An antimicrobial modified silicone peritoneal catheter with activity against both Gram positive and Gram negative bacteria
An antimicrobial modified silicone peritoneal catheter with activity against both Gram positive and Gram negative bacteria
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DOI：
10.1016/j.biomaterials.2009.02.028
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发表时间：
2009-06-01
期刊：
影响因子：
14
通讯作者：
Weber, Klaus
中科院分区：
文献类型：
--
作者：
Bayston, Roger;Fisher, Leanne E.;Weber, Klaus
腹膜炎、出口部位和隧道感染是腹膜透析（CAPD）的严重并发症，尽管已采取措施降低感染率，但仍可能导致导管丢失。涂有抗菌剂的导管仅显示出短期活性。我们开发了一种工艺，可在CAPD导管上赋予广谱、长效抗菌活性，同时降低耐药性风险。使用浸渍法处理导管。使用了三种药物：利福平、三氯生和甲氧苄啶。试验包括确定试验细菌产生耐药性前的活性持续时间。在预定时间（tK 100）内杀死100%附着细菌的能力，以及承受多次高计数挑战直到流动模型失败的能力。抗微生物活性持续到280天停止，这些药物防止了耐药菌株的出现。tK100结果显示附着细菌减少> 99.9%。当用高负荷的耐甲氧西林金黄色葡萄球菌或大肠杆菌反复挑战类似于90天时，流动模型显示没有定植。抗菌导管材料对常见CAPD病原体表现出长期活性，有望减少临床CAPD感染。(C)2009爱思唯尔有限公司版权所有。
Peritonitis, exit site and tunnel infections are serious complications of peritoneal dialysis (CAPD), which may lead to catheter loss, despite measures taken to reduce the infection rate. Catheters coated with antimicrobials have shown only short-term activity. We have developed a process for conferring broad-spectrum, long-duration antimicrobial activity on CAPD catheters while reducing the risk of resistance. Catheters were processed using an impregnation method. Three agents were used: rifampicin, triclosan and trimethoprim. Tests included establishing the duration of activity before test bacteria became resistant. the ability to kill 100% of attached bacteria in a predetermined time (tK100), and ability to withstand multiple high-count challenges until failure in a flow model. Antimicrobial activity continued until it was stopped at 280 days and the agents prevented the emergence of resistant strains. tK100 results showed a > 99.9% reduction of attached bacteria. The flow model showed no colonization when repeatedly challenged with high loads of meticillin-resistant Staphylococcus aureus or Escherichia coli for similar to 90 days. The antimicrobial catheter material showed prolonged activity against common CAPD pathogens and promises to reduce clinical CAPD infection. (C) 2009 Elsevier Ltd. All rights reserved.