Local treatment of Dacron patch graft contaminated with Staphylococcus aureus with antibiotic-releasing porous apatite ceramic: An experimental study in the rabbit

Abstract Objective: The purpose of this study was to investigate whether or not infection of prosthetic vascular graft could be prevented with the placement of antibiotic-loaded porous apatite ceramic on the graft with bacterial contamination. Methods: Teicoplanin as an antibiotic was loaded into a β-tricalcium phosphate (TCP) block of porous apatite ceramic. The activity of teicoplanin released from teicoplanin-loaded TCP was examined for 40 days at 2-day intervals. In an in vivo study, the graft was patched in the abdominal aorta of a rabbit. Two different doses of Staphylococcus aureus were applied (n = 13). Teicoplanin-loaded TCP was placed around the graft infected with S aureus (n = 6). The graft, the tissue around it, and the arterial blood were collected and cultivated 4 weeks after operation. Results: The activity of teicoplanin in the replaced saline solution was maintained for at least 40 days. Because graft infection was established in all rabbits with a dose of 2 × 10 7 colony forming units, this dose was used as the dose of S aureus in this study. Fifty-seven percent of the subjects died from the infection. When teicoplanin-loaded TCP was placed around the graft contaminated with S aureus , no rabbits died. Bacterial cultures of the graft and of tissues around it were negative in all rabbits killed 4 weeks after operation. This infection was prevented with teicoplanin-loaded TCP in all rabbits. Conclusion: Teicoplanin-loaded TCP may be useful in avoiding Dacron graft infection with S aureus in rabbits. (J Vasc Surg 2003;37:169-74.)