Nondevelopment of resistance by bacteria during hospital use of povidone-iodine.
Nondevelopment of resistance by bacteria during hospital use of povidone-iodine.
复制标题
医院使用聚维酮碘期间细菌不会产生耐药性。
作者：
B. Lanker Klossner;H. Widmer;F. Frey
由于细菌对其周围环境的各种因素产生抗药性的能力是众所周知的现象，因此对碘的抗药性，特别是对聚维酮碘（PVP-I）的抗药性已得到广泛研究。然而，对于持续性非卧床腹膜透析（CAPD）患者长期日常使用消毒剂的细菌耐药性知之甚少。我们研究的目的是调查在至少 6 个月的时间内每天使用 PVP-I，凝固酶阴性葡萄球菌 (CNS)（腹膜炎的主要感染性微生物）是否会对 PVP-I 产生耐药性。在 40 名 CAPD 患者的导管出口部位，我们分离出 36 个 CNS。 23 CNS (CNS + PVP) 源自使用 PVP-I 的患者，13 CNS (CNS + CI) 源自使用次氯酸钠 (NaOCl) 作为消毒剂的患者。对菌株进行生物分型，确定抗生素抗性模式，并使用定量悬浮试验结合比浊标准化计算对 PVP-I 或 NaOCl 的抗性作为折减因子。每个患者组在两次接触时间（30 秒和 300 秒）测定对 PVP-I 0.01% 和 NaOCl 0.005% 的耐药性。此外，我们还研究了质粒丢失对 PVP-I 敏感性的影响。在 5 个多重抗生素耐药 CNS 中，有 3 个菌株在治疗前后针对 PVP-I 的降低因子没有表现出差异。与NaOCl相比，还原因子没有显着差异。 CNS + PVP 对 PVP-I 的敏感性甚至显着高于 CNS + Cl。综上所述，我们的结果表明，长期使用 PVP-I 不会导致 CAPD 患者中枢神经系统出现任何细菌耐药性。
Since the bacterial ability to develop resistance against various factors of their surroundings is a well-known phenomenon, resistance against iodine and specifically against povidone-iodine (PVP-I) has been widely investigated. Yet there is little known about bacterial resistance in long-term daily use of disinfectants in continuous ambulatory peritoneal dialysis (CAPD) patients. The aim of our study was to investigate whether on daily use of PVP-I over a period of at least 6 months coagulase-negative staphylococci (CNS)--the predominant infective organisms of peritonitis--developed resistance against PVP-I. At the catheter exit site of 40 CAPD patients we isolated 36 CNS. 23 CNS (CNS + PVP) orginate from patients using PVP-I, 13 CNS (CNS + CI) from patients using sodium hypochlorite (NaOCl) as disinfectant. The strains were biotyped, antibiotic resistance patterns were determined and resistance against PVP-I or NaOCl was calculated as reduction factor using the quantitative suspension test combined with a turbidimetric standardization. Resistance against PVP-I 0.01% and against NaOCl 0.005% was determined at two contact times (30 and 300 s) for each patient group. In addition, we investigated the effects of plasmid loss on sensitivity to PVP-I. Out of 5 multiple-antibiotic-resistant CNS, 3 strains showed no difference in reduction factor against PVP-I before and after curing. There was no significant difference in reduction factor against NaOCl. CNS + PVP were even significantly more sensitive to PVP-I than CNS + Cl. Taken together, our results demonstrate that long-term use of PVP-I does not cause any bacterial resistance in CNS of CAPD patients.