Fig. 4.

ALT and parenteral daptomycin treatment, separately and together, of methicillin-susceptible Staphylococcus aureus (MSSA) central venous catheter infection. (A) Daily central venous catheter blood draws were used to monitor S. aureus ATCC 25923 biofilms in rats (means ± standard deviations). CFU/ml data before dosing are presented as a single group (days 1 to 5 following inoculation; n = 18). ALT for only 30 min daily was initiated along with systemic dosing for four consecutive days starting on day 5. ALT with 5 mg/ml daptomycin, combined with either systemic lactated Ringer's solution (2 ml/kg s.c.) or systemic daptomycin (40 mg/kg s.c.), resulted in a significant decrease in the bacterial burden from daily drawn catheter blood from day 6 (after only one dose) through harvesting on day 9 (P < 0.001 versus both groups with ALT with lactated Ringer's solution). (B) Bar graph showing bacterial titers (means ± standard deviations) for catheter blood, cardiac blood, harvested catheter, vena cava, heart, lung, kidneys, and spleen 24 h following the end of four daily ALT treatments. Tissues and fluids from rats receiving ALT with 5 mg/ml daptomycin had significantly decreased bacterial loads compared with those from rats receiving ALT with lactated Ringer's solution and systemic lactated Ringer's solution (P value of <0.001, except for kidneys, with a P value of <0.01).