305. Development and Efficacy of Chlorhexidine (CHX)-Minocycline/Rifampin (MR) Impregnated Penile Implants Against Resistance Pathogenes
Session: Poster Abstract Session: HAI: Device Associated Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • Penile.pdf (706.5 kB)
  • Background:

    Inflatable penile prosthesis (IPP) implantation is an established treatment for erectile dysfunction and has been increasing due to the large numbers of patients with diabetes and prostate cancer. Infection is the most dreaded complication of IPP. The incidence of infection is in the range of 5% and increases up to8% for diabetics and 10% for revision surgeries. Infections can lead to removal of the implants, loss of function, difficult replacement and re-implantation. The use of M/R impregnated IPPs produced a 50% decrease in infection rate; nevertheless breakthrough infections occur. To further improve outcomes, we developed CHX-M/R silicone penile implant prototype by sequential impregnation of CHX followed by M/R and tested against various resistant pathogens.

     

    Methods:

    CHX-M/R silicone discs, prepared from the same elastomer used to make the shells of IPPs, were impregnated by presaturation with M/R followed by impregnation with CHX  and compared to untreated controls, M/R only and CHX only impregnated discs. Antimicrobial efficacy and durability of the discs was determined against methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE), Pseudomonas aeruginosa (PA), Enterobacter cloacae (EB), Klebsiella pneumoniae (KP) and Candida albicans (CA) by immersion for 2 weeks in serum with samples taken weekly for microbial challenge in a biofilm colonization model.

     

    Results:

    CHX-MR impregnated silicone discs showed complete inhibition of biofilm formation for all resistant bacteria and candida  tested at baseline. This result was sustained following 2 weeks immersion in serum.  CHX-M/R provided a significant improvement in colonization reduction over M/R and CHX discs  against MRSA, VRE, EB, KP and CA as shown in the Figure below (P<0.001).

    Conclusion:

    A novel sequential CHX-M/R treatment was superior to M/R and CHX only treatments on silicone discs and significantly reduced as well as completely inhibitedadherence of both bacteria and fungi for 2 weeks in simulated implantation model.

     

    Mohamed Jamal, PhD1, Joel Rosenblatt, PhD2, Anne-Marie Chaftari, MD1, Ying Jiang, MS3, Ray Hachem, MD, FIDSA3 and Issam Raad, MD, FACP, FIDSA, FSHEA1,4, (1)Infectious Diseases, Infection Control & Employee Health, 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)Department of Infectious Diseases, Infection Control and Employee Health. The University of Texas M. D. 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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