Experimental treatment of vascular graft infection due to Staphylococcus epidermidis by in situ replacement with a rifampin-bonded polyester graft

In situ prosthetic graft replacement (ISPGR) of an infected prosthesis rais es the risk of recurrent infection in the new graft, especially in cases in volving drug-resistant microorganisms. The purpose of this animal study was to evaluate in situ replacement of a vascular graft infected by a highly r ifampin-resistant strain of Staphylococcus epidermidis with the use of a ri fampin-bonded polyester graft. Antibiotic bonding was obtained by soaking g rafts in a high dose of rifampin solution (60 mg/mL). The infrarenal abdomi nal aorta of 20 dogs was replaced using a polyester prosthesis infected wit h a highly rifampin-resistant strain of Staphylococcus epidermidis. One wee k later, the 18 surviving animals were randomized into three groups. Group I (n = 6) did not undergo reoperation. Group II (n = 6) underwent ISPGR usi ng 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 finding s of this experimental study show that soaking a polyester prosthesis in a high-dose rifampin solution can prevent reinfection after in situ replaceme nt of a prosthesis infected by a highly rifampin-resistant Staphylococcus e pidermidis.