Original ArticlesIn vitro evaluation of antibiotic prophylaxis in the prevention of biliary stent blockage☆,☆☆
Section snippets
Modified Robbins device
The MRD is an acrylic sampling device, 42 cm long with a 2 × 10 mm chamber (Fig. 1).It has 25 evenly spaced sampling ports and is designed in such a way that the sampling surfaces lie flush with the inner surface of the flow chamber. In this experiment, segments of polyethylene stent were attached onto rubber discs using a
Effects of antibiotics on E coli adherence
In the control experiments, examination of the stents after perfusion with E coli infected ox bile revealed a dense bacterial biofilm on the plastic surface at 24 hours. The total number of bacteria continued to increase and stabilized after 2 days, reaching a density of 104 CFU/cm2 when measured with the viable plate count method. The bacterial density remained at this level up to the end of 1 week. With ciprofloxacin perfusion at a concentration of 1 μg/mL, the bacterial density of E coli
Discussion
Biliary biofilm formation involves a multitude of different bacteria and potential interactions between them. Some bacteria may prime the surface or facilitate the attachment of other bacteria.22 Such interaction may be through the production of glycocalyx or chemical signaling factors that stimulate bacterial adherence. Other bacteria may contribute to sludge formation through their enzymatic activities with production of glycocalyx. Those that possess β-glucuronidase deconjugated conjugated
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Cited by (38)
Safety and efficacy of a metal stent covered with a silicone membrane containing integrated silver particles in preventing biofilm and sludge formation in endoscopic drainage of malignant biliary obstruction: a phase 2 pilot study
2019, Gastrointestinal EndoscopyCitation Excerpt :To inhibit biofilm formation on membrane-covered metal stents, the use of antibiotics or antibiotic-eluting metal stents to inhibit bacterial adhesion has been suggested. However, studies found that prolonged use of antibiotics or cefotaxime-eluting covered metal stents did not reduce biofilm formation due to decrease in drug concentration and efficacy over time.24-28 Studies of a silver coating on biliary plastic stents revealed inhibition or reduction of bacterial adhesion and prolonged stent patency due to silver’s antibacterial activity.
Palliation of Malignant Pancreaticobiliary Obstruction
2019, Clinical Gastrointestinal EndoscopyRole of EfrAB efflux pump in biocide tolerance and antibiotic resistance of Enterococcus faecalis and Enterococcus faecium isolated from traditional fermented foods and the effect of EDTA as EfrAB inhibitor
2014, Food MicrobiologyCitation Excerpt :Thus, enterococci have emerged as important nosocomial pathogens with high-level resistance to antibiotics (Murray, 2000). Enterococcus faecalis and Enterococcus faecium are the main enterococci species causing nosocomial infections of about 75 and 20% of the enterococcal-related infections (Conde-Estevez et al., 2011; Peel et al., 2011) such as urinary tract, endocarditis, bacteremia, catheter-related infections, wound infections, and intra-abdominal and pelvic infections (Koch et al., 2004; Leung et al., 2000; Poh et al., 2006; Svanborg and Godaly, 1997). While some enterococci are known for their pathogenic implications (Edmond et al., 1999; Kayser, 2003; Murray, 1997; Vergis et al., 2001), other species are used as starter cultures in food fermentations (Foulquie Moreno et al., 2006) or as probiotics (Franz et al., 2003) being only some E. faecium stains authorized by the European Food Safety Authority (EFSA, 2012) as feed additives.
Palliation of Malignant Pancreaticobiliary Obstruction
2011, Clinical Gastrointestinal Endoscopy, Second EditionEndoscopic Palliation of Pancreatic Cancer
2007, Gastroenterology Clinics of North AmericaCitation Excerpt :Despite promising results in vitro, oral administration of mucolytic agents (ie, aspirin) or choleretic agents (ie, ursodeoxycholic acid) in combination with different antibiotics has not proved effective in preventing biliary stent occlusion [27–29]. Stent design has focused on developing stents from ultrasmooth materials to prevent bacterial adherence or impregnating with bactericidal agents to prevent biofilm formation [30]. Unfortunately, these designs have not proved successful.
Impact of reducing duodenobiliary reflux on biliary stent patency: an in vitro evaluation and a prospective randomized clinical trial that used a biliary stent with an antireflux valve{A figure is presented}
2007, Gastrointestinal EndoscopyCitation Excerpt :To reduce bacterial adherence and sludge formation, antibiotic and choleretic agents have also been tried, either separately or in combination. Unlike in vitro studies, clinical studies again did not consistently show significant benefits when using this approach.40-50 In this study, a new approach was tried that targeted the influence of duodenobiliary reflux on stent patency rates.
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Supported by VA Merit Review Grant, No. 94-07-003.
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Reprint requests: Joseph W. Leung, MD, Division of Gastroenterology, University of California, Davis Medical Center, Ste 3500, PSSB, 4150 V St., Sacramento, CA 95817