Cellular coating of the left ventricular assist device textured polyurethane membrane reduces adhesion of Staphylococcus aureus
Cellular coating of the left ventricular assist device textured polyurethane membrane reduces adhesion of Staphylococcus aureus
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DOI：
10.1016/j.jtcvs.2006.10.084
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发表时间：
2007-05-01
影响因子：
6
通讯作者：
Lowy, Franklin D.
中科院分区：
文献类型：
--
作者：
Asai, Tomohiro;Lee, Mei-Ho;Lowy, Franklin D.
目的：感染是心室辅助装置植入术最常见和最严重的并发症之一。这些感染通常发生在手术后的前两个月内。这种高感染发生率的基础还没有很好地建立，因此通过主动脉植入目前用于HeartMate心室辅助装置（Thoratec Corporation普莱森顿，CA）的纹理聚氨酯补片材料来开发小鼠血管内感染模型。然后在植入后1或14天用金黄色葡萄球菌感染小鼠。在体外粘附力的研究进行了聚氨酯膜涂有内皮细胞和膜涂有fibrin.Results：小鼠容易感染的剂量和时间依赖性的方式。贴片材料在第1天比第14天明显更易感染。免疫组织学和形态学研究表明，CD31（+）细胞沉积在膜表面的表型似乎是内皮细胞。聚氨酯膜涂有内皮细胞的体外粘附力的研究表明，他们是不太容易金黄色葡萄球菌的结合比膜涂有纤维蛋白原。结论：纹理聚氨酯膜是不太容易感染的细胞沉积发生。这些膜被细胞物质填充的时间范围与感染的时间依赖性临床发病率一致。聚氨酯的细胞涂层可以提供降低感染风险的策略。
Objective: Infections are among the most common and serious complications of ventricular assist device implantation. These infections generally occur within the first 2 months after surgery. The basis for this high incidence of infection is not well established, so a murine intravascular infection model was developed with aortic implantation of the textured polyurethane patch material currently used in HeartMate ventricular assist devices (Thoratec Corporation Pleasanton, Calif).Methods: Polyurethane patch material was placed in the wall of the mouse descending aorta. Mice were then infected with Staphylococcus aureus 1 or 14 days after implantation. In vitro adhesion studies were conducted with polyurethane membranes coated with endothelial cells and membranes coated with fibrinogen.Results: Mice were susceptible to infection in both dose- and time-dependent fashions. The patch material was significantly more susceptible to infection at day 1 than day 14. Immunohistologic and morphologic studies demonstrated that the CD31(+) cells deposited on the membrane surface phenotypically appeared to be endothelial cells. In vitro adhesion studies of polyurethane membranes coated with endothelial cells showed them to be less susceptible to S aureus binding than were membranes coated with fibrinogen.Conclusion: Textured polyurethane membranes are less susceptible to infection as cellular deposition occurs. The time frame within which these membranes become populated with cellular material is consistent with the time-dependent clinical incidence of infection. Cellular coating of polyurethane may provide a strategy for reducing the risk of infection.