Using Bacteriophages To Reduce Formation of Catheter-Associated Biofilms byStaphylococcus epidermidis

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Abstract
Use of indwelling catheters is often compromised as a result of biofilm formation. This study investigated if hydrogel-coated catheters pretreated with a coagulase-negative bacteriophage would reduceStaphylococcus epidermidisbiofilm formation. Biofilms were developed on hydrogel-coated silicone catheters installed in a modified drip flow reactor. Catheter segments were pretreated with the lyticS. epidermidisbacteriophage 456 by exposing the catheter lumen to a 10-log-PFU/ml culture of the bacteriophage for 1 h at 37°C prior to biofilm formation. The untreated mean biofilm cell count was 7.01 ± 0.47 log CFU/cm2of catheter. Bacteriophage treatment with and without supplemental divalent cations resulted in log-CFU/cm2reductions of 4.47 (P< 0.0001) and 2.34 (P= 0.001), respectively. Divalent cation supplementation without bacteriophage treatment provided a 0.67-log-CFU/cm2reduction (P= 0.053). Treatment of hydrogel-coated silicone catheters with anS. epidermidisbacteriophage in an in vitro model system significantly reduced viable biofilm formation byS. epidermidisover a 24-h exposure period, suggesting the potential of bacteriophage for mitigating biofilm formation on indwelling catheters and reducing the incidence of catheter-related infections.

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