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Infection of expanded polytetrafluoroethylene and Dacron-coated stents with Staphylococcus epidermidis: an experimental study in pigs

Infecção de stents revestidos com politetrafluoretileno expandido e Dacron com Staphylococcus epidermidis: estudo experimental em porcos

Abstract

Background

Diagnosis of the etiologic agent of endoprosthesis infections is essential to enable treatment, since these infections constitute important complications of endovascular procedures. Sonication of explanted tissue and materials is a technique that can be used to facilitate detection of biofilm-producing bacteria.

Objectives

To evaluate infection of pigs' aortas after implantation of nitinol stents coated with polytetrafluoroethylene (ePTFE) or Dacron, previously infected with biofilm-producing Staphylococcus epidermidis. Intimal thickening and the inflammatory response in the aortic wall were also evaluated.

Methods

11 ePTFE-coated nitinol stents and 10 Dacron stents infected with S. epidermidis strains were implanted in the infrarenal aorta of 21 8-week-old pigs. After 2 weeks, the aorta containing the stents was removed. A vortex mixer and ultrasound were used to homogenize the samples and remove the biofilm. Subsequently, the number of colony-forming units was counted.

Results

There were no significant differences between the two groups in terms of the number of colony-forming units or of inflammation in the arterial wall. With the exception of one specimen from the Dacron group, all aortic stent cultures were positive for S. epidermidis.

Conclusions

There were no significant differences in the inflammatory response or infection rate between ePTFE and Dacron-coated stents actively infected with biofilm-producing S. epidermidis. Intimal thickening and the inflammatory response to infection of endoprostheses were similar. These results suggest that the two most widely used stent lining materials have a similar infection rate.

Keywords:
stent; infection; Staphylococcus epidermidis; aorta; pigs

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