In vitro zones of inhibition of coated vascular catheters predict efficacy in preventing catheter infection with Staphylococcus aureus in vivo

• Published in: European journal of clinical microbiology & infectious diseases Vol. 19; no. 8; pp. 612 - 617
• Main Authors: BASSETTI, S, HU, J, D'AGOSTINO, R. B, SHERERTZ, R. J
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.08.2000; Springer Nature B.V
• Subjects: Animals; Anti-Bacterial Agents - pharmacology; Antimicrobial agents; Bacteremia - epidemiology; Bacteremia - microbiology; Biological and medical sciences; Catheters; Catheters, Indwelling - microbiology; Clinical trials; Confidence intervals; Disease Models, Animal; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical research; Medical sciences; Microbial Sensitivity Tests - methods; Miscellaneous. Technology; Nosocomial infections; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Predictive Value of Tests; Rabbits; Randomized Controlled Trials as Topic; Staphylococcal Infections - microbiology; Staphylococcal Infections - prevention & control; Staphylococcus aureus; Staphylococcus aureus - drug effects; United States > US; Instrumentation therapy; Catheter; Rabbit; Cardiovascular disease; Lagomorpha; In vitro; Vascularization; Vascular disease; Infection; Prevention; In vivo; Vertebrata; Mammalia; Animal; Risk factor; Bacteriosis; Bacteria; Micrococcales; Micrococcaceae; Inhibition; Staphylococcus aureus
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s100960000330

This report summarizes data from 35 rabbit model experiments investigating the relationship between in vitro anti-infective catheter coating zones of inhibition and in vivo efficacy. The rabbit model studies involving 15 anti-infective coatings demonstrate an inverse correlation between the sizes of zones of inhibition of Staphylococcus aureus and both the quantity of Staphylococcus aureus removed from the catheter and the risk of a purulent infection. The review of seven previously published clinical trials reveals that the use of anti-infective coated catheters, efficacious in the rabbit model, was associated with a higher success rate than the use of uncoated catheters in preventing both Staphylococcus aureus catheter colonization (odds ratio: 1.28; 95% confidence interval: 0.84-1.93) and Staphylococcus aureus catheter-related bloodstream infection (odds ratio: 3.07; 95% confidence interval: 0.98-9.60) in humans. These findings strongly suggest a correlation between zones of inhibition and in vivo efficacy. In vitro zones of inhibition may serve as a useful screening test for evaluating new anti-infective coatings.