Jamal, M.A., Hachem, R.Y., Rosenblatt, J., McArthur, M.J., Felix, E., Jiang, Y., Tailor, R.C. and Raad, I. (2015) Development of Antimicrobial Gendine Coated Central Catheters: In Vivo Biocompatibility and In Vitro Efficacy. Antimicrobial Agents and Chemotherapy. June 29th. [epub ahead of print].
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Antimicrobial Peripherally inserted central catheters (PICCs) might reduce the incidence of CLABSI. We tested biocompatibility of a novel gendine (combination of chlorhexidine-CHX and gentian violet-GV) PICC in a rabbit intravascular model and tested antimicrobial efficacy in comparison with commercially available minocycline/rifampin (M/R), and CHX PICCs in an in vitro biofilm colonization model. Gendine and uncoated control PICCs were inserted in the jugular veins of rabbits for 4 days. Histopathologic analysis was performed at the end of the four day period and circulating levels of CHX and GV in blood were measured at different time points using liquid chromatography/mass spectrometry. Antimicrobial efficacy of the PICCs were tested following simulated intravascular indwells of 24 hours and 1 week against clinical isolates of methicillin-resistant Staphylococcus aureus, Vancomycin-resistant enterococci Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii, Enterobacter cloacae, Candida albicans, and Candida glabrata. Rabbits implanted with gendine PICCs exhibited reduced levels of thrombosis and inflammation compared to rabbits with uncoated controls. No GV was detected in blood samples over the entire study period and trace concentrations of CHX were detected. The gendine-PICCs completely prevented adherence of all pathogens from 24 hrs to 1 week (P ≤ 0.001) while M/R, CHX and control PICCs did not. Gendine-PICCs were highly effective in preventing biofilm formation of multi-drug resistant pathogenic bacteria and fungi. Gendine-PICCs were biocompatible in an intravascular setting. Further, the pharmacokinetic testing established that acute systemic exposures of CHX and GV from the gendine catheters were well within safe levels.
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