A Milestone In The Fight Against MRSA Is Reached With Antibiotic Impregnated Catheters

Main Category: MRSA / Drug Resistance
Also Included In: Medical Devices;  Infectious Diseases / Bacteria / Viruses
Article Date: 02 Jun 2008 - 7:00 PDT

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Data presented at a conference in America shows that catheters impregnated with the antibiotics minocycline and rifampin not only reduce the risk of bacteraemia (the presence of bacteria in the blood), but also the likelihood of bacteria developing antibiotic resistance.

This research has very positive implications for those fighting the spread of healthcare associated infections (HCAIs) - which affect at least 100,000 people a year in the UK and cost the NHS in the region of £1,000 million.[1]

Dr Duncan Wyncoll, a Consultant Intensivist in London believes that the findings will be of significant interest to doctors in the UK. He said: "It is very reassuring that resistance doesn't increase with long term use of the antibiotic impregnated catheters. It is also great to see such a long term and sustained decrease in catheter related bloodstream infection (CRBSI) rates with use of these catheters.

"Bloodstream infections are the fourth most common healthcare associated infection in the UK, and over 60 percent of these infections occur as a result of the use of catheters, intravenous feeding lines or similar devices. This is a significant step forward in the fight against healthcare associated infections."

Previously, some medical researchers had expressed concern that the use of these devices could promote antimicrobial resistance. However, Issam I. Raad, M.D., an infectious disease expert at the University of Texas M.D. Anderson Cancer Centre, presented this data that disputes this perception at the Society of Healthcare Epidemiology of America's annual conference.

The research demonstrates that after seven years of extensive use of central venous catheters impregnated with minocycline and rifampin, the rate of microbial resistance to minocycline and rifampin actually decreased after use of these catheters.

Charles McIntosh, M.D., chief medical science and technology officer for Cook Group, which manufactures the minocycline/rifampin catheter, explains how this decrease in resistance has come about: "This study is proof of the well known concept that to reduce the amount of resistant bacterial strains one must decrease antibiotic use throughout the treatment pathway and beyond. It is through overuse of antibiotics that bacteria have had the opportunity to develop resistance.

"In this study Cook's minocycline and rifampin impregnated catheter reduced blood stream infection rates by a factor of 12 over a seven year period compared with catheters simply coated with antiseptic or invasive agents. By reducing the incidence of CRBSIs, the need for systemic antibiotics like vancomycin is reduced. Thus in this study the levels of resistant MRSA strains decreased after to a long term reduction in antibiotic use. "

Data Explained

In his presentation, Dr. Raad noted that after more than 500,000 catheter-days using the antibiotic-impregnated catheter, the rate of resistance to tetracylines (the 'family' of antibiotics, which minocycline belongs to) and rifampin dramatically decreased.

The data demonstrated that the percentage of MRSA resistance to tetracycline decreased from 12 to 7 percent and MRSA resistance to rifampin decreased from 12 to 4 percent (P < 0.01).

Dr. Raad is the co-inventor of the synergistic pairing of the antibiotics minocycline and rifampin that are impregnated within the catheter material of the Cook Spectrum® catheter. His institution receives a royalty payment based upon Cook's licence to use this patented technology.

Notes:

The Society of Healthcare Epidemiology of America held its 18th annual conference from April 5th - 8th in Florida, US. For further information, please visit http://www.shea-online.org.

Infection rates from the National Audit Office:

Hospital acquired infections may be causing the NHS in the region of £1,000 million a year. However these infections could be reduced by around 15% across the NHS through better management and control.

In most developed countries, 6-10% of patients who go into hospital acquire an infection. This amounts to at least 100,000 hospital infections a year.

The commonest sites of healthcare associated infection are; urinary: 23%, lung: 22%, wound: 9% and blood: 6%.

Over 60% of blood infections are introduced by intravenous feeding lines, catheters or similar devices.

About Cook Medical:

Cook Medical was one of the first companies to help popularise interventional medicine, pioneering many of the devices now commonly used worldwide to perform minimally invasive medical procedures. Today, the company integrates device design, biopharma, gene and cell therapy and biotech to enhance patient safety and improve clinical outcomes in the fields of aortic intervention; interventional cardiology; critical care medicine; gastroenterology; radiology, peripheral vascular, bone access and oncology; surgery and soft tissue repair; urology; and assisted reproductive technology, gynecology and high-risk obstetrics. Cook is a past winner of the prestigious Medical Device Manufacturer of the Year Award from Medical Device & Diagnostic Industry magazine.

For more information, please visit http://www.cookmedical.com.