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Laser‐induced shock waves enhance sterilization of infected vascular prosthetic grafts
Author(s) -
Nigri Giuseppe R.,
Tsai Sheaumei,
Kossodo Sylvie,
Waterman Peter,
Fungaloi Patrick,
Hooper David C.,
Doukas Apostolos G.,
LaMuraglia Glenn M.
Publication year - 2001
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.1138
Subject(s) - staphylococcus epidermidis , antibiotics , microbiology and biotechnology , saline , staphylococcus aureus , biofilm , sterilization (economics) , bacteria , vancomycin , multidrug tolerance , colony forming unit , biology , medicine , monetary economics , economics , foreign exchange market , genetics , foreign exchange
Abstract Background and Objective Bacteria that cause infection of vascular prosthetic grafts produce an exopolysaccharide matrix known as biofilm. Growth in biofilms protects the bacteria from leukocytes, antibodies and antimicrobial drugs. Laser‐generated shock waves (SW) can disrupt biofilms and increase drug penetration. This study investigates the possibility of increasing antibiotic delivery and sterilization of vascular prosthetic graft. Study Design/Materials and Methods Strains of Staphylococcus epidermidis and S. aureus were isolated from infected prosthetic grafts obtained directly from patients. Dacron grafts were inoculated with the isolated bacteria, which were allowed to form adherent bacterial colonies. The colonized grafts underwent the following treatments: (a) antibiotic (vancomycin) alone; (b) antibiotic and SW (c) saline only; and (d) saline and SW. Six hours after treatment, the grafts were sonicated, the effluent was cultured and the colony forming units (CFU) were counted. Results CFU recovered from control grafts colonized by S. epidermidis were comparable: saline, 3.05 × 10 8 and saline + SW 3.31 × 10 8 . The number of S. epidermidis CFU diminished to 7.61 × 10 6 after antibiotic treatment but the combined antibiotic + SW treatment synergistically decreased CFU number to 1.27 × 10 4 ( P < 0.001). S. aureus showed a higher susceptibility to the antibiotic: 2.26 × 10 6 CFU; antibiotic + SW treatment also had an incremental effect: 8.27 × 10 4 CFU ( P < 0.001). Conclusions This study demonstrates that laser‐generated shock waves have no effects alone, but can enhance the effectiveness of antibiotics against bacteria associated with prosthetic vascular graft biofilms, suggesting that this treatment may be of value as adjunctive therapy for prosthetic graft infections. Lasers Surg. Med. 29:448–454, 2001. © 2001 Wiley‐Liss, Inc.