Rabih O. Darouiche, M.D.
Physical Medicine & Rehabilitation
The bionic man: prevention of infections of software and hardware
Infection is the most common serious complication of indwelling medical prostheses.
Management of prosthesis-related infections remains problematic as it often requires
removal of the infected prosthesis to establish cure and can be very expensive.
Although a large number of strategies have been proposed to be preventive, only
few have been demonstrated to clinically protect against prosthesis-related infections.
Because bacterial colonization of the surface of the prosthesis is a prerequisite
for the occurrence of prosthesis-related infection, Dr. Darouiche and his laboratory
developed novel approaches to render a variety of medical prostheses anti-infective
by coating them with effective antimicrobial agents. Their ability to transfer new
technology from the bench-side to the bed‑side was best exemplified by their series
of in vitro, animal and clinical studies demonstrating that central venous catheters
coated with minocycline and rifampin significantly protect against catheter-related
infections, as compared with either uncoated catheters or another preexisting type
of antimicrobial-coated catheters. They utilized various coating technologies to
render other types of medical prostheses anti‑infective, including bladder catheters
(completed clinical trial), ventricular catheters (clinical trial in progress),
nephrostomy catheters (embarking on a clinical trial), prosthetic heart valve sewing
cuffs (embarking on a clinical trial), left ventricular assist devices (preclinical
studies), penile implants (preclinical studies), vascular grafts (preclinical studies),
breast implants (preclinical studies), and fracture fixation devices (preclinical
studies). The use of anti‑infective medical prostheses that can improve patient
care and decrease the cost of health care is likely to become the standard of care
in patients at high risk of infection.
Dr. Darouiche’s nomination was based on the following publications:
Darouiche RO, Farmer J, Chaput C, Mansouri M, Saleh G, Landon GC"
Anti-infective efficacy of antiseptic-coated intramedullary nails. ".J Bone
Joint Surg Am. 1998 Sep;80(9):1336-40.
Darouiche RO, Meade R, Mansouri M, Raad II. "
In vivo efficacy of antimicrobial-coated fabric from prosthetic heart valve sewing
rings. ". J Heart Valve Dis. 1998 Nov;7(6):639-46.
Darouiche RO, Raad II, Heard SO, Thornby JI, Wenker OC, Gabrielli A, Berg J, Khardori
N, Hanna H, Hachem R, Harris RL, Mayhall G."
A comparison of two antimicrobial-impregnated central venous catheters.
". Catheter Study Group. N Engl J Med. 1999 Jan 7;340(1):1-8.
Hull RA, Rudy DC, Donovan WH, Wieser IE, Stewart C, Darouiche RO. "
Virulence properties of Escherichia coli 83972, a prototype strain associated with
asymptomatic bacteriuria. ". Infect Immun. 1999 Jan;67(1):429-32.