Thai Thao P, Keast David H, Campbell Karen E, Woodbury M Gail, Houghton Pamela E
School of Physical Therapy, University of Western Ontario, London, Ontario, Canada N6G 1H1.
Ostomy Wound Manage. 2005 Oct;51(10):32-45.
Ultraviolet light C (light wavelength 200 nm to 290 nm) has been shown to kill cultures of antibiotic resistant strains of bacteria such as methicillin-resistant Staphylococcus aureus. To evaluate the ability of ultraviolet light C to reduce the amount and type of bacteria present in chronically infected ulcers, as well as to establish the test-retest reliability of the semi-quantitative swab technique, a prospective, one-group, pre-post treatment study was conducted among patients receiving treatment in several in- and outpatient facilities and nursing homes. Individuals with chronic ulcers exhibiting at least two signs of infection and critically colonized with bacteria (n = 22) received a single 180-second treatment using an ultraviolet light C lamp (wavelength = 254 nm) placed 1 inch from the wound bed. Semi-quantitative swabs taken immediately before and after UVC treatment were used to assess changes in the bacterial bioburden present within the wound bed. Results demonstrated excellent test-retest reliability of the semi-quantitative swab technique used to evaluate the type and amount of bacteria present in chronic wounds (Cohen's kappa = 0.92). Assessment of wound bioburden using semi-quantitative swabs revealed a statistically significant (P <0.0001) reduction in the relative amount of bacteria following a single treatment of ultraviolet light C. The greatest reduction in semi-quantitative swab scores following ultraviolet light C treatment were observed for wounds colonized with the bacteria Pseudomonas aeruginosa and wounds colonized with only one species of bacteria. Significant (P <0.05) reductions in the relative amount of bacteria also were observed in 12 ulcers in which methicillin-resistant Staphylococcus aureus was present. These results confirm previous laboratory studies and demonstrate that ultraviolet light C can kill bacteria such as Pseudomonas aeruginosa, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus present in superficial layers of chronic wounds.
紫外线C（波长200纳米至290纳米的光）已被证明可杀死耐抗生素细菌菌株的培养物，如耐甲氧西林金黄色葡萄球菌。为了评估紫外线C减少慢性感染溃疡中细菌数量和种类的能力，以及确定半定量拭子技术的重测信度，在几家门诊和住院医疗机构以及疗养院接受治疗的患者中进行了一项前瞻性单组治疗前后研究。患有慢性溃疡且表现出至少两种感染迹象并被细菌严重定植的个体（n = 22）使用距离伤口床1英寸处放置的紫外线C灯（波长 = 254纳米）接受了单次180秒的治疗。在紫外线C治疗前后立即采集的半定量拭子用于评估伤口床内细菌生物负荷的变化。结果表明，用于评估慢性伤口中细菌种类和数量的半定量拭子技术具有出色的重测信度（科恩kappa系数 = 0.92）。使用半定量拭子评估伤口生物负荷显示，单次紫外线C治疗后细菌相对数量有统计学意义的减少（P <0.0001）。对于被铜绿假单胞菌定植的伤口和仅被一种细菌定植的伤口，紫外线C治疗后半定量拭子评分的降低最为明显。在存在耐甲氧西林金黄色葡萄球菌的12个溃疡中，也观察到细菌相对数量有显著（P <0.05）减少。这些结果证实了先前的实验室研究，并表明紫外线C可杀死慢性伤口表层中存在的铜绿假单胞菌、金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌等细菌。
