A dalbavancin lock solution can reduce enterococcal biofilms after freezing



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Díaz Navarro, Marta and Hafian, Rama and Manzano, Irene and Pérez Granda, María José and Cercenado Mansilla, Emilia and Pascual, Cristina and Rodríguez, Carmen and Muñoz, Patricia and Guembe Ramírez, María (2022) A dalbavancin lock solution can reduce enterococcal biofilms after freezing. Infectious Diseases and Therapy, 11 (2). pp. 743-755. ISSN 2193-8229, Electronic: 2193-6382

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Official URL: https://doi.org/10.1007/s40121-021-00579-4


Introduction: We previously demonstrated the efficacy of a frozen dalbavancin–heparin (DH) lock solution against biofilms of staphylococci. However, as enterococci also commonly cause catheter-related bloodstream infections (CRBSI), we assessed the bioactivity of frozen dalbavancin (D) and DH against enterococci.
Methods: Over 6 months, we compared the bioactivity of a solution of DH (1 mg/ml) with that of D in terms of cfu counts and metabolic activity against biofilms of Enterococcus faecalis and Enterococcus faecium (four strains each). For each solution, we individually compared results obtained at each time point (months 3 and 6) with baseline (month 0). We also compared the median DH value of each variable at baseline and at months 3 and 6 of freezing with the values obtained for D alone. We used both statistical and clinical criteria when results were within 25% of the reference value.
Results: At the end of the experiment (month 6), neither a statistically nor a clinically significant reduction in the bioactivity of D solution was observed in terms of cfu count and metabolic activity against enterococcal biofilms. Regarding the DH solution, we found both statistical and clinical significance in the median percentage reduction in metabolic activity between months 0 and 6 in E. faecalis strains (51.8% vs. 77.8%, P = 0.007). Moreover, after freezing, the DH solution lost significant bioactivity compared with the D solution, especially in E. faecalis.
Conclusion: A dalbavancin lock solution can be frozen for up to 6 months with no negative effect on its bioactivity against enterococcal biofilms. However, when combined with heparin, its efficacy was reduced. Therefore, we recommend that if lock therapy with frozen dalbavancin is used in the management of enterococcal C-RBSI, heparin should be added simultaneously at the time of catheter lock.

Item Type:Article
Uncontrolled Keywords:Biofilms; Dalbavancin; Enterococci; Freezing; Heparin; Lock therapy
Subjects:Medical sciences > Biology > Microbiology
ID Code:74817
Deposited On:03 Oct 2022 15:26
Last Modified:10 Oct 2022 14:10

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