Prophylaxis against Staphylococcus aureus vascular graft infection with mupirocin-soaked, collagen-sealed dacron

A rat model was used to investigate the efficacy of mupirocin in the preven tion of vascular prosthetic graft infections. The effect of mupirocin-soake d Dacron was compared with the effect of rifampin-soaked, collagen-sealed D acron in the rat model of graft infection caused by methicillin-susceptible Staphylococcus aureus and methicillin-resistant S. aureus. Graft infection s were established in the back subcutaneous tissue of 195 adult male Wistar rats by implantation of 1-cm(2) Dacron prostheses followed by topical inoc ulation with 5 X 10(7) colony-forming units of S. aureus. The study include d a control group (no graft contamination), two contaminated groups that di d not receive any antibiotic prophylaxis, two contaminated groups in which perioperative intraperitoneal. amoxicillin clavulanate prophylaxis (50 mg/k g) was administered, four contaminated groups that received mupirocin- or r ifampin-soaked graft, and four contaminated groups that received mupirocin- or rifampin-soaked graft and perioperative intraperitoneal amoxicillin cla vulanate prophylaxis (50 mg/kg). The grafts were sterilely removed 7 days a fter implantation and the infection was evaluated by using sonication and q uantitative agar culture. Data analysis showed that the efficacy of mupiroc in against both strains was significantly different from that of the untrea ted control. In addition, mupirocin was more effective than rifampin agains t the methicillin-resistant strain. Finally, only the combination of mupiro cin and amoxicillin clavulanate produced complete suppression of growth of all strains. (C) 2001 Academic Press.