Cho Y H, Lee S J, Lee J Y, Kim S W, Kwon I C, Chung S Y, Yoon M S
Department of Urology, Catholic University Medical College and Korea Institute of Science and Technology, Seoul, Korea.
BJU Int. 2001 Jan;87(1):104-9. doi: 10.1046/j.1464-410x.2001.00978.x.
To describe an indwelling urethral catheter coated with gentamicin sulphate on the inner and outer surface of the catheter, and to evaluate the efficacy and safety of this catheter in preventing catheter-associated infections in rabbits. Materials and methods Sixty rabbits were divided equally into control and experimental groups which were then subdivided equally according to the duration of catheterization (1, 3 and 5 days). Silicone-treated latex catheters were used in the control group and gentamicin-releasing catheters in the experimental group. Urine samples and surface swabs from the catheter were cultured for bacteriological assessment, and the catheter surface examined by scanning electron microscopy to structurally analyse the biofilms.
The gentamicin-releasing catheter reduced the incidence of bacteriuria (defined as > or = 100 c.f.u./mL) after both 3 and 5 days of catheterization (eight and 10 rabbits, respectively, for the control catheter, vs two and four rabbits for the gentamicin-releasing catheter, P < 0.05). The surfaces of the gentamicin-releasing catheter were colonized less often than those of the control catheter after both 3 and 5 days (eight and 10, respectively, for the control, vs one and four for the gentamicin-releasing catheter, P < 0.05). Scanning electron microscopy showed the formation of bacterial biofilm throughout the 3-day and 5-day control catheters, but deterioration of the bacterial biofilm was visible on the surface of the gentamicin-releasing catheters.
This new gentamicin-releasing catheter produced an antibacterial barrier which inhibited catheter-associated urinary tract infection with no toxicity for at least 5 days. These in vivo studies suggest that this new catheter may be useful for controlling infection, with systemic and local safety, in patients undergoing short-term indwelling urethral catheterization.
描述一种在导尿管内外表面均涂有硫酸庆大霉素的留置导尿管,并评估该导尿管在预防兔导尿管相关感染方面的有效性和安全性。材料与方法:60只兔被平均分为对照组和实验组,然后根据导尿时间(1天、3天和5天)再平均分为小组。对照组使用经硅处理的乳胶导尿管,实验组使用释放庆大霉素的导尿管。对尿液样本和导尿管表面拭子进行细菌培养以进行细菌学评估,并通过扫描电子显微镜检查导尿管表面以对生物膜进行结构分析。
在导尿3天和5天后,释放庆大霉素的导尿管降低了菌尿症(定义为≥100 c.f.u./mL)的发生率(对照导尿管分别为8只和10只兔,而释放庆大霉素的导尿管分别为2只和4只兔,P<0.05)。在导尿3天和5天后,释放庆大霉素的导尿管表面被定植的情况比对照导尿管少(对照导尿管分别为8只和10只,而释放庆大霉素的导尿管分别为1只和4只,P<0.05)。扫描电子显微镜显示,在整个3天和5天的对照导尿管上均形成了细菌生物膜,但在释放庆大霉素的导尿管表面可见细菌生物膜的降解。
这种新型释放庆大霉素的导尿管产生了一种抗菌屏障,可抑制导尿管相关的尿路感染,且至少5天无毒性。这些体内研究表明,这种新型导尿管可能有助于控制短期留置导尿管患者的感染,具有全身和局部安全性。