Antimicrobial Efficacy of a Taurolidine-Based Antimicrobial Compound on Contaminated Surfaces Simulated in a Standardized 4-Field Test.

Abstract

Implantable medical devices, including cardiac electronic implants, joint prostheses, and breast implants, are essential to modern healthcare but remain susceptible to infection from microbial contamination during placement. Staphylococcus spp. and Candida albicans are the predominant pathogens, often causing severe complications, increased mortality, and substantial healthcare costs. With antibiotic resistance on the rise, intraoperative surface disinfection has emerged as a critical yet underutilized preventive strategy. Taurolidine, a broad-spectrum antimicrobial with a strong safety profile and no known resistance, can be applied directly to both tissues and device surfaces. To replicate intraoperative decontamination, taurolidine-saturated swabs are tested under standardized mechanical wiping using the European Norm EN 16615 "4-field test." The model reproduced short contact times and organic load conditions reflective of clinical practice, enabling assessment of both chemical and mechanical antimicrobial effects. Taurolidine achieved >5 log₁₀ reductions in Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans, and >4 log₁₀ for Enterococcus hirae. The observed activity demonstrated a surface-driven, enzyme-independent mechanism involving spontaneous release of reactive N-methylol functional groups that disrupt microbial membranes. Taurolidine's enzyme-independent antimicrobial mechanism distinguishes it from solvent- or oxidant-based disinfectants. These results support taurolidine as a potential adjunctive prophylactic agent to reduce device-related infections during implantation procedures.