Experimental treatment of vascular graft infection due to Staphylococcus epidermidis by in situ replacement with a rifampin-bonded polyester graft |
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| Authors: | Coggia M Goëau-Brissonnière O Leflon V Nicolas M H Pechère J C |
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| Institution: | 1. Service de Chirurgie Vasculaire, Hôpital Ambroisé Paré, Boulogne-Billancourt, France;2. Service de Microbiologie, Hôpital Ambroisé Paré, Boulogne-Billancourt, France;3. Departement de Génétique et Microbiologie, Faculté de Médecine, Université de Genève, Geneva, Switzerland;1. Department of Vascular Surgery, Bordeaux University Hospital, Bordeaux, France;2. Department of Infectious Diseases, Bordeaux University Hospital, Bordeaux, France;3. Department of Anesthesiology, Bordeaux University Hospital, Bordeaux, France;4. Department of Vascular Surgery, Imperial College London, London, UK;1. Department of Vascular Surgery, Bordeaux University Hospital, Bordeaux, France;2. Department of Infectious Diseases, Bordeaux University Hospital, Bordeaux, France;3. Department of Vascular Surgery, Imperial College London, United Kingdom;1. Department of Vascular Surgery, Vita-Salute University School of Medicine, San Raffaele Scientific Institute, Milan, Italy;2. Department of Vascular and Thoracic Surgery, Ghent University Hospital, Ghent, Belgium;3. Department of Vascular Surgery and Kidney Transplantation, University Hospital of Strasbourg, Strasbourg, France;1. Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium;2. Department of Cardiovascular Sciences, Research Unit of Vascular Surgery, KU Leuven, Leuven, Belgium;3. Department of Cardiac surgery, University Hospitals Leuven, Leuven, Belgium;4. Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium |
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| Abstract: | In situ prosthetic graft replacement (ISPGR) of an infected prosthesis raises the risk of recurrent infection in the new graft, especially in cases involving drug-resistant microorganisms. The purpose of this animal study was to evaluate in situ replacement of a vascular graft infected by a highly rifampin-resistant strain of Staphylococcus epidermidis with the use of a rifampin-bonded polyester graft. Antibiotic bonding was obtained by soaking grafts in a high dose of rifampin solution (60 mg/mL). The infrarenal abdominal aorta of 20 dogs was replaced using a polyester prosthesis infected with a highly rifampin-resistant strain of Staphylococcus epidermidis. One week later, the 18 surviving animals were randomized into three groups. Group I (n = 6) did not undergo reoperation. Group II (n = 6) underwent ISPGR using a rifampin-bonded prosthesis. Group III (n = 6) underwent ISPGR using an untreated prosthesis. All surviving animals were killed 28 days after the first procedure. Infectious signs were noted and bacteriological study was carried out on explanted prostheses and various tissue samples. The findings of this experimental study show that soaking a polyester prosthesis in a high-dose rifampin solution can prevent reinfection after in situ replacement of a prosthesis infected by a highly rifampin-resistant Staphylococcus epidermidis. |
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