The Experts below are selected from a list of 4752 Experts worldwide ranked by ideXlab platform
Issam I Raad - One of the best experts on this subject based on the ideXlab platform.
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minocycline edta ethanol Antimicrobial Catheter lock solution is highly effective in vitro for eradication of candida auris biofilms
Antimicrobial Agents and Chemotherapy, 2020Co-Authors: Ruth Reitzel, Joel Rosenblatt, Nylev Vargascruz, Bahgat Z Gerges, Issam I RaadAbstract:Candida auris is an emerging pathogen that can cause virulent central-line-associated bloodstream infections. Catheter salvage through the eradication of biofilms is a desirable therapeutic option. We compared taurolidine and minocycline-EDTA-ethanol (MEE) Catheter lock solutions in vitro for the eradication of biofilms of 10 C. auris strains. MEE fully eradicated all C. auris biofilms, while taurolidine lock partially eradicated all of the C. auris biofilms. The superiority was significant for all C. auris strains tested (P = 0.002).
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comparative efficacies of Antimicrobial Catheter lock solutions for fungal biofilm eradication in an in vitro model of Catheter related fungemia
Journal of Fungi, 2017Co-Authors: Joel Rosenblatt, Ruth Reitzel, Ray Y Hachem, Nylev Vargascruz, Annemarie Chaftari, Issam I RaadAbstract:Fungal Catheter-related bloodstream infections (CRBSIs)—primarily due to Candida species—account for over 12% of all CRBSIs, and have been progressively increasing in prevalence. They present significant health and economic burdens, and high mortality rates. Antimicrobial Catheter lock solutions are an important prophylactic option for preventing fungal CRBSIs. In this study, we compared the effectiveness of two FDA-approved Catheter lock solutions (heparin and saline) and three experimental Antimicrobial Catheter lock solutions—30% citrate, taurolidine-citrate-heparin (TCH), and nitroglycerin-citrate-ethanol (NiCE)—in an in vitro model of Catheters colonized by fungi. The fungi tested were five different strains of Candida clinical isolates from cancer patients who contracted CRBSIs. Time-to-biofilm-eradication was assessed in the model with 15, 30, and 60 min exposures to the lock solutions. Only the NiCE lock solution was able to fully eradicate all fungal biofilms within 60 min. Neither 30% citrate nor TCH was able to fully eradicate any of the Candida biofilms in this time frame. The NiCE lock solution was significantly superior to TCH in eradicating biofilms of five different Candida species (p = 0.002 for all).
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in vitro assessment of the Antimicrobial efficacy of optimized nitroglycerin citrate ethanol as a nonantibiotic Antimicrobial Catheter lock solution for prevention of central line associated bloodstream infections
Antimicrobial Agents and Chemotherapy, 2016Co-Authors: Ruth Reitzel, Joel Rosenblatt, Ray Y Hachem, Annemarie Chaftari, Cheryl Hirshginsberg, Kimberly Murray, Issam I RaadAbstract:The rapid, broad-spectrum, biofilm-eradicating activity of the combination of 0.01% nitroglycerin, 7% citrate, and 20% ethanol and its potential as a nonantibiotic, Antimicrobial Catheter lock solution (ACLS) were previously reported. Here, a nitroglycerin-citrate-ethanol (NiCE) ACLS optimized for clinical assessment was developed by reducing the nitroglycerin and citrate concentrations and increasing the ethanol concentration. Biofilm-eradicating activity was sustained when the ethanol concentration was increased from 20 to 22% which fully compensated for reducing the citrate concentration from 7% to 4% as well as the nitroglycerin concentration from 0.01% to 0.0015% or 0.003%. The optimized formulations demonstrated complete and rapid (2 h) eradication of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-intermediate Staphylococcus aureus (VISA), methicillin-resistant Staphylococcus epidermidis (MRSE), vancomycin-resistant enterococci (VRE), multidrug-resistant (MDR) Pseudomonas aeruginosa, MDR Klebsiella pneumoniae, MDR Enterobacter cloacae, MDR Acinetobacter baumannii, MDR Escherichia coli, MDR Stenotrophomonas maltophilia, Candida albicans, and Candida glabrata biofilms. The optimized NiCE lock solutions demonstrated anticoagulant activities comparable to those of heparin lock solutions. NiCE lock solution was significantly more effective than taurolidine-citrate-heparin lock solution in eradicating biofilms of Staphylococcus aureus and Candida glabrata The optimized, nonantibiotic, heparin-free NiCE lock solution demonstrates rapid broad-spectrum biofilm eradication as well as effective anticoagulant activity, making NiCE a high-quality ACLS candidate for clinical assessment.
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glyceryl trinitrate complements citrate and ethanol in a novel Antimicrobial Catheter lock solution to eradicate biofilm organisms
Antimicrobial Agents and Chemotherapy, 2013Co-Authors: Joel Rosenblatt, Ruth Reitzel, Tanya Dvorak, Ying Jiang, Ray Y Hachem, Issam I RaadAbstract:Antimicrobial Catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous Catheters. Citrate has been used clinically as an anticoagulant in heparin-free Catheter locks. Ethanol has also been widely studied as an Antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for Catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a Catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
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glyceryl trinitrate complements citrate and ethanol in a novel Antimicrobial Catheter lock solution to eradicate biofilm organisms
Antimicrobial Agents and Chemotherapy, 2013Co-Authors: Joel Rosenblatt, Ruth Reitzel, Tanya Dvorak, Ying Jiang, Ray Y Hachem, Issam I RaadAbstract:Antimicrobial Catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous Catheters. Citrate has been used clinically as an anticoagulant in heparin-free Catheter locks. Ethanol has also been widely studied as an Antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for Catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a Catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
Joel Rosenblatt - One of the best experts on this subject based on the ideXlab platform.
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minocycline edta ethanol Antimicrobial Catheter lock solution is highly effective in vitro for eradication of candida auris biofilms
Antimicrobial Agents and Chemotherapy, 2020Co-Authors: Ruth Reitzel, Joel Rosenblatt, Nylev Vargascruz, Bahgat Z Gerges, Issam I RaadAbstract:Candida auris is an emerging pathogen that can cause virulent central-line-associated bloodstream infections. Catheter salvage through the eradication of biofilms is a desirable therapeutic option. We compared taurolidine and minocycline-EDTA-ethanol (MEE) Catheter lock solutions in vitro for the eradication of biofilms of 10 C. auris strains. MEE fully eradicated all C. auris biofilms, while taurolidine lock partially eradicated all of the C. auris biofilms. The superiority was significant for all C. auris strains tested (P = 0.002).
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comparative efficacies of Antimicrobial Catheter lock solutions for fungal biofilm eradication in an in vitro model of Catheter related fungemia
Journal of Fungi, 2017Co-Authors: Joel Rosenblatt, Ruth Reitzel, Ray Y Hachem, Nylev Vargascruz, Annemarie Chaftari, Issam I RaadAbstract:Fungal Catheter-related bloodstream infections (CRBSIs)—primarily due to Candida species—account for over 12% of all CRBSIs, and have been progressively increasing in prevalence. They present significant health and economic burdens, and high mortality rates. Antimicrobial Catheter lock solutions are an important prophylactic option for preventing fungal CRBSIs. In this study, we compared the effectiveness of two FDA-approved Catheter lock solutions (heparin and saline) and three experimental Antimicrobial Catheter lock solutions—30% citrate, taurolidine-citrate-heparin (TCH), and nitroglycerin-citrate-ethanol (NiCE)—in an in vitro model of Catheters colonized by fungi. The fungi tested were five different strains of Candida clinical isolates from cancer patients who contracted CRBSIs. Time-to-biofilm-eradication was assessed in the model with 15, 30, and 60 min exposures to the lock solutions. Only the NiCE lock solution was able to fully eradicate all fungal biofilms within 60 min. Neither 30% citrate nor TCH was able to fully eradicate any of the Candida biofilms in this time frame. The NiCE lock solution was significantly superior to TCH in eradicating biofilms of five different Candida species (p = 0.002 for all).
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in vitro assessment of the Antimicrobial efficacy of optimized nitroglycerin citrate ethanol as a nonantibiotic Antimicrobial Catheter lock solution for prevention of central line associated bloodstream infections
Antimicrobial Agents and Chemotherapy, 2016Co-Authors: Ruth Reitzel, Joel Rosenblatt, Ray Y Hachem, Annemarie Chaftari, Cheryl Hirshginsberg, Kimberly Murray, Issam I RaadAbstract:The rapid, broad-spectrum, biofilm-eradicating activity of the combination of 0.01% nitroglycerin, 7% citrate, and 20% ethanol and its potential as a nonantibiotic, Antimicrobial Catheter lock solution (ACLS) were previously reported. Here, a nitroglycerin-citrate-ethanol (NiCE) ACLS optimized for clinical assessment was developed by reducing the nitroglycerin and citrate concentrations and increasing the ethanol concentration. Biofilm-eradicating activity was sustained when the ethanol concentration was increased from 20 to 22% which fully compensated for reducing the citrate concentration from 7% to 4% as well as the nitroglycerin concentration from 0.01% to 0.0015% or 0.003%. The optimized formulations demonstrated complete and rapid (2 h) eradication of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-intermediate Staphylococcus aureus (VISA), methicillin-resistant Staphylococcus epidermidis (MRSE), vancomycin-resistant enterococci (VRE), multidrug-resistant (MDR) Pseudomonas aeruginosa, MDR Klebsiella pneumoniae, MDR Enterobacter cloacae, MDR Acinetobacter baumannii, MDR Escherichia coli, MDR Stenotrophomonas maltophilia, Candida albicans, and Candida glabrata biofilms. The optimized NiCE lock solutions demonstrated anticoagulant activities comparable to those of heparin lock solutions. NiCE lock solution was significantly more effective than taurolidine-citrate-heparin lock solution in eradicating biofilms of Staphylococcus aureus and Candida glabrata The optimized, nonantibiotic, heparin-free NiCE lock solution demonstrates rapid broad-spectrum biofilm eradication as well as effective anticoagulant activity, making NiCE a high-quality ACLS candidate for clinical assessment.
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glyceryl trinitrate complements citrate and ethanol in a novel Antimicrobial Catheter lock solution to eradicate biofilm organisms
Antimicrobial Agents and Chemotherapy, 2013Co-Authors: Joel Rosenblatt, Ruth Reitzel, Tanya Dvorak, Ying Jiang, Ray Y Hachem, Issam I RaadAbstract:Antimicrobial Catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous Catheters. Citrate has been used clinically as an anticoagulant in heparin-free Catheter locks. Ethanol has also been widely studied as an Antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for Catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a Catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
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glyceryl trinitrate complements citrate and ethanol in a novel Antimicrobial Catheter lock solution to eradicate biofilm organisms
Antimicrobial Agents and Chemotherapy, 2013Co-Authors: Joel Rosenblatt, Ruth Reitzel, Tanya Dvorak, Ying Jiang, Ray Y Hachem, Issam I RaadAbstract:Antimicrobial Catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous Catheters. Citrate has been used clinically as an anticoagulant in heparin-free Catheter locks. Ethanol has also been widely studied as an Antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for Catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a Catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
Ray Y Hachem - One of the best experts on this subject based on the ideXlab platform.
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comparative efficacies of Antimicrobial Catheter lock solutions for fungal biofilm eradication in an in vitro model of Catheter related fungemia
Journal of Fungi, 2017Co-Authors: Joel Rosenblatt, Ruth Reitzel, Ray Y Hachem, Nylev Vargascruz, Annemarie Chaftari, Issam I RaadAbstract:Fungal Catheter-related bloodstream infections (CRBSIs)—primarily due to Candida species—account for over 12% of all CRBSIs, and have been progressively increasing in prevalence. They present significant health and economic burdens, and high mortality rates. Antimicrobial Catheter lock solutions are an important prophylactic option for preventing fungal CRBSIs. In this study, we compared the effectiveness of two FDA-approved Catheter lock solutions (heparin and saline) and three experimental Antimicrobial Catheter lock solutions—30% citrate, taurolidine-citrate-heparin (TCH), and nitroglycerin-citrate-ethanol (NiCE)—in an in vitro model of Catheters colonized by fungi. The fungi tested were five different strains of Candida clinical isolates from cancer patients who contracted CRBSIs. Time-to-biofilm-eradication was assessed in the model with 15, 30, and 60 min exposures to the lock solutions. Only the NiCE lock solution was able to fully eradicate all fungal biofilms within 60 min. Neither 30% citrate nor TCH was able to fully eradicate any of the Candida biofilms in this time frame. The NiCE lock solution was significantly superior to TCH in eradicating biofilms of five different Candida species (p = 0.002 for all).
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in vitro assessment of the Antimicrobial efficacy of optimized nitroglycerin citrate ethanol as a nonantibiotic Antimicrobial Catheter lock solution for prevention of central line associated bloodstream infections
Antimicrobial Agents and Chemotherapy, 2016Co-Authors: Ruth Reitzel, Joel Rosenblatt, Ray Y Hachem, Annemarie Chaftari, Cheryl Hirshginsberg, Kimberly Murray, Issam I RaadAbstract:The rapid, broad-spectrum, biofilm-eradicating activity of the combination of 0.01% nitroglycerin, 7% citrate, and 20% ethanol and its potential as a nonantibiotic, Antimicrobial Catheter lock solution (ACLS) were previously reported. Here, a nitroglycerin-citrate-ethanol (NiCE) ACLS optimized for clinical assessment was developed by reducing the nitroglycerin and citrate concentrations and increasing the ethanol concentration. Biofilm-eradicating activity was sustained when the ethanol concentration was increased from 20 to 22% which fully compensated for reducing the citrate concentration from 7% to 4% as well as the nitroglycerin concentration from 0.01% to 0.0015% or 0.003%. The optimized formulations demonstrated complete and rapid (2 h) eradication of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-intermediate Staphylococcus aureus (VISA), methicillin-resistant Staphylococcus epidermidis (MRSE), vancomycin-resistant enterococci (VRE), multidrug-resistant (MDR) Pseudomonas aeruginosa, MDR Klebsiella pneumoniae, MDR Enterobacter cloacae, MDR Acinetobacter baumannii, MDR Escherichia coli, MDR Stenotrophomonas maltophilia, Candida albicans, and Candida glabrata biofilms. The optimized NiCE lock solutions demonstrated anticoagulant activities comparable to those of heparin lock solutions. NiCE lock solution was significantly more effective than taurolidine-citrate-heparin lock solution in eradicating biofilms of Staphylococcus aureus and Candida glabrata The optimized, nonantibiotic, heparin-free NiCE lock solution demonstrates rapid broad-spectrum biofilm eradication as well as effective anticoagulant activity, making NiCE a high-quality ACLS candidate for clinical assessment.
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glyceryl trinitrate complements citrate and ethanol in a novel Antimicrobial Catheter lock solution to eradicate biofilm organisms
Antimicrobial Agents and Chemotherapy, 2013Co-Authors: Joel Rosenblatt, Ruth Reitzel, Tanya Dvorak, Ying Jiang, Ray Y Hachem, Issam I RaadAbstract:Antimicrobial Catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous Catheters. Citrate has been used clinically as an anticoagulant in heparin-free Catheter locks. Ethanol has also been widely studied as an Antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for Catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a Catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
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glyceryl trinitrate complements citrate and ethanol in a novel Antimicrobial Catheter lock solution to eradicate biofilm organisms
Antimicrobial Agents and Chemotherapy, 2013Co-Authors: Joel Rosenblatt, Ruth Reitzel, Tanya Dvorak, Ying Jiang, Ray Y Hachem, Issam I RaadAbstract:Antimicrobial Catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous Catheters. Citrate has been used clinically as an anticoagulant in heparin-free Catheter locks. Ethanol has also been widely studied as an Antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for Catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a Catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
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optimal Antimicrobial Catheter lock solution using different combinations of minocycline edta and 25 percent ethanol rapidly eradicates organisms embedded in biofilm
Antimicrobial Agents and Chemotherapy, 2007Co-Authors: Issam I Raad, Tanya Dvorak, Hend Hanna, Gassan Chaiban, Ray Y HachemAbstract:Antimicrobial lock solutions may be needed to salvage indwelling Catheters in patients requiring continuous intravenous therapy. We determined the activity of minocycline, EDTA, and 25% ethanol, alone or in combination, against methicillin-resistant Staphylococcus aureus and Candida parapsilosis Catheter-related bloodstream infection strains in two established models of biofilm colonization. Biofilm-colonized Catheter segments from a modified Robbins device and a silicone disk biofilm colonization model were exposed to these Antimicrobial agents for 15 or 60 min, respectively. After exposure, segments were sonicated and cultured. To determine regrowth after incubation at 37°C, following the brief exposure to the Antimicrobial agents, an equal number of segments were washed, reincubated for 24 h, and then sonicated and cultured. The triple combination of minocycline-EDTA (M-EDTA) in 25% ethanol was the only Antimicrobial lock solution that completely eradicated S. aureus and C. parapsilosis in biofilm of all segments tested in the two models, and it completely prevented regrowth. In addition, M-EDTA in 25% ethanol was significantly more effective in rapidly eradicating the growth or regrowth of methicillin-resistant S. aureus and C. parapsilosis biofilm colonization in the two models than the other solutions—minocycline, EDTA, M-EDTA, 25% ethanol, and EDTA in ethanol. We conclude that M-EDTA in 25% ethanol is highly effective at rapidly eradicating S. aureus and C. parapsilosis embedded in biofilm adhering to Catheter segments.
Ruth Reitzel - One of the best experts on this subject based on the ideXlab platform.
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minocycline edta ethanol Antimicrobial Catheter lock solution is highly effective in vitro for eradication of candida auris biofilms
Antimicrobial Agents and Chemotherapy, 2020Co-Authors: Ruth Reitzel, Joel Rosenblatt, Nylev Vargascruz, Bahgat Z Gerges, Issam I RaadAbstract:Candida auris is an emerging pathogen that can cause virulent central-line-associated bloodstream infections. Catheter salvage through the eradication of biofilms is a desirable therapeutic option. We compared taurolidine and minocycline-EDTA-ethanol (MEE) Catheter lock solutions in vitro for the eradication of biofilms of 10 C. auris strains. MEE fully eradicated all C. auris biofilms, while taurolidine lock partially eradicated all of the C. auris biofilms. The superiority was significant for all C. auris strains tested (P = 0.002).
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comparative efficacies of Antimicrobial Catheter lock solutions for fungal biofilm eradication in an in vitro model of Catheter related fungemia
Journal of Fungi, 2017Co-Authors: Joel Rosenblatt, Ruth Reitzel, Ray Y Hachem, Nylev Vargascruz, Annemarie Chaftari, Issam I RaadAbstract:Fungal Catheter-related bloodstream infections (CRBSIs)—primarily due to Candida species—account for over 12% of all CRBSIs, and have been progressively increasing in prevalence. They present significant health and economic burdens, and high mortality rates. Antimicrobial Catheter lock solutions are an important prophylactic option for preventing fungal CRBSIs. In this study, we compared the effectiveness of two FDA-approved Catheter lock solutions (heparin and saline) and three experimental Antimicrobial Catheter lock solutions—30% citrate, taurolidine-citrate-heparin (TCH), and nitroglycerin-citrate-ethanol (NiCE)—in an in vitro model of Catheters colonized by fungi. The fungi tested were five different strains of Candida clinical isolates from cancer patients who contracted CRBSIs. Time-to-biofilm-eradication was assessed in the model with 15, 30, and 60 min exposures to the lock solutions. Only the NiCE lock solution was able to fully eradicate all fungal biofilms within 60 min. Neither 30% citrate nor TCH was able to fully eradicate any of the Candida biofilms in this time frame. The NiCE lock solution was significantly superior to TCH in eradicating biofilms of five different Candida species (p = 0.002 for all).
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in vitro assessment of the Antimicrobial efficacy of optimized nitroglycerin citrate ethanol as a nonantibiotic Antimicrobial Catheter lock solution for prevention of central line associated bloodstream infections
Antimicrobial Agents and Chemotherapy, 2016Co-Authors: Ruth Reitzel, Joel Rosenblatt, Ray Y Hachem, Annemarie Chaftari, Cheryl Hirshginsberg, Kimberly Murray, Issam I RaadAbstract:The rapid, broad-spectrum, biofilm-eradicating activity of the combination of 0.01% nitroglycerin, 7% citrate, and 20% ethanol and its potential as a nonantibiotic, Antimicrobial Catheter lock solution (ACLS) were previously reported. Here, a nitroglycerin-citrate-ethanol (NiCE) ACLS optimized for clinical assessment was developed by reducing the nitroglycerin and citrate concentrations and increasing the ethanol concentration. Biofilm-eradicating activity was sustained when the ethanol concentration was increased from 20 to 22% which fully compensated for reducing the citrate concentration from 7% to 4% as well as the nitroglycerin concentration from 0.01% to 0.0015% or 0.003%. The optimized formulations demonstrated complete and rapid (2 h) eradication of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-intermediate Staphylococcus aureus (VISA), methicillin-resistant Staphylococcus epidermidis (MRSE), vancomycin-resistant enterococci (VRE), multidrug-resistant (MDR) Pseudomonas aeruginosa, MDR Klebsiella pneumoniae, MDR Enterobacter cloacae, MDR Acinetobacter baumannii, MDR Escherichia coli, MDR Stenotrophomonas maltophilia, Candida albicans, and Candida glabrata biofilms. The optimized NiCE lock solutions demonstrated anticoagulant activities comparable to those of heparin lock solutions. NiCE lock solution was significantly more effective than taurolidine-citrate-heparin lock solution in eradicating biofilms of Staphylococcus aureus and Candida glabrata The optimized, nonantibiotic, heparin-free NiCE lock solution demonstrates rapid broad-spectrum biofilm eradication as well as effective anticoagulant activity, making NiCE a high-quality ACLS candidate for clinical assessment.
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glyceryl trinitrate complements citrate and ethanol in a novel Antimicrobial Catheter lock solution to eradicate biofilm organisms
Antimicrobial Agents and Chemotherapy, 2013Co-Authors: Joel Rosenblatt, Ruth Reitzel, Tanya Dvorak, Ying Jiang, Ray Y Hachem, Issam I RaadAbstract:Antimicrobial Catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous Catheters. Citrate has been used clinically as an anticoagulant in heparin-free Catheter locks. Ethanol has also been widely studied as an Antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for Catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a Catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
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glyceryl trinitrate complements citrate and ethanol in a novel Antimicrobial Catheter lock solution to eradicate biofilm organisms
Antimicrobial Agents and Chemotherapy, 2013Co-Authors: Joel Rosenblatt, Ruth Reitzel, Tanya Dvorak, Ying Jiang, Ray Y Hachem, Issam I RaadAbstract:Antimicrobial Catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous Catheters. Citrate has been used clinically as an anticoagulant in heparin-free Catheter locks. Ethanol has also been widely studied as an Antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for Catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a Catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
Tanya Dvorak - One of the best experts on this subject based on the ideXlab platform.
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glyceryl trinitrate complements citrate and ethanol in a novel Antimicrobial Catheter lock solution to eradicate biofilm organisms
Antimicrobial Agents and Chemotherapy, 2013Co-Authors: Joel Rosenblatt, Ruth Reitzel, Tanya Dvorak, Ying Jiang, Ray Y Hachem, Issam I RaadAbstract:Antimicrobial Catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous Catheters. Citrate has been used clinically as an anticoagulant in heparin-free Catheter locks. Ethanol has also been widely studied as an Antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for Catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a Catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
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glyceryl trinitrate complements citrate and ethanol in a novel Antimicrobial Catheter lock solution to eradicate biofilm organisms
Antimicrobial Agents and Chemotherapy, 2013Co-Authors: Joel Rosenblatt, Ruth Reitzel, Tanya Dvorak, Ying Jiang, Ray Y Hachem, Issam I RaadAbstract:Antimicrobial Catheter lock therapy is practiced to prevent lumenal-sourced infections of central venous Catheters. Citrate has been used clinically as an anticoagulant in heparin-free Catheter locks. Ethanol has also been widely studied as an Antimicrobial lock solution component. This study reports on the synergy of glyceryl trinitrate (GTN) with citrate and ethanol in rapidly eradicating methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis, Pseudomonas aeruginosa, and Candida albicans biofilms in an in vitro model for Catheter biofilm colonization. GTN has a long history of intravenous use as a hypotensive agent. It is potentially attractive as a component of a Catheter lock solution because its physiologic half-life is quite short and its metabolic pathways are known. A lock containing 7% citrate and 20% ethanol required 0.01% GTN to fully eradicate biofilms of all test organisms within 2 h in the model. This GTN concentration is below the levels where clinically significant hypotensive effects are expected.
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optimal Antimicrobial Catheter lock solution using different combinations of minocycline edta and 25 percent ethanol rapidly eradicates organisms embedded in biofilm
Antimicrobial Agents and Chemotherapy, 2007Co-Authors: Issam I Raad, Tanya Dvorak, Hend Hanna, Gassan Chaiban, Ray Y HachemAbstract:Antimicrobial lock solutions may be needed to salvage indwelling Catheters in patients requiring continuous intravenous therapy. We determined the activity of minocycline, EDTA, and 25% ethanol, alone or in combination, against methicillin-resistant Staphylococcus aureus and Candida parapsilosis Catheter-related bloodstream infection strains in two established models of biofilm colonization. Biofilm-colonized Catheter segments from a modified Robbins device and a silicone disk biofilm colonization model were exposed to these Antimicrobial agents for 15 or 60 min, respectively. After exposure, segments were sonicated and cultured. To determine regrowth after incubation at 37°C, following the brief exposure to the Antimicrobial agents, an equal number of segments were washed, reincubated for 24 h, and then sonicated and cultured. The triple combination of minocycline-EDTA (M-EDTA) in 25% ethanol was the only Antimicrobial lock solution that completely eradicated S. aureus and C. parapsilosis in biofilm of all segments tested in the two models, and it completely prevented regrowth. In addition, M-EDTA in 25% ethanol was significantly more effective in rapidly eradicating the growth or regrowth of methicillin-resistant S. aureus and C. parapsilosis biofilm colonization in the two models than the other solutions—minocycline, EDTA, M-EDTA, 25% ethanol, and EDTA in ethanol. We conclude that M-EDTA in 25% ethanol is highly effective at rapidly eradicating S. aureus and C. parapsilosis embedded in biofilm adhering to Catheter segments.