The antimicrobial efficacy of a new central venous catheter with long-term broad-spectrum activity.

Indwelling vascular catheters are a major cause of nosocomial sepsis. Prevention of colonization of polymeric surfaces by continuous release of bactericidal, highly biocompatible antimicrobials incorporated into polymers has been investigated as a promising new approach. An antimicrobial polyurethane catheter was investigated by HPLC and various antimicrobial assays. Controlled drug delivery governed by the physico-chemical mass transfer from the polyurethane bulk provided long-term release of the antimicrobial substances from the material to the outer surface and catheter lumen. The in vitro activity of catheters coated with miconazole and rifampicin against 158 clinical isolates of catheter-associated infections was evaluated. Incubated in physiological NaCl at 37 degrees C, the half-life of inhibitory activity of catheters coated with miconazole or rifampicin exceeded 3 weeks. In static and dynamic adhesion assays, coated catheters were able to prevent colonization with Staphylococcus aureus, Staphylococcus epidermidis and enterococci. To produce catheters resistant to infection, a potent antimicrobial efficacy combined with an excellent biocompatibility over time is needed. The long lasting efficacy of the antimicrobial polyurethane alloy as well as the increased antifungal activity of miconazole combined with rifampicin may be regarded as a promising improvement for long-term central venous access.