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2004
OMIG, Abstract 18
OMIG
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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
OMIG
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