Mohammad S F
Utah Artificial Heart Institute, Salt Lake City 84103, USA.
ASAIO J. 2000 Nov-Dec;46(6):S63-8. doi: 10.1097/00002480-200011000-00039.
Thrombosis and infection are two well-recognized risks with prosthetic devices that contact blood. Many of the currently used biomaterials may present an attractive surface for thrombus development as well as bacterial adhesion and colonization. Clinical experience with vegetative endocarditis patients has suggested that thrombosis may lead to enhanced risk of infection, and the possibility that adherent bacteria may enhance the risk of thrombosis has been noted by several investigators. To investigate the correlation between thrombosis and infection, a series of tests were conducted to assess the affinity of pathogen with surfaces in the absence and presence of blood components. Coronary stents were used as a model device to attract thrombi in a recirculating loop in vitro. Fresh heparinized blood was used to investigate thrombus development and bacterial interaction. (111)Indium-labeled Staphylococcus epidermidis and (111)Indium-labeled platelets were utilized to quantify bacterial interaction with thrombi under various test conditions. Anticoagulants, antiplatelet agents, and antibiotics were utilized in attempts to selectively influence bacteria, platelets, or thrombosis. The results suggest that under appropriate conditions, bacteria may preferentially adhere to platelet rich thrombus. These observations also suggest that by reducing the risk of thrombosis, the risk of device-associated infection may also be reduced.
血栓形成和感染是与接触血液的人工装置相关的两种公认风险。许多目前使用的生物材料可能为血栓形成以及细菌黏附和定植提供一个有吸引力的表面。心内膜炎患者的临床经验表明，血栓形成可能导致感染风险增加，并且有几位研究者已经注意到黏附细菌可能增加血栓形成风险的可能性。为了研究血栓形成与感染之间的相关性，进行了一系列测试，以评估在有无血液成分的情况下病原体与表面的亲和力。冠状动脉支架被用作模型装置，在体外循环回路中吸引血栓。使用新鲜的肝素化血液来研究血栓形成和细菌相互作用。利用铟 - 111标记的表皮葡萄球菌和铟 - 111标记的血小板来量化在各种测试条件下细菌与血栓的相互作用。使用抗凝剂、抗血小板药物和抗生素试图选择性地影响细菌、血小板或血栓形成。结果表明，在适当条件下，细菌可能优先黏附于富含血小板的血栓。这些观察结果还表明，通过降低血栓形成风险，与装置相关的感染风险也可能降低。
