An ex vivo bacteriologic study comparing antiseptic techniques for natural orifice translumenal endoscopic surgery (NOTES) via the gastrointestinal tract.
An ex vivo bacteriologic study comparing antiseptic techniques for natural orifice translumenal endoscopic surgery (NOTES) via the gastrointestinal tract.
复制标题
一项离体细菌学研究，比较通过胃肠道进行自然孔腔内窥镜手术 (NOTES) 的抗菌技术。
DOI：
10.1007/s10620-012-2126-3
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发表时间：
2012
影响因子：
3.1
通讯作者：
Thompson,ChristopherC
中科院分区：
文献类型：
--
作者：
Ryou,Marvin;Hazan,Ronen;Rahme,Laurence;Thompson,ChristopherC
BackgroundNOTES via the gastrointestinal tract raises the specter of intra-peritoneal infection. Various anti-microbial techniques have been employed in animal and human survival studies, including saline lavage, intravenous and topical antibiotics, and povidone-iodine, although there is a paucity of data regarding their general effectiveness.AimTo assess the effectiveness of existing sterilization techniques for NOTES by quantifying and speciating colony-forming units (CFUs) before and after treatment.DesignEx vivo animal studies; bacteriological study.MethodsStomachs and distal colons were harvested en bloc from ten fasted adult white pigs following euthanasia. Half received cefazolin 1 g intravenously prior to killing. Multiple tissue samples were obtained from each resected organ. Each tissue sample was then assigned to one of five treatment arms: (1) normal saline, (2) Betadine, (3) cefazolin/metronidazole suspension, (4) chlorhexidine, (5) no treatment. Fifteen samples were used per arm. After treatment, the mucosal surface of each sample was swabbed and inoculated in normal saline, followed by serial dilutions, which were then plated onto sheep’s blood agar plates and incubated under aerobic and anaerobic conditions. CFUs were quantified and speciated.ResultsMedian bacterial density was estimated to be 8.0 × 105CFUs/ml (stomach) and 1.9 × 106CFUs/ml (colon). The predominant organisms wereEscherichia coli(stomach) and bothE. coliand Enterococcus sp. (colon). Saline and antibiotic suspension lavages caused a 1-log reduction in stomach and colon. Betadine/chlorhexidine lavage resulted in a 4-log reduction. Intravenous antibiotics alone resulted in a 4-log reduction. Combining intravenous antibiotics and either Betadine or chlorhexidine decreased counts to the 101level. By Kruskal–Wallis method, differences were statistically significant (p= 0.001).ConclusionsThe use of intravenous antibiotics in addition to topical Betadine or chlorhexidine effectively reduced microbial burden in both gastric and colonic mucosa in this porcine model to the 101level.
