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NDT Advance Access published online on January 30, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn776
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© The Author [2009].
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org


Microbial inactivation properties of a new antimicrobial/ antithrombotic catheter lock solution (citrate/methylene blue/parabens)

Janusz Steczko1, Stephen R. Ash1,2,3, David E. Nivens4, Lloyd Brewer1 and Roland K. Winger1

1 R&D, Ash Access Technology, Inc., Lafayette, IN 2 Clarian Arnett Health and Wellbound Inc., Lafayette, IN 3 Veterinary Medicine 4 Department of Food Science, Purdue University, West Lafayette, IN, USA

Correspondence and offprint requests to: Janusz Steczko, Ash Access Technology, Inc., 3601 Sagamore Pkwy N., Suite B, Lafayette, IN 47904, USA. Tel: +1-765-742-4813; Fax: +1-765-742-4823; E-mail: jsteczko{at}ashaccess.com



  Abstract

Background. Microbial infections are the most serious complications associated with indwelling central venous catheters. A catheter lock solution that is both antibacterial and antithrombotic is needed. The goal of this study was to determine whether a new catheter lock solution containing citrate, methylene blue and parabens has antimicrobial properties against planktonic bacteria and against sessile bacteria within a biofilm. These effects were compared to the antimicrobial properties of heparin at 2500 units/ml.

Methods. The tested solution (C/MB/P comprising 7% sodium citrate, 0.05% methylene blue and 0.165% parabens) and individual components were challenged against gram-positive and gram-negative organisms and fungi. Control solutions were heparin with preservatives. Studies included evaluation of eradication of planktonic bacteria and sessile organisms in a biofilm grown on polymeric and glass coupons. Biofilm samples were inspected by scanning electron microscopy, atomic force microscopy and vital stains.

Results. The C/MB/P solution, contrary to heparin, kills most tested planktonic microorganisms within 1 h of incubation. All tested organisms have an MIC of 25% or less of the original concentration of a new catheter lock. Bacteria strains did not develop resistance over more than 40 passages of culture suspensions. The C/MB/P solution is able to kill nearly all sessile bacteria in biofilm growth on plastic or glass discs in 1 h. Microscopic methods demonstrated extensive physical elimination of biofilm deposits from treated coupons. In contrast, heparin had a minimal effect on planktonic or biofilm organisms.

Conclusions. The new multicomponent lock solution has strong antimicrobial properties against both planktonic and sessile microorganisms. By comparison, heparin with preservative has weak antibacterial properties against planktonic and biofilm bacteria. The tested catheter lock may have usefulness in preventing bacterial colonization of haemodialysis catheters and diminishing the incidence of catheter-related bacteraemia.

Keywords: biofilm; catheter infection; CRBSI; haemodialysis; lock solution

Received for publication: 31. 7.08
Accepted in revised form: 27.12.08


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