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Thomas M. Bergamini, MD; Roberto A. Corpus, Jr; Terry M. McCurry; James C. Peyton, MS; Kenneth R. Brittian; William G. Cheadle, MD

Arch Surg. 1995;130(12):1345-1350.

Abstract
Objective
To determine if systemic suppression of host defenses during graft implantation alters the initial adherence and subsequent growth of Staphylococcus epidermidis on vascular prostheses.

Design
Dacron grafts 1 cm² were implanted in the back subcutaneous tissue of Swiss-Webster mice (n=247), followed by topical inoculation with 2x10⁷, 2x10⁵, 2x10³, or 2x10¹ colony-forming units of S epidermidis. Half of the mice were immunosuppressed with cyclophosphamide (150 mg/kg intraperitoneally), to achieve a consistent, significant decrease in the white blood cell count and major histocompatibility complex class II (Ia) expression. Control mice received an equal volume of saline solution. Graft bacterial biofilm concentrations were determined at 1 day for adherence and within 2 weeks for bacterial growth, by using sonication and quantitative agar culture.

Results
Immunosuppression did not significantly alter the initial adherence of bacteria to vascular grafts. Immunosuppressed animals that were inoculated with 2x10⁷ and 2x10⁵ colony-forming units of S epidermidis had significantly higher bacterial biofilm concentrations as compared with those in control animals. Graft infection persisted at 14 days in all animals, with and without immunosuppression.

Conclusions
Suppression of immune function during graft implantation augmented growth of adherent bacteria. The effect of short-term perioperative immunosuppression on late-appearing S epidermidis graft infection needs further study.

(Arch Surg. 1995;130:1345-1350)

Author Affiliations
From the Department of Surgery, University of Louisville (Ky) School of Medicine, and the Veterans Administration Medical Center, Louisville.

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