Ji. Greenfeld et al., DECREASED BACTERIAL ADHERENCE AND BIOFILM FORMATION ON CHLORHEXIDINE AND SILVER SULFADIAZINE-IMPREGNATED CENTRAL VENOUS CATHETERS IMPLANTEDIN SWINE, Critical care medicine, 23(5), 1995, pp. 894-900
Objective: To determine if antiseptic central venous catheters impregn
ated with silver sulfadiazine and chlorhexidine (antiseptic) reduce ba
cterial adherence and biofilm formation without producing local or sys
temic toxicity. Design: Prospective, randomized, controlled trial. Set
ting: Experimental laboratory in a university teaching hospital. Subje
cts: Ten outbred New Hampshire pigs. Interventions: Nonimpregnated (co
ntrol) and antiseptic-impregnated catheters were inserted intravascula
rly into swine for 7 days. After explantation, the catheters were asse
ssed for bacterial adherence and biofilm formation, and the surroundin
g tissue was assessed for signs of toxicity. Before retrieval, systemi
c concentrations of antimicrobials were determined. Measurements and M
ain Results: Sequential roll plate and centrifuging were used to detec
t moderately and tightly adherent bacteria on the outer and luminal su
rfaces of the catheter. The presence of biofilm was detected by scanni
ng electron microscopy. Tissues surrounding the catheters were examine
d histopathologically; systemic concentrations of chlorhexidine, sulfa
diazine, and silver were determined by atomic absorption and high-perf
ormance Liquid chromatography. As compared with the controls, antisept
ic catheters had significantly (p < .01) fewer moderately and tightly
adherent bacteria on outer and luminal surfaces, and fewer adherent ba
cteria when outer surfaces alone were examined (p < .01). Scanning ele
ctron microscopy showed bacterial biofilm and adherence on the control
catheters but not on the antiseptic catheters. There were no abnormal
histopathologic changes associated with the test catheter, and serum
concentrations of the antibacterial agents were shown to be within non
-toxic ranges. Conclusion: The antiseptic-impregnated catheters preven
ted bacterial adherence and biofilm formation and produced no local or
systemic toxicity.