NDT Advance Access originally published online on April 1, 2007
Nephrology Dialysis Transplantation 2007 22(8):2239-2246; doi:10.1093/ndt/gfm141
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In vitro activity of daptomycin and vancomycin lock solutions on staphylococcal biofilms in a central venous catheter model
1Department of Pharmacy Practice, University of Rhode Island, Kingston, RI 02881, 2Veterans Affairs Medical Center, 3Division of Infectious Diseases, Rhode Island Hospital, Providence, RI 02903 and 4Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI 02912, USA
Correspondence and offprint requests to: Kerry L. LaPlante, University of Rhode Island, Veterans Affairs Medical Center (151), Research Building, 830 Chalkstone Avenue, Providence, RI 02908. Email: KerryTedesco{at}uri.edu
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Abstract |
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Background. Catheter lock solutions are used for prevention and management of catheter-related bloodstream infections. We investigated the activity of daptomycin and vancomycin lock solutions against Staphylococcus aureus and Staphylococcus epidermidis in an in vitro central venous catheter (CVC) model.
Methods. Biofilm-producing reference strains of S. aureus and S. epidermidis were evaluated. After 24 h of bacterial growth in a CVC model, daptomycin and vancomycin bactericidal activity (+/– preservative-containing heparin sodium) were separately evaluated as a lock solution using 0.5, 1 and 35 mg/ml. Calcium carbonate (50 mg/l) was added to all lock solutions containing daptomycin. Each CVC was drained, flushed and sonicated at 72 h to assess CFU/ml.
Results. After 72 h of exposure in the catheter lock solutions, daptomycin and vancomycin at 0.5, 1 and 5 mg/ml demonstrated bactericidal activity (>3.0 log10 CFU/ml) against S. aureus and S. epidermidis (P 
0.001). Heparin lock solution alone produced a non-significant reduction in S. aureus and S. epidermidis (1.92 ± 0.07 and 1.65 ± 0.03 log10 CFU/ml, respectively). Daptomycin 5 mg/ml lock solution +/– heparin eradicated (limit of detection 2.0 log10 CFU/ml) S. epidermidis at 72 h as did the vancomycin 5 mg/ml plus heparin. S. aureus was only eradicated from the daptomycin 5 mg/ml catheter lock-solution.
Conclusions. Our CVC model demonstrated that 72 h of exposure to 5 mg/ml lock solutions of daptomycin (plus calcium), +/– heparin or 5 mg/ml of vancomycin plus heparin demonstrate promise in treating catheter infections with biofilm-producing S. epidermidis. Similarly, 5 mg/ml of daptomycin (plus calcium) as a lock solution shows great promise in treating S. aureus catheter infections.
Keywords: biofilms; catheter lock solutions; daptomycin; Staphylococcus aureus; Staphylococcus epidermidis; vancomycin
Received for publication: 18.12.06
Accepted in revised form: 22. 2.07
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