Efficacy of silver-coated fabric to prevent bacterial colonization and subsequent device-based biofilm formation.

Efficacy of silver-coated poly(ethylene terephthalate) to prevent bacterial attachment and subsequent infection was quantified in vitro, in both batch- and flowing-fluid experiments. Kinetic analysis of batch suspended cell cultures of Staphylococcus epidermidis (SE), at various growth-limiting nutrient concentrations, in the absence of any fabric, indicated a maximum culture growth rate constant micro(max) = 0.78 +/- 0.02 h(-1). Batch experiments for Control fabric samples indicated that SE cultures exhibited about the same suspended cell growth rate (0.72 +/- 0.02 h(-1)) as observed in batch suspended cultures without fabric. Suspended SE cultures in the presence of silver-coated fabric grew at a considerably lower rate, 0.15 +/- 0.01 h(-1), indicating the inhibitory effect of Ag(+2) ion released from the fabric. Growth rates of suspended SE cultures were 5-6 times higher in the fluid phase in contact with the Control fabric compared to cultures exposed to silver-coated fabric. Maximum suspended cell concentrations attained at time = 24 h were 1-2 orders of magnitude higher for Control fabrics vs. silver-coated fabric. In all batch colonization experiments, both live and dead SE bacterial cells accumulate on the surfaces of both silver-coated and Control fabrics. Adherent viable SE cells accumulated to 1-2 orders of magnitude more ( approximately 5 x 10(+8) cells/cm(2)) on Control fabric than SE cells on the silver-coated fabric ( approximately 1.1 x 10(+6) cells/cm(2)), respectively. Between 70-95% SE cells on the Control fabric were viable, while on the silver-coated fabric samples, at 24 h, viable cells were less than 10% of the adherent community (i.e., greater than 90% nonviable cells). In flow cell colonization experiments, SE cells accumulated on Control fabric to a maximum adherent cell concentration of 6 x 10(+7) - 8 x 10(+7) cells/cm(2) by 24 h with the proportion of viable cells remaining relatively constant at 76% throughout an experiment. Both noninvasive microscopic enumeration and destructive assays gave the same results for adherent cell numbers. Using silver-coated fabric, total cells numbers (live + dead) reached a level of approximately 1.1 x 10(+7) - 3.0 x 10(+7) cells/cm(2) after about 6 h and remained constant. However, while the proportion of viable cells initially on the surface was 63-75%, this fraction dropped continuously during each experiment to less than 6% viable cells at 24 h. Regardless of the criteria, the number of viable or nonviable cells attached to silver-coated fabric were significantly lower than on Control fabric. Copyright 2000 John Wiley & Sons, Inc.