282. Development of Antimicrobial Gendine Coated Central Catheters: In Vivo Biocompatibility and In Vitro Efficacy
Session: Poster Abstract Session: HAI: Device Associated Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • Pilot in Vivo Biocompatibility and In Vitro Efficacy_revised.pdf (620.5 kB)
  • Background:

    The use of Peripherally Inserted Central Catheters (PICCs) has recently been increased among hospitalized and critically ill patients.  PICC-associated central line associated blood stream infections (CLABSIs) occur as frequently as with CVCs in hospitalized settings. The antimicrobial-coated PICCs might reduce the risk of CLABSI. We tested the gendine (combination of chlorhexidine and gentian violet) PICC for biocompatibility in a rabbit intravascular model against uncoated controls. We also tested the in vitro efficacy of the gendine PICC in comparison with minocycline/rifampin (M/R), and chlorhexidine (CHX) PICCs tested against different pathogens.

    Methods:

    In vivo biocompatibility was tested in a rabbit model by inserting the gendine and uncoated control catheters in the jugular veins for a 4 days. Histopathologic analysis was performed and pharmacokinetics of circulating levels of CHX and GV in blood were measured at different time points using liquid chromatography/mass spectrometry. M/R and CHX PICCs were compared to gendine and uncoated control PICCs in an in vitro biofilm colonization model for  24hr and 1 week against methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE) Pseudomonas aeruginosa (PS), Escherichia coli (EC),Acinetobacter baumannii (AN), Enterobacter cloacae (EB) Candida albicans (CA) and Candida glabrata (CG). 

    Results:

    Rabbits implanted with gendine PICCs exhibited similar or reduced thrombosis and inflammation compared to uncoated control PICC animals. No detectable levels of GV were found in the blood. Trace concentrations of CHX, well below safe levels, were detected in blood over the entire study period.  The gendine-PICCs completely prevented biofilm adherence of MRSA, VRE, PS, EC, EB, CA and CG at 24hr and 1 week (P<0.0001) compared to M/R, CHX and control PICCs which did not. 

    Conclusion:

    Gendine treated PICCs were very effective in preventing biofilm formation of pathogenic bacteria and fungi. Gendine PICCs were found to be biocompatible in an intravascular setting, with tissue responses less severe than those to unocated control in rabbits. Further, the pharmacokinetic testing established that acute systemic exposures of CHX and gentian violet from the gendine catheters were well within safe levels.

    Mohamed Jamal, PhD1, Ray Hachem, MD, FIDSA2, Joel Rosenblatt, PhD3, Mark Mcarthur, DVM4, Edd Felix, BS5, Ying Jiang, MS2, Ramesh Tailor, Ph.D.5 and Issam Raad, MD, FACP, FIDSA, FSHEA1, (1)Infectious Diseases, Infection Control & Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, (2)University of Texas, M.D. Anderson Cancer Center, Houston, TX, (3)1515 Holcombe - Suite FCT12.6030, UT MD Anderson Cancer Center, Houston, TX, (4)University of Texas MD Anderson Cancer Center, Houston, TX, (5)MD Anderson Cancer Center, Houston, TX

    Disclosures:

    M. Jamal, None

    R. Hachem, None

    J. Rosenblatt, UT MD Anderson Cancer Center: Shareholder , Licensing agreement or royalty
    Novel Anti-Infective Technologies LLC: Shareholder , Licensing agreement or royalty

    M. Mcarthur, None

    E. Felix, None

    Y. Jiang, None

    R. Tailor, None

    I. Raad, UT MD Anderson Cancer Center: Shareholder , Licensing agreement or royalty
    Novel Anti-Infective Technologies LLC: Shareholder , Licensing agreement or royalty

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.