Vascular Web Logo

SVS  SVS Foundation
A A A
VascularWeb

 PS186. Efficacy of Antibiotic-Impregnated Bone Cement Beads Against Organisms Found in Abdominal Vascular Graft Infections

​Fernando Kubrusly, Samuel S. Leake, Harleen K. Sandhu, Ali Azizzadeh, Hazim J. Safi, Kristofer M. Charlton-Ouw
Dept. of Cardiothoracic and Vascular Surgery, University of Texas at Houston Medical School, Houston, TX.


OBJECTIVES: Graft infection often involves several different organisms. Antibiotic-impregnated polymethylmethacrylate (PMMA) beads may be effective in controlling re-infection after infected graft replacement. We sought to determine an effective antibiotic combination in PMMA beads for use in vascular graft infection.

METHODS: PMMA beads were impregnated with different combinations of antibiotics including daptomycin (DA), tobramycin (TO) and meropenem (ME). Beads were plated into separate 0.8% Mueller-Hinton agar plates with vancomycin-resistant enterococcus (VRE), Klebsiella, S. epidermidis and methicillin-resistant staphylococcus aureus (MRSA). Antibiotic inhibition was recorded in millimeters using the disc agar-diffusion method and averaged from three separate platings.

RESULTS: DA alone was not active against Klebsiella (average = 0mm). TO alone was not active against VRE, Klebsiella or MRSA. ME showed broad-spectrum activity against all organisms with >15mm inhibition halo. The efficacy of ME was decreased by TO but not DA. Adding DA and TO to ME did not improve efficacy.
CONCLUSIONS: Meropenem in PMMA beads shows activity against difficult pathogens encountered in vascular graft infections. Daptomycin can be added for double coverage against multi-drug resistant gram-positive pathogens such as VRE and MRSA. Tobramycin appears to reduce the efficacy of meropenem when used in combination.

AUTHOR DISCLOSURES: A. Azizzadeh: Nothing to disclose; K. M. Charlton-Ouw: Nothing to disclose; F. Kubrusly: Nothing to disclose; S. S. Leake: Nothing to disclose; H. J. Safi: Nothing to disclose; H. K. Sandhu: Nothing to disclose.

Average inhibition halo in millimeters
VRE
Klebsiella
S. epidermidis
MRSA
DA
9.8
0
10.2
9.6
TO
2.0
10.7
14.0
4.7
DA+TO
8.0
10.8
14.3
9.9
ME
17.0
15.3
21.0
17.3
ME+DA
17.2
16
21.7
17.7
ME+TO
13.8
13.5
16.7
13.4
ME+DA+TO
16.9
15.0
21.0
17.0
Control
3.2
6.9
8.7
4.2
 
 
 
Posted April 2013

Contact Us

Society for Vascular Surgery
633 North Saint Clair Street, 22nd Floor | Chicago, IL 60611
Phone: 312-334-2300 | 800-258-7188
Fax: 312-334-2320
Email: vascular@vascularsociety.org

Follow Us

YouTube

VascularWeb® is the prime source for all vascular health and disease information, and is presented by the Society for Vascular Surgery®. Its members are vascular surgeons, specialists, and vascular health professionals who are specialty-trained in all treatments for vascular disease including medical management, non-invasive procedures, and surgery.