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NDT Advance Access originally published online on April 21, 2009
Nephrology Dialysis Transplantation 2009 24(10):3204-3209; doi:10.1093/ndt/gfp187
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Eradication of microorganisms embedded in biofilm by an ethanol-based catheter lock solution

Damien Balestrino1, Bertrand Souweine2,3, Nicolas Charbonnel1, Alexandre Lautrette3, Claire Aumeran4,5, Ousmane Traoré4,5 and Christiane Forestier1

1 Université Clermont1 UFR Pharmacie, Laboratoire de Bactériologie 2 Université Clermont1 UFR Médecine, Réanimation Médicale 3 CHU Clermont-Ferrand, Unité de Réanimation Médicale, Pôle Reunnirh, Hôpital Gabriel Montpied 4 Université Clermont1 UFR Médecine, Hygiène Hospitalière 5 CHU Clermont-Ferrand, Service d’Hygiène Hospitalière, Pôle Reunnirh, Hôpital Gabriel Montpied, Clermont-Ferrand, France

Correspondence and offprint requests to: Bertrand Souweine; E-mail: bsouweine{at}chu-clermontferrand.fr



  Abstract

Background. Interdialytic locking of catheters with antimicrobial agents is frequently used for preventing catheter-related infections, often associated with biofilm formation. We determined the bactericidal effect of 60% ethanol (ETOH) versus a 46.7% trisodium citrate (TSC) solution on biofilm embedded in silicone catheters.

Methods. Four- and 24-h biofilms of Staphylococcus aureus, S. epidermidis, Pseudomonas aeruginosa, Klebsiella pneumoniae and Candida albicans established in a microfermentor were exposed to ETOH and TSC for up to 24 h and the number of remaining viable microorganisms was determined.

Results. ETOH 60% was significantly more effective than 46.7% TSC in rapidly eradicating sessile cells from all microorganisms tested. A 20-min ETOH 60% treatment completely eradicated the Gram-negative bacilli and C. albicans biofilms, which initially contained up to 108 and 105 cells, respectively. Gram-positive cocci biofilms only showed a significant 2.6–4.3 log reduction in the initial viable counts after 20 min of ETOH 60% treatment, with eradication occurring after 30 min. Confocal laser scanning microscopy observation of ETOH-treated biofilm showed sparse cells with respiratory activity. TSC 46.7% eradicated none of the tested microorganisms. In contrast, ETOH 60% totally eradicated planktonic cells, whereas TSC had significant bactericidal activity against K. pneumoniae, P. aeruginosa and C. albicans after 20 min, 1 and 24 h, respectively, but none on the Staphylococcus species.

Conclusions. This in vitro study demonstrates the superior antimicrobial activity of ETOH 60% in contrast to TSC 46.7% in eradicating biofilm formed on a silicon catheter. Hence, ethanol-based solution shows promise as a catheter lock solution.

Keywords: biofilm; catheter; infection; lock solution

Received for publication: 8. 1.09
Accepted in revised form: 31. 3.09


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