Journal of Medical and Surgical Intensive Care Medicine 2010 , Vol 1, Issue 1
In Vitro Antifungal Activities of Antimicrobial Coated/Impregnated Central Venous Catheters Against Candida Albicans
Banu Sancak 1 , Kaya Yorgancı 1 , Barış Gürsoy 2 , Sevtap Arıkan 3 , Sibel Gelecek Geyik 4
1Hacettepe University Faculty of Medicine, Department of General Surgery, Sıhhiye, Ankara, Turkey
2Vehbi Koç Foundation, İstanbul American Hospital, İstanbul, Turkey
3Hacettepe University Faculty of Medicine, Department of Clinical Microbiology and Infectious Disease, Sıhhiye, Ankara, Turkey
4Ankara Keçiören Research and Education Hospital, Division of General Surgery, Keçiören, Ankara, Turkey

Introduction: Antimicrobial coated catheters have variable activities against micro-organisms and little is known about their antifungal effect. The aim of the present study was to determine and compare the antifungal activities of silver sulfadiazine-chlorhexidine impregnated, minocycline and rifampicin bonded and rifampicin-miconazole coated catheters against Candida albicans. 

Material and Methods: A non-antiseptic Hickman catheter was used as a control group. All catheter segments were trisected in one-centimeter pieces and were immersed in phosphate-buffered saline (0.01 mol/l ) with 0.25% dextrose and incubated at 37 oC. This solution was replaced daily. On days 1, 3, 14 and 21, a 1 ml standardized inoculum Candida albicans was added for 30 min and then replaced with phosphate-buffered saline with 0.25% dextrose. One-third of the samples were sonicated and plated to determine fungal adherence immediately at 30 min. The remaining segments were plated in sabora-dextrose agar after 4 and 24 h incubation time to determine the further formation of fungal colonies. 

Results: Rifampicin-miconazole impregnated catheters significantly prevented initial fungal adherence and 4th hour colonization for the entire study period. At 24 hours, although the rifampicin-miconazole catheter colonization was lower, this did not reach statistical significance. Silver sulfadiazine-chlorhexidine impregnated and minocycline-rifampin coated catheters prevented neither initial candidial adherence nor colonization.

Conclusions: Central venous catheters coated with rifampicin-miconazole were found to be effective against initial candidial adherence. These catheters are also effective against Candida albicans colonization for a limited time period.

Keywords : Blood-stream infections, Candida albicans, central venous cateter