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Antibacterial activity of antibiotic-soaked polyvinylpyrrolidone-grafted silicon elastomer hydrocephalus shunts
J J Boelens1, W F Tan, J Dankert
1Department of Medical Microbiology and Department of Neurosurgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. BoelensJJ@yahoo.com
Abstract:
If shunts, inserted for the relief of hydrocephalus, are pretreated with antimicrobials, the incidence of shunt-associated infections (SAI) may be reduced. The duration of the antibacterial activity of shunts, made from conventional silicon elastomer (SE) or from SE grafted with the hydrogel polyvinylpyrrolidone (SEpvp), which had been soaked in various antibiotics, was assessed in vitro. For any antibiotic or combination, using an arbitrary breakpoint (aBP), SEpvp remained antibacterially active for longer periods than SE. Bacterial adherence to either shunt was prevented during the period of antibacterial activity. Thus, the aBP is a good indicator of the capacity of antimicrobial-treated shunts to prevent bacterial colonization in vitro. Hydrogel-grafting of shunts may be useful in preventing SAI.
Insights
Hydrogel-grafted shunts show prolonged antibacterial activity, reducing the risk of shunt-associated infections (SAI). This enhanced material effectively prevents bacterial adherence, offering a promising strategy for preventing SAI.
Area of Science:
- Biomaterials Science
- Infectious Disease Prevention
- Neurosurgery
Background:
- Shunt-associated infections (SAI) are a significant complication following hydrocephalus treatment.
- Antimicrobial pretreatment of shunts aims to reduce the incidence of SAI.
- Conventional silicon elastomer (SE) shunts have limitations in sustained antimicrobial release.
Purpose of the Study:
- To evaluate the duration of antibacterial activity of antimicrobial-soaked shunts.
- To compare the efficacy of conventional SE shunts versus hydrogel-grafted SE shunts (SEpvp).
- To assess the role of an arbitrary breakpoint (aBP) in predicting shunt performance against bacterial colonization.
Main Methods:
- Shunts made from SE and SEpvp were soaked in various antibiotics.
- In vitro assessment of the duration of antibacterial activity using an arbitrary breakpoint (aBP).
- Evaluation of bacterial adherence to both types of shunts during the active antibacterial period.
Main Results:
- SEpvp shunts demonstrated significantly longer periods of antibacterial activity compared to SE shunts for all tested antibiotics and combinations.
- Bacterial adherence to shunts was effectively prevented throughout the duration of their antibacterial activity.
- The aBP served as a reliable indicator for the shunts' capacity to prevent bacterial colonization in vitro.
Conclusions:
- Hydrogel-grafting of shunts with polyvinylpyrrolidone (SEpvp) enhances and prolongs their antibacterial properties.
- Antimicrobial-treated SEpvp shunts show potential in preventing shunt-associated infections.
- This approach may offer an improved strategy for reducing SAI in hydrocephalus management.