In vivo Activity of Combination of N-acetyl Cysteine and Levofloxacin against Colonization and Catheter-Associated Infection
Abstract
Despite many recent advancements and improvements to infection control measures and practices in healthcare facilities, infections associated with intravascular catheters remain problematic and even fatal. Since these infections are generally biofilm-based, effective antibiofilm strategies combined with antimicrobial approaches that can inhibit pathogenic colonization are important in preventing catheter-associated infections. We evaluated in vivo the activities of intravascular catheters impregnated with a combination of N-acetyl cysteine, an antibiofilm agent, and levofloxacin (NACLEV) compared to chlorhexidine/silver sulfadiazine-treated catheters (CHSS) against bacterial colonization and device-associated infection with representatives of both Gram-positive and Gram-negative bacteria including Staphylococcus aureus, vancomycin-resistant enterococcus (VRE), Pseudomonas aeruginosa, or Klebsiella pneumoniae. NACLEV catheters inoculated with S. aureus, VRE, or K. pneumoniae were generally as effective as inoculated CHSS catheters against device colonization (75%, 70%, or 80% vs. 65%, 55%, or 85% colonization reduction, respectively) and device-associated infection (65%, 65%, or 60% vs. 50%,3%, or 50% device-associated infection reduction, respectively). However, NACLEV catheters inoculated with P. aeruginosa were significantly more effective compared to CHSS catheters against both colonization (80% vs. 10% colonization reduction, P < 0.001) and device-associated infection…
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