185. In Vitro Assessment of Microbial Barrier Properties of Cyanoacrylate and Non-Cyanoacrylate Skin Adhesives
Session: Poster Abstract Session: Catheter-associated BSIs
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Background:  A variety of pressure sensitive adhesives (PSA's) are commonly used to secure wound dressings and medical devices to the skin.  Despite improvements in these products, wound infections and catheter-related bloodstream infections continue. In addition to PSA's, a group of adhesives called cyanoacrylates have been used to provide primary wound closure.  Some studies have demonstrated a reduction in wound colonization and infections when cyanoacrylates were used in place of sutures.  This antimicrobial effect is thought to be due to the improved barrier protection to microflora that colonize the skin. It is unclear if PSA’s provide similar barrier properties.  The purpose of this study was to compare the microbial barrier properties of common PSA's to two FDA-approved cyanoacrylates.

Methods:

Adhesives: Cyanoacrylates: 2-octyl-cyanoacrylate (Dermabond™) and N-butyl-cyanoacrylate (Indermil™);  Six PSA's: three vinyl acetate products; hexamethyldisiloxane; gum rubber; natural rubber/latex.

Agar: D/E Neutralizing Agar - containing bromocresol, a pH-sensitive dye that changes color with bacterial growth.

Each adhesive was applied to the agar in a uniform manner to produce a thick film ≥ 20 mm in diameter and allowed to cure completely.  S.epidermidis, S. aureus, MRSA, VRE, and E. coli were grown on blood agar at 370C overnight for 18-24hrs prior to plating.  A bacterial dilution (0.5 – 0.6 McFarland) was produced for each strain. 10 μL of bacterial dilution was placed on top of the cured adhesive.  5 plates were made for each bacteria / adhesive combination. Pos and neg controls were included.

Plates were incubated right side up for 72 hr at 37 °C and inspected for visible growth/color change every 24hrs.

Results:

At 72 hrs, breakthrough growth was not seen on any of the 50 plates in which the cyanoacrylate adhesive was used. However, at 24 hrs evidence of bacterial penetration through the PSA's was seen in 145 of 150 samples; at 72 hrs, in 149 of 150 PSA samples.

Conclusion:

Unlike PSAs which allowed rapid and consistent bacterial penetration, polymerized 2-octyl- and N-butyl-cyanoacrylate adhesives provided an excellent barrier to bacterial penetration.  Their use may result in lower infection rates.  Use of cyanoacrylates in this manner will require effective & safe means to remove the device without resulting in injury to the skin.

Stephen Waller, MD, Division of Infectious Diseases, University of Kansas, Kansas City, KS, Lisa Clough, MD, Infectious Diseases, University of Kansas Medical Center, kansas City, KS and Rebecca Horvat, PhD, Pathology and Laboratory Medicine, University of Kansas, Kansas City, KS

Disclosures:

S. Waller, None

L. Clough, None

R. Horvat, None

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