304. Antimicrobial Efficacy of Chlorhexidine-Minocycline/Rifampin (CHX-M/R) Coated Nephrostomy Catheter against Multi-drug Resistant Pathogens including Carbapenem-Resistant Enterobacteriaceae
Session: Poster Abstract Session: HAI: Device Associated Infections
Thursday, October 8, 2015
Room: Poster Hall

Background:

The placement of nephrostomy tube/catheter is performed to relieve benign ureteral obstruction, malignant ureteral obstruction and ureteral fistulas and leaks. Studies have shown that the use of nephrostomy tube among cancer patients is associated with significant rate of pyelonephritis and infections. In an attempt to develop a prototype antimicrobial nephrostomy catheter that might reduce the risk of infections, we impregnated nephrostomy tube with minocycline/rifampin (M/R) alone; chlorhexidine coated M/R (CHX-M/R) and tested its efficacy against different pathogens that causes infection upon use of this catheter.

Methods:

Nephrostomy catheters were impregnated with M/R solution and dried. To prepare CHX-M/R catheter, M/R impregnated nephrostomy catheters were sequentially over-coated on external and luminal surfaces with chlorhexidine (CHX) with polyether urethane polymer solution. Antimicrobial efficacy and durability of M/R, CHX-M/R nephrostomy catheters were tested against clinical isolates of methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, vancomycin-resistant enterococci (VRE), carbapenem-resistant Enterobacteriaceae (CRE)-Klebsiella pneumoniae carbapenemase (KPC), and Pseudomonas aeruginosa, Candida albicans and using biofilm colonization method.

Results:

CHX-M/R coated nephrostomy catheters were effective in significantly reducing biofilm formation of all pathogens tested compared to M/R and non-antimicrobial coated  control nephrostomy catheters (P<0.0001). CHX-MR also had longer antimicrobial durability against all pathogens than MR, CHX and control in up to 3 weeks follow up  (P<0.0001).

Conclusion:

CHX-M/R coated nephrostomy catheters appear to be a promising approach to reduce nephrostomy tube related pyelonephritis. These finding warrants further investigation using this novel coated nephrostomy catheters in vivo and in a randomized clinical trial.  

 

 

 

Mohamed Jamal, PhD1, Joel Rosenblatt, PhD2, Anne Marie Chaftari, MD3, Ying Jiang, MS3, Ray Hachem, MD, FIDSA3 and Issam Raad, MD, FACP, FIDSA, FSHEA4, (1)Infectious Diseases, Infection Control & Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, (2)1515 Holcombe - Suite FCT12.6030, UT MD Anderson Cancer Center, Houston, TX, (3)University of Texas, M.D. Anderson Cancer Center, Houston, TX, (4)Infectious Diseases, Infection Control & Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX

Disclosures:

M. Jamal, None

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

A. M. Chaftari, None

Y. Jiang, None

R. Hachem, None

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

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