Action of linezolid or vancomycin on biofilms in ventriculoperitoneal shunts in vitro

Cerebrospinal fluid (CSF) shunts used to treat hydrocephalus have an overall infection rate of about 10% of operations. The commonest causative bacteria are Staphylococcus epidermidis, followed by Staphylococcus aureus and enterococci. Major difficulties are encountered with nonsurgical treatment du...

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Main Authors: Bayston, Roger, Ullas, Gautham, Ashraf, Waheed
Format: Article
Published: American Society for Microbiology 2012
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Online Access:https://eprints.nottingham.ac.uk/1648/
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author Bayston, Roger
Ullas, Gautham
Ashraf, Waheed
author_facet Bayston, Roger
Ullas, Gautham
Ashraf, Waheed
author_sort Bayston, Roger
building Nottingham Research Data Repository
collection Online Access
description Cerebrospinal fluid (CSF) shunts used to treat hydrocephalus have an overall infection rate of about 10% of operations. The commonest causative bacteria are Staphylococcus epidermidis, followed by Staphylococcus aureus and enterococci. Major difficulties are encountered with nonsurgical treatment due to biofilm development in the shunt tubing and inability to achieve sufficiently high CSF drug levels by intravenous administration. Recently, three cases of S. epidermidis CSF shunt infection have been treated by intravenous linezolid without surgical shunt removal, and we therefore investigated vancomycin and linezolid against biofilms of these bacteria in vitro. A continuous-perfusion model of shunt catheter biofilms was used to establish mature (1-week) biofilms of Staphylococcus aureus, Staphylococcus epidermidis (both methicillin resistant [MRSA and MRSE]), Enterococcus faecalis, and Enterococcus faecium. They were then “treated” with either vancomycin or linezolid in concentrations achievable in CSF for 14 days. The biofilms were then monitored for 1 week for eradication and for regrowth. Enterococcal biofilms were not eradicated by either vancomycin or linezolid. Staphylococcal biofilms were eradicated by both antibiotics after 2 days and did not regrow. No resistance was seen. Linezolid at concentrations achievable by intravenous or oral administration was able to eradicate biofilms of both S. epidermidis (MRSE) and S. aureus (MRSA). Neither vancomycin at concentrations achievable by intrathecal administration nor linezolid was able to eradicate enterococcal biofilms. It is hoped that these in vitro results will stimulate further clinical trials with linezolid, avoiding surgical shunt removal.
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spelling nottingham-16482020-05-04T20:21:35Z https://eprints.nottingham.ac.uk/1648/ Action of linezolid or vancomycin on biofilms in ventriculoperitoneal shunts in vitro Bayston, Roger Ullas, Gautham Ashraf, Waheed Cerebrospinal fluid (CSF) shunts used to treat hydrocephalus have an overall infection rate of about 10% of operations. The commonest causative bacteria are Staphylococcus epidermidis, followed by Staphylococcus aureus and enterococci. Major difficulties are encountered with nonsurgical treatment due to biofilm development in the shunt tubing and inability to achieve sufficiently high CSF drug levels by intravenous administration. Recently, three cases of S. epidermidis CSF shunt infection have been treated by intravenous linezolid without surgical shunt removal, and we therefore investigated vancomycin and linezolid against biofilms of these bacteria in vitro. A continuous-perfusion model of shunt catheter biofilms was used to establish mature (1-week) biofilms of Staphylococcus aureus, Staphylococcus epidermidis (both methicillin resistant [MRSA and MRSE]), Enterococcus faecalis, and Enterococcus faecium. They were then “treated” with either vancomycin or linezolid in concentrations achievable in CSF for 14 days. The biofilms were then monitored for 1 week for eradication and for regrowth. Enterococcal biofilms were not eradicated by either vancomycin or linezolid. Staphylococcal biofilms were eradicated by both antibiotics after 2 days and did not regrow. No resistance was seen. Linezolid at concentrations achievable by intravenous or oral administration was able to eradicate biofilms of both S. epidermidis (MRSE) and S. aureus (MRSA). Neither vancomycin at concentrations achievable by intrathecal administration nor linezolid was able to eradicate enterococcal biofilms. It is hoped that these in vitro results will stimulate further clinical trials with linezolid, avoiding surgical shunt removal. American Society for Microbiology 2012-06 Article PeerReviewed Bayston, Roger, Ullas, Gautham and Ashraf, Waheed (2012) Action of linezolid or vancomycin on biofilms in ventriculoperitoneal shunts in vitro. Antimicrobial Agents and Chemotherapy, 56 (6). pp. 2842-2845. ISSN 0066-4804 hydrocephalus shunt infection treatment linezolid biofilm http://aac.asm.org/content/56/6/2842.full.pdf+html doi:10.1128/AAC.06326-11 doi:10.1128/AAC.06326-11
spellingShingle hydrocephalus shunt infection
treatment
linezolid
biofilm
Bayston, Roger
Ullas, Gautham
Ashraf, Waheed
Action of linezolid or vancomycin on biofilms in ventriculoperitoneal shunts in vitro
title Action of linezolid or vancomycin on biofilms in ventriculoperitoneal shunts in vitro
title_full Action of linezolid or vancomycin on biofilms in ventriculoperitoneal shunts in vitro
title_fullStr Action of linezolid or vancomycin on biofilms in ventriculoperitoneal shunts in vitro
title_full_unstemmed Action of linezolid or vancomycin on biofilms in ventriculoperitoneal shunts in vitro
title_short Action of linezolid or vancomycin on biofilms in ventriculoperitoneal shunts in vitro
title_sort action of linezolid or vancomycin on biofilms in ventriculoperitoneal shunts in vitro
topic hydrocephalus shunt infection
treatment
linezolid
biofilm
url https://eprints.nottingham.ac.uk/1648/
https://eprints.nottingham.ac.uk/1648/
https://eprints.nottingham.ac.uk/1648/