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2004 OMIG, Abstract 18

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Influence of Vancomycin on Adhesion of a Staphylococcus epidermidis Strain Encoding ica Locus to Intraocular Lenses
L Kodjikian1,2,3,4, S Baillif1,2, C Roques6, J Garweg4, J Freney3,5, C Burillon2,3.
1Department of Ophthalmology, Croix-Rousse Hospital, Lyon, France 2Department of Ophthalmology, Edouard Herriot Hospital, Lyon, France 3Laboratory "Biomaterials and Matrix Remodeling", EA 3090, Claude Bernard University Lyon, France 4Department of Ophthalmology, Inselspital, Bern University, Bern, Switzerland 5Department of Microbiology, Institute of Pharmaceutical and Biological Sciences, Lyon, France 6Department of Microbiology, EA 819, Xenobiotics Kenetics, Pharmacy Faculty, Paul Sabatier University, Toulouse, France

Purpose: To assess anti-adhesion and/or bactericidal properties of vancomycin in vitro and to determine exactly when these effects are detectable, in order to estimate its relevance to perioperative antibiotic prophylaxis. To also analyze the efficiency of a newly designed vancomycin insert prototype for endophthalmitis prevention.
Methods: Staphylococcus epidermidis clinical strain N890074, containing the intercellular adhesion (ica) locus, was used as infectious agent. Vancomycin was used at 20 ug/ml. A sterile biocompatible biodegradable vancomycin insert, releasing 230 ug of antibiotics over 100 minutes, was designed especially for this study. To obtain bacterial killing curves, the first experiments were performed in a 103 CFU/ml bacterial suspension containing no intraocular lenses (IOL). Then lOLs were incubated in the suspension and bacterial adherence was determined using bacterial counting, with and without antibiotic.
Results: Vancomycin (solution and insert) had an anti-adhesion effect after 1 hour and a relevant bactericidal effect after 6 hours of incubation.
Conclusion: Vancomycin used along with irrigating solutions does not remain in the anterior chamber long enough to develop any bactericidal effect. Even if it initially reduces bacterial adhesion, used with a drug level dropping below the bacterial minimal inhibitory concentration, it could result in a secondary increase of adhesion of slime-producing bacteria. A sufficiently high concentration was obtained by the new sustained release system thereby overcoming the drawback of a short half life within the anterior chamber and allowing a clinically satisfying anti-adhesion and bactericidal action of vancomycin.

Disclosure Code: N

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