GH3 cells, ionic currents and cell killing: photomodification sensitized by Rose Bengal

The effects of subinhibitory concentrations (sub-MICs) of gentamicin, netilmicin and amikacin on the serum sensitivity and the cell surface hydrophobicity of Klebsiella pneumoniae were investigated. At concentrations 1/16 or 1/8 of the MICs, in all antibiotics significantly enhanced the sensitivity of K. pneumoniae to human serum as compared to nontreated bacteria. The higher concentration of the antibiotics tested was more efficient. Survival of bacteria under these conditions ranged from 24.1% to 36.7% after incubation with 10% serum for 180 min when compared with the viability of the control bacteria. Bacteria grown with the test antibiotics at sub-MICs (1/8 or 1/4 of the MICs) manifested an effective decrease of the surface hydrophobicity. The aminoglycosides which were more effective at a concentration of 1/4 of the MICs reduced bacterial hydrophobicity to 28.5% (gentamicin), 14.8% (netilmicin) and 12.7% (amikacin) of the nontreated bacteria.     

Influence of subinhibitory concentrations of ceftazidime, ciprofloxacin and azithromycin on the morphology and adherence of P-fimbriated escherichia coli

The influence of subinhibitory concentrations (1/2, 1/4, 1/8, 1/16 and 1/32 x MIC) of ceftazidime, ciprofloxacin and azithromycin on the morphology and adherence of 29 wild-type P-fimbriated strains of Escherichia coli was studied. Bacterial adherence to the Buffalo green monkey (BGM) cell line was tested before and after treatment with antibiotics and detected by means of an immunofluorescence staining. Significant dose dependent reduction of bacterial adherence was observed, which correlated with the alterations in bacterial cell morphology. After exposure of strains to sub-MICs of antibiotics, normal shapes, spherical forms and filaments were noted. The greatest filamentation and the greatest loss of adherence ability occurred at 1/2 x MIC of ceftazidime. Treatment with sub-MICs of ciprofloxacin resulted in shorter filaments, while filamentation did not occur after bacterial exposure to sub-MICs of azithromycin. Azithromycin was least damaging to the adherence ability of E. coli and at a concentration of 1/2 x MIC caused globoid cell formation.     

Agricultural use of antibiotics and the evolution and transfer of antibiotic-resistant bacteria

Microbial Resistance to antibiotics is on the rise, in part because of inappropriate use of antibiotics in human medicine but also because of practices in the agricultural industry. Intensive animal production involves giving livestock animals large quantities of antibiotics to promote growth and prevent infection. These uses promote the selection of antibiotic resistance in bacterial populations. The resistant bacteria from agricultural environments may be transmitted to humans, in whom they cause disease that cannot be treated by conventional antibiotics. The author reviews trends in antibiotic use in animal husbandry and agriculture in general. The development of resistance is described, along with the genetic mechanisms that create resistance and facilitate its spread among bacterial species. Particular aspects of resistance in bacterial species common to both the human population and the agrifood industry are emphasized. Control measures that might reverse the current trends are highlighted.     

Effect of dirithromycin on Haemophilus influenzae infection of the respiratory mucosa

Macrolides have properties other than their antibiotic action which may benefit patients with airway infections. We have investigated the effect of dirithromycin (0.125 to 8.0 microg/ml) on the interaction of Haemophilus influenzae with respiratory mucosa in vitro using human nasal epithelium, adenoid tissue, and bovine trachea. Dirithromycin did not affect the ciliary beat frequency of the nasal epithelium or the transport of mucus on bovine trachea, but dirithromycin (1 microg/ml) did reduce the slowing of the ciliary beat frequency and the damage to the nasal epithelium caused by H. influenzae broth culture filtrate. Amoxicillin (2 microg/ml) did not reduce the effects of the H. influenzae broth culture filtrate. H. influenzae infection of the organ cultures for 24 h caused mucosal damage and the loss of ciliated cells. Bacteria adhered to damaged epithelium and to a lesser extent to mucus and unciliated cells. Incubation of H. influenzae with dirithromycin at sub-MICs (0.125 and 0.5 microg/ml) prior to infection of the organ cultures did not reduce the mucosal damage caused by bacterial infection. By contrast, incubation of adenoid tissue with dirithromycin (0.125 to 1.0 microg/ml) for 4 h prior to assembling the organ culture reduced the mucosal damage caused by subsequent H. influenzae infection by as much as 50%. The number of bacteria adherent to the mucosa was reduced, although the tissue that had been incubated with dirithromycin (0.125 and 0.5 microg/ml) did not inhibit bacterial growth. This was achieved by a reduction in the amount of damaged epithelium to which H. influenzae adhered and a reduction in the density of bacteria adhering to mucus. We conclude that dirithromycin at concentrations achievable in vivo markedly reduces the mucosal damage caused by H. influenzae infection due to a cytoprotective effect.     

Computed tomographic evaluation of comminuted middle phalangeal fractures in the horse

The effect of subinhibitory concentrations of amikacin on Proteus mirabilis motility and adherence to human uroepithelial and to HeLa cells was compared with that of gentamicin. In addition, the effect of both antibiotics on cell surface hydrophobicity was also examined. Exposure of bacterial cells in the logarithmic phase to one fourth of amikacin or gentamicin at one fourth of their respective minimal inhibitory concentrations causes the inhibition of swarming and motility of Proteus strains. Amikacin significantly reduced adhesion of Proteus strains to human uroepithelial cells and gentamicin exerts the same effect to a lesser extent. Such inhibitory concentrations of amikacin or gentamicin had no significant effect on the attachment ability of these strains to HeLa cells compared to the nontreated cells. Treatment of the bacterial cells with amikacin or gentamicin changed significantly the cell surface hydrophobicity towards the hydrophilic state compared to nontreated cells, and it was found to be strain dependent. Since motility and attachment ability are considered as pathogenic traits, these data indicate the impact of amikacin on the virulence factors especially in urinary tract infections with Proteus strains.     

The peptide antibiotic LL-37/hCAP-18 is expressed in epithelia of the human lung where it has broad antimicrobial activity at the airway surface

The airway surface is an important host defense against pulmonary infection. Secretion of proteins with antimicrobial activity from epithelial cells onto the airway surface represents an important component of this innate immune system. Defensins are the best characterized epithelial-derived peptide antibiotics. A member of another family of peptide antibiotics called cathelicidins recently was identified from human bone marrow. We show in this paper that this human peptide named LL-37/hCAP-18 also may play a role in innate immunity of the human lung. In situ hybridization localized high levels of LL-37/hCAP-18 RNA to surface epithelial cells of the conducting airway as well as serous and mucous cells of the submucosal glands. LL-37/hCAP-18 peptide with antimicrobial activity was partially purified from airway surface fluid from human lung and a human bronchial xenograft model. The synthetic peptide LL-37 demonstrated antibiotic activity against a number of Gram-negative and Gram-positive organisms including Pseudomonas aeruginosa; bacterial killing of LL-37 was sensitive to NaCl and was synergistic with lactoferrin and lysozyme. In summary, we show that LL-37/hCAP-18 is a peptide with broad antimicrobial activity that is secreted onto the airway surface from epithelial cells of the human lung.     

Analysis of the economic evaluation of drugs in primary care: concept, methodology and practical applications

The evaluation of the potentially septic newborn is often a source of frustration for practitioners. In the past, it has often been standard practice to evaluate and treat empirically all neonates whose mothers received antibiotics during labor, regardless of whether the infant had any signs or symptoms suggestive of infection. With the advent of recommendations for intrapartum antibiotic therapy to prevent early-onset neonatal group B streptococcal infections, this strategy is no longer practicable because too many infants would thus be evaluated and treated needlessly. This two-part review addresses the issues involved in managing asymptomatic newborns whose mothers received intrapartum antibiotics. This first part reviews the rationale behind strategies for preventing intrapartum transmission of bacterial infection. The administration of intravenous antibiotics to laboring mothers appears to reduce the incidence of group B streptococcal infections in neonates. Additionally, intrapartum antibiotic therapy for maternal chorioamnionitis may inhibit transmission of infection to the infant. Part 2--to be published separately--will address the evaluation and management of the newborn.     

An assay to measure antibiotic efficacy against Staphylococcus epidermidis biofilms on implant surfaces

Infection is a major limitation of implantable devices. Optimal antibiotic therapeutic regimes have not yet been defined. Implant-associated infections have a number of differentiating characteristics, which include the predominance of Staphylococcus epidermidis and other skin bacteria of normally low pathogenicity as the causative agents, together with a relative resistance to host defenses and to antibiotic therapy. These properties have been ascribed to the ability of the bacteria to exist on implant surfaces in the biofilm phase, which is protective. An assay of antibiotic activity using a standardized bacterial biofilm preparation of S. epidermidis is described. The assay is used to evaluate the relative efficacy of antibiotics to sterilize the biofilm, when they are used singly, or in double or triple combinations. The modulating effects of changing antibiotic concentrations and modifying the environment with CAPD variables (fresh and spent dialysis fluid, common PD solution additives) are also measured and the data summarized. It is hoped that, by using this and similar assays, individualized optimal therapeutic regimes of implant-associated infections may be logically planned.     

Antibiotic susceptibilities of mycoplasmas and treatment of mycoplasmal infections

Mycoplasmas are the smallest free-living microorganisms, being about 300 nm in diameter. They are bounded by a triple-layered membrane and, unlike conventional bacteria, do not have a rigid cell wall. Hence, they are not susceptible to penicillins and other antibiotics that act on this structure. They are, however, susceptible to a variety of other broad-spectrum antibiotics, most of which only inhibit their multiplication and do not kill them. The tetracyclines have always been in the forefront of antibiotic usage, particularly for genital tract infections, but macrolides are also widely used for respiratory tract infections. Indeed, in comparison with the tetracyclines, erythromycin, the newer macrolides, the ketolides and the newer quinolones have equal or sometimes greater activity. The two latter antibiotic groups also have some cidal activity. The antibiotic susceptibility profiles of several mycoplasmas of human origin are presented, those of Mycoplasma pneumoniae and Mycoplasma genitalium being similar. Apart from the penicillins, mycoplasmas are innately resistant to some other antibiotics, for example the rifampicins. In addition, some may develop resistance, either by gene mutation or by acquisition of a resistance gene, to antibiotics to which they are usually sensitive. Resistance of mycoplasmas to tetracyclines is common and due to acquisition of the tetM gene. The antibiotic susceptibility pattern may be influenced greatly by the source of the mycoplasma; for example, one recovered from a contaminated eukaryotic cell culture that has been subjected to extensive antibiotic treatment may have an antibiotic profile quite different from the same mycoplasmal species that has been recovered directly from a human or animal source. Mycoplasmas may be difficult to eradicate from human or animal hosts or from cell cultures by antibiotic treatment because of resistance to the antibiotic, or because it lacks cidal activity, or because there is invasion of eukaryotic cells by some mycoplasmas. Eradication may be particularly difficult in immunosuppressed or immunodeficient individuals, particularly those who are hypogammaglobulinaemic. The regimes that are most likely to be effective in the treatment of respiratory or genitourinary mycoplasmal infections are presented.     

The role of residue 238 of TEM-1 beta-lactamase in the hydrolysis of extended-spectrum antibiotics

beta-Lactamases inactivate beta-lactam antibiotics by catalyzing the hydrolysis of the amide bond in the beta-lactam ring. The plasmid-encoded class A TEM-1 beta-lactamase is a commonly encountered beta-lactamase. It is able to inactivate penicillins and cephalosporins but not extended-spectrum antibiotics. However, TEM-1-derived natural variants containing the G238S amino acid substitution display increased hydrolysis of extended-spectrum antibiotics. Two models have been proposed to explain the role of the G238S substitution in hydrolysis of extended-spectrum antibiotics. The first proposes a direct hydrogen bond of the Ser238 side chain to the oxime group of extended-spectrum antibiotics. The second proposes that steric conflict with surrounding residues, due to increased side chain volume, leads to a more accessible active site pocket. To assess the validity of each model, TEM-1 mutants with amino acids substitutions of Ala, Ser, Cys, Thr, Asn, and Val have been constructed. Kinetic analysis of these enzymes with penicillins and cephalosporins suggests that a hydrogen bond is necessary but not sufficient to achieve the hydrolytic activity of the G238S enzyme for the extended-spectrum antibiotics cefotaxime and ceftazidime. In addition, it appears that the new hydrogen bond interaction is to a site on the enzyme rather than directly to the extended-spectrum antibiotic. The data indicate that, for the G238S substitution, a combination of an optimal side chain volume and hydrogen bonding potential results in the most versatile and advantageous antibiotic hydrolytic spectrum for bacterial resistance to extended-spectrum antibiotics.     

Principles of ex ovo competitive exclusion and in ovo administration of Lactobacillus reuteri

The data that have been presented indicate that the in ovo use of competitive exclusion (CE) agents is feasible for both chickens and turkeys. However, there are many pitfalls that await the use of in ovo application of CE agents, including the use of nonspecies-specific intestinal microbes and the use of harmful proteolytic, gas-producing and toxin-producing intestinal microbes. Of the potential CE agents that have posthatch application, only Lactobacillus reuteri has been shown to be safe and effective in terms of not affecting hatchability and in having a prolonged effect in the hatched chick or poult. Lactobacillus reuteri administration in ovo increases its rate of intestinal colonization and decreases the colonization of Salmonella and Escherichia coli in both chicks and poults. Additionally, mortality due to in-hatcher exposure to E. coli or Salmonella is reduced with in ovo L. reuteri. Use of antibiotics in ovo may preclude the use of co-administered CE agents, but Gentamicin and L. reuteri are a compatible mixture when administered in ovo in separate compartments. Nevertheless, the intestinal morphology can be affected by both the CE agent and by antibiotics. Lactobacillus reuteri both in ovo and ex ovo will increase villus height and crypt depth, and Gentamicin in ovo causes a shortening and blunting of the villus. Both Gentamicin and L. reuteri in ovo suppress potentially pathogenic enteric microbes, but with diminished antibiotic effects shortening and blunting of the intestinal villi does not correct itself. Goblet cell numbers increase significantly on the ileum villus of chicks treated with Gentamicin in ovo, and this is presumably due to the increase in potentially pathogenic bacteria in the intestinal tract. Diminishing antibiotic effects posthatch would then negatively affect the absorption of nutrients and reduce growth at least in a transitory manner. Thus, L reuteri administration in ovo singly or in combination with Gentamicin followed by L reuteri via drinking water or feed appears to have potential to control many enteric pathogens in poultry. Additional work in the use of in ovo CE cultures is mandated because there is a world-wide movement to reduce antibiotic use in poultry due to increased microbial resistance to antibiotics. Use of naturally occurring intestinal bacterial cultures, either in mixed culture or as single well-defined cultures, has potential for immediate use in the poultry industry.     

Antibacterial activity of antibiotic coated silicone grafts

PURPOSE: Postoperative infection remains one of the most serious complications of implantation of penile prostheses. Attempts to reduce the rate of infection by spraying the prosthesis with an antibiotic solution prior to implantation, along with perioperative antibiotics, have failed to eradicate infection. No published studies have evaluated the effect of antibiotic coating of penile prostheses. In this study, we evaluate the antibacterial effect of antibiotic-coated silicone strips as a surrogate for the penile prosthesis. MATERIALS AND METHODS: Strips coated with several different antibiotics were dipped in bacterial solutions containing Staphylococcus epidermidis or S. aureus and implanted subcutaneously in adult Sprague-Dawley rats. After a week, the strips were removed, and the number of bacteria on the strips and in the surrounding tissue were determined. The in vitro antibiotic activity of the antibiotic-coated strips against the same organisms was also determined. RESULTS: In the group of rats that received silicone strips contaminated in vitro with S. epidermidis, six of nine control rats yielded strips and tissues containing heavy bacterial growth. None of six strips coated with rifampin/minocycline yielded bacterial growth, nor did any of the seven strips coated with vancomycin. One of seven rats that received amikacin-coated strips had infection of the strip. The tissue results were similar to the strip results. In the group using S. aureus as the contaminating bacterium, the strips and tissues from eight of nine control rats yielded bacteria. None of the six rifampin/minocycline-coated strips yielded bacteria, while two of seven vancomycin-treated strips and two of six amikacin-coated strips were infected with S. aureus. The difference in bacterial growth between controls and antibiotic-coated strips reached a level of statistical significance for the rifampin/minocycline and vancomycin groups and was highly significant for the rifampin/minocycline groups. CONCLUSION: The experimental results presented here suggest that coating silicone graft material with antibiotics, particularly rifampin/minocycline, can reduce the incidence of graft colonization in contaminated wounds in rats, even in the absence of systemic antibiotics. These graft materials may prove useful in preventing the infection of penile prostheses.     

Penetration of antibiotics in diseased antral mucosa

OBJECTIVES: To investigate extracellular concentrations of antibiotics in inflammatory diseased sinus mucosa in critically ill patients and to find out whether there were any correlations between the concentrations of antibiotics in extracellular tissue and the presence of bacterial infection. DESIGN: Prospective case series. Sinoscopic findings were used as the criterion standard. SETTING: The general and the neurosurgical intensive care units of a tertiary care hospital. PATIENTS: Critically ill patients, nasotracheally intubated or tracheotomized, who received ventilator treatment (> 7 days) and antibiotic therapy. INTERVENTIONS: Bilateral sinoscopies were performed; antral secretions were collected for bacterial cultures; and serum and tissue samples were obtained for bioassay of antibiotic concentrations. RESULTS: The concentrations of all antibiotics found in extracellular fluid were lower than those found in serum samples. CONCLUSION: Measurable extracellular tissue concentrations of antibiotics were found in the antral mucosa, demonstrating that inflammatory maxillary sinus disease does not impede the antibiotic penetration of the mucosa or antibiotic activity in the extracellular tissue.     

Bacterial lipopolysaccharide confers resistance to G418, doxorubicin, and taxol in the murine macrophage cell line, RAW264

Many bacterial pathogens including Salmonella and Listeria replicate within macrophages. The susceptibility of these organisms to various antibiotics is dependent on the ability of macrophages to take up, retain, and deliver the antibiotic to the correct intracellular compartment. In this context, macrophages are known to express proteins that are involved in efflux of antibiotics and cytotoxic drugs, thereby reducing intracellular accumulation of such compounds. In our studies on the action of bacterial lipopolysaccharide (LPS) on the macrophage-like cell line, RAW264 we found that LPS treatment of these cells conferred resistance to the neomycin-related aminoglycoside G418 (geneticin). This phenotype was stable and was specific to LPS since colony-stimulating factor 1 and phorbol myristate acetate had no effect on G418 resistance. We have extended this observation to show that LPS induces transient resistance to the cytotoxic drugs taxol and doxorubicin. Macrophage resistance to cytotoxic drugs and antibiotics may have a number of important clinical consequences.     

Peripheral nerve regeneration: the effects of postoperative irradiation

Our purpose is to review recent data and provide a clinical opinion on the use of antibiotics to prevent preterm birth or related maternal-neonatal complications. A literature review and a synthesis of opinion are provided. During prenatal care, standard practices should be applied regarding Neisseria gonorrhoeae, Chlamydia trachomatis, and bacteriuria. In addition, screen for and treat bacterial vaginosis in patients at high risk for preterm birth but do not treat Ureaplasma urealyticum or group B streptococci genital colonization. With preterm labor and intact membranes, standard practices should be applied regarding group B streptococci prophylaxis. Do not give antibiotics routinely to prolong pregnancy, but in patients with bacterial vaginosis and Trichomonas vaginalis specific treatment should be given. With preterm premature rupture of membranes, standard practices should be applied regarding group B streptococci prophylaxis, but additional antibiotics should also be given to prolong pregnancies at 24 to 32 weeks' gestation. Reported adverse effects have been few to date. However, increased diligence is needed for resistant organisms. In selected clinical settings antibiotic therapy is now indicated to prolong pregnancy and prevent maternal-neonatal complications associated with preterm birth.     

异相类Fenton催化剂降解废水中抗生素研究进展及发展趋势

水中抗生素具有成分复杂、毒性高和难于生物降解等特点,成为近些年水处理领域的研究热点。均相Fenton氧化技术（Fe2+/H₂O₂体系）因其反应快速、简单高效而备受青睐。而异相类Fenton氧化技术采用铁基固体催化剂代替液相Fe2+,能够有效减少含铁污泥的生成,同时拓宽反应的pH值范围,且催化剂可以回收利用,在近些年得到了快速发展,将其应用于抗生素的降解也取得了理想的效果。从异相类Fenton催化原理出发,综述了异相类Fenton催化剂降解抗生素的研究进展。基于异相类Fenton催化剂的核心问题,重点阐述了改善催化性能的方法、措施以及新的观点。针对异相类Fenton技术降解抗生素存在的问题提出了今后的发展方向。      

Acinetobacter radioresistens metabolizing aromatic compounds. 2. Biochemical and microbiological characterization of the strain

The metabolic potentialities of an Acinetobacter radioresistens strain, isolated from the soil adjacent to an activated sludge plant, were investigated. Among 26 aromatic substrates tested, only phenol, benzoate and catechol were metabolized. Since this strain possessed abundant plasmid DNA, the antibiotic and heavy metal resistance was examined, and the bacterial cells proved to be sensitive to all metals (Ni, Tl, Pb, Cd, Ag, Co, Zn) and antibiotics tested except for Fosfomycin and chloramphenicol. The degradation kinetics for phenol and benzoate as the sole carbon/energy source (pH 7, 30 degrees C) displayed different trends, confirmed by the bacterial growth curve. Crude extracts from phenol-grown cultures showed both phenol hydroxylating activity and catechol dioxygenating activity. Phenol hydroxylase possessed a reductase component able to reduce nitroblue tetrazolium (NBT) and cytochrome C, thus exhibiting differences from previously reported monocomponent phenol hydroxylases from the same genus. Catechol dioxygenase is an intradiol-cleaving enzyme recognizing also substituted catechols.     

Chronic ulcers and antibiotic treatment

This study analysed 656 wound samples from patients with chronic wounds in order to determine the bacterial flora and patterns of antibiotic use and resistance. Almost all wounds (95.1%) were colonised with at least one bacterial species; 26% of all patients were on antibiotic treatment. The total number of bacterial isolates resistant to antibiotics was low.     

Low-dose clozapine in acute and continuation treatment of severe borderline personality disorder

High-dose chemotherapy using autologous bone marrow or mobilized blood as the source of stem cells for haematologic rescue, is being widely used for a variety of haematological malignancies and solid tumours. To collect sufficient numbers of haematopoietic stem cells for successful engraftment, standard apheresis procedures are performed. Newer techniques and refinements of the procedure allow using only 1 to 2 apheresis products (AP) for autografting. Bacterial contamination of the AP, although very rare, sometimes occurs and may lead to generalized infection in the recipient. The apheresis must be repeated, sometimes even including time-consuming and costly mobilization. At our institution, the patients' blood stem cells are usually mobilized with chemotherapy followed by daily s.c. haematopoietic growth factor injections or with growth factor alone. An apheresis machine is used for collection through a central venous line and the AP is routinely checked for bacterial contamination. Results are only available after the product has been processed and cryopreserved. In the last 5 years, we observed bacterial contamination in four of our AP. Therefore, we investigated the possibility of in vitro antibiotic decontamination. Using standard antibiograms, we determined the sensitivities of the contaminating bacteria. By incubating the products with the specific antibiotics at bactericidal concentrations, we were able to sterilize the probes from the contaminating bacteria. In the concurrently performed controls without the active substance, bacteria were still detectable. We conclude that in selected cases, in vitro decontamination using pretested antibiotics, may be a feasible, cost-effective, and easy alternative to performing additional apheresis procedures.     

A new model to assess staphylococcal adhesion to intraocular lenses under in vitro flow conditions

Adhesion of staphylococcal cells to intraocular lenses coated with heparin was studied under in vitro flow conditions (280 microl min(-1)) at 37 degrees C. The intraocular lenses were incubated with human cerebrospinal fluid for 1 h or with cerebrospinal fluid including 0.50% plasma for 12 h, prior to bacterial challenge. Two strains of Staphylococcus epidermidis selected for this study, were isolated from biomaterial-associated infections. Bacterial adhesion was quantitated by bioluminescence and visualized by fluorescence microscopy of acridine orange stained bacteria. Surface coating with heparin significantly decreased bacterial adhesion of both strains after incubation with cerebrospinal fluid including 0.50% plasma for 12 h (p = 0.0209). However, no difference in bacterial adhesion was obtained between intraocular lenses with and without heparin, after incubation with cerebrospinal fluid for 1 h (p = 0.327). Microscopy showed that more bacteria were present on intraocular lenses without heparin than on intraocular lenses with heparin. The results show that preincubation with a proteinaceous fluid influences subsequent bacterial adhesion to the polymer surface. The results suggest that IOLs with heparin coating may be less prone to bacterial adhesion under perfusion conditions after surface conditioning in human CSF with 0.50% plasma and a preincubation period of 12 h. Heparin coating might be a valuable tool to decrease implant-associated bacterial endophthalmitis.