. Journal of Surgical Research, 1992; 52: 101-105.
  9. Giacometti A, Cirioni O, Ghiselli R, Goffi L, Moccheigiani F, Riva A, Scalise G, Saba V. Efficacy of polycationic peptides in preventing vascular graft infection due to Staphylococcus epidermidis. Journal of Antimicrobial Chemotherapy, 2000; 46: 751-756.
  10. Ghiselli R, Giacometti A, Cirioni O, Mocchegiani F, Orlando F, Del Prete MS, D'Amato G, Scalise G, Saba V. Quinopristin/dalfopristin bonding in combination with intraperitoneal antibiotics prevent infection of knitted polyester graft material in a subcutaneous rat pouch model infected with resistant Staphylococcus epidermidis. European Journal of Vascular and Endovascular Surgery, 2002; 24: 230-234.
  11. Hennes N, Sandmann W, Torsello G, Kniemeyer HW, Grabitz K. Infection of a vascular prosthesis-a retrospective analysis of 99 cases. Chirurg, 1996; 67(1): 37-43.
  12. Osada T, Yamamura K, Fujimoto K, Mizuno K, Sakurai T, Ohta M, Nabeshima T. Prophylaxis of local vascular graft infection with levofloxacin incorporated into albumin-sealed Dacron graft (LVFX-ALB Graft). Microbiology and Immunology, 1999; 43(4): 317-321.
  13. Bunt TJ. Vascular graft infections: an update. Journal of Cardiovascular Surgery, 2001; 9(3): 225-233.
  14. Allen GP, Cha R, Ryback MJ. In vitro activities of quinupristin – dalfopristin and cefepime, alone and in combination with various antimicrobials, against multidrug resistant staphylococci and enterococci in an in vitro pharmacodynamic model. Antimicrobial Agents and Chemotherapy, 2002; 46(8): 2606-2612.
  15. Naylor AR, Hayes PD, Darke S. A prospective audit of complex wound and graft infection in Great Britain and Ireland: Emergence of MRSA. European Journal of Vascular and Endovascular Surgery, 2001; 21: 289-294.
  16. Abdulrahman IS, Al-Mueilo SH, Bokhary HA, Ladipo GOA, Al-Rubaish A. A prospective study of haemodialysis access-related bacterial infections. Journal of Infection and Chemotherapy, 2002; 8: 242-246.
  17. Lee BY, Tsui BY, Bailey RR, Smith KJ, Muder RR, Lewis GJ, Harrison LH. Should vascular surgery patient be screened preoperatively for MRSA. Infection Control & Hospital Epidemiology, 2009; 30: 1158-1165.
  18. Hiramastu K, Hanaki H, Ino T, Yabyta K, Oguri T, Tenover FC. Methicillin resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. Journal of Antimicrobial Chemotherapy, 1997; 40: 135-136.
  19. Ariza J, Pujol M, Cabo J, Pena C, Fernandez A, Linares J, Ayats J, Gudiol F. Vancomycin in surgical infections due to methicillin resistant Staphylococcus aureus whit heterogeneous resistance to Vancomycin. Lancet, 1999; 353: 1587-1588.
  20. Hiramastu K, Aritaka N, Hanaki H, Kawasaki S, Hosoda Y, Hori S, Fukuchi Y, Kobayashi I. Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vancomycin. Lancet, 1999; 350: 1670-1673.
  21. Lozniewski A, Lion C, Mory F, Weber M. In vitro synergy between cefepime and vancomycin against methicillin susceptible and methicillin resistant Staphylococcus aureus and Staphylococcus epidermidis. Journal of Antimicrobial Chemotherapy, 2001; 47: 83-86.
  22. Rio PD, Vellon M, Fragapane P, Millo MD, Mazzitelli R, Allergi C, Nuzzo G, Sianesi M. Cefepime for prophylaxis of infections in the surgery of cholelithiasis. Result of multicentric comparative trial. Acta Biomed, 2008; 79: 23-27.
  23. Toitzis P, Dul M, Oriordan MN, Salvator A, Rosolwski B, Toitzis H. Cefepime use in a pediatric intensive care unit reduces colonization with resistant bacilli. The Pediatric Infectious Disease Journal, 2003; 22(2): 109-114.
  24. Guide to the Care and Use of Experimental Animals, Volume 1, 2nd Edn, Canadian Council On Animal Care (CCAC), Canada, Ottawa, Ontario, 1993.
  25.  Turgut H, Sacar S, Kaleli I, Sacar M, Goksin I, Toprak S, Asan A, Cevahir N, Tekin K, Baltalarli A. Systemic and local antibiotic prophylaxis in the prevention of Staphylococcus epidermidis graft infection. BMC Infectious Diseases, 2005; 5(1): 91.
  26. Schmitt DD, Bandyk DF, Pequet AJ, Towne JB. Bacterial adherence to vascular protheses. Journal of Surgical Research. 1986; 3(5): 732-740.
  27. Falkenback D, Lundberg F, Ribbe E, Ljungh A. Exposure of plasma proteins on Dacron and ePTFE vascular material in a prefusion model. European Journal of Vascular Surgery, 2000; 19: 468-475.
  28. Malangoni MA, Livingston DH, Peyton JC: Te effect of protein Binding on the adherence of staphylococci to prosthetic vascular grafts. Journal of Surgical Research, 1993; 54: 168-172.
  29. Camiade C, Goldschmidt P, Koskas F, Ricco JB, Jarraya M, Gerota J, Kieffer E. Optimization of the resistance of arterial allografts to infection: comparative study with synthetic prostheses. Annals of Vascular Surgery, 2001; 15: 186-196.
  30. Ghiselli R, Giacometti A, Goffi L, Cirioni O, Boccoli G, Mocchegiani F, Riva A, Scalise G, Saba V. Efficacy of Rifampin-levofloxacin as a prophylactic agent in preventing Staphylococcus epidermidis graft infection. European Journal of Vascular and Endovascular Surgery, 2000; 20(6): 508-511.
  31. Barr JG, Smyth ETM, Hogg GM. In vitro antimicrobial activity of imipenem in combination with vancomycin or tiecoplanin against Staphylococcus aureus and Staphylococcus epidermidis. European Journal of Clinical Microbiology and Infectious Diseases, 1990; 9: 804-809.
  32. Reymond J, Vedel G, Beregeret M. In vitro bactericidal activity of cefpirome in combination with vancomycin against Staphylococcus aureus and coagulase negative staphylococci. Journal of Antimicrobial Chemotherapy, 1996; 38: 1067-1071.
  33. Ravizzola G., Cabibo E, Peroni L, Longo M, Pollara P, Carolli M. In vitro study of the synergy between β-lactam antibiotics and glycopeptides against enterococci. Journal of Antimicrobial Chemotherapy, 1997; 39: 461-470.
  34. Citak MS, Cue JI, Peyton JC, Malangoni MA. The critical relationship of antibiotic dose and bacterial contamination in experimental infection. Journal of Surgical Research, 1992; 52: 127-130.
  35. Lenhgharardit FJ, Torsello G, Claeys LGY, Pfeiffer M, Wachol Drewek Z, Grundmann RT, Sandmann W. Systemic and local antibiotic prophylaxis in the prevention of prosthetic vascular graft infection: An experimental study. European Journal of Vascular Surgery, 2002; 23: 127-133.
  36. Cohn LA, Middleton JR. A veterinary perspective on methicillin-resistant staphylococci. Journal of Veterinary Emergency and Critical care, 2010; 20(1): 31-45.

  • Receive Date 28 December 2020
  • Revise Date 26 January 2021
  • Accept Date 07 April 2021
  • First Publish Date 07 April 2021