Rajpurkar Atul, Fairfax Marilynn, Li Haikun, Dhabuwala Chirpriya B
Department of Urology, Wayne State University School of Medicine, Detroit, MI 48201, USA.
J Sex Med. 2004 Sep;1(2):215-20. doi: 10.1111/j.1743-6109.2004.04031.x.
To find conditions that reduce the susceptibility of penile prostheses to infection, we studied the effect of coating the surface of polyurethane (Bioflex) with a hydrophilic material with and without antibiotics in decreasing bacterial colony counts both in vitro and in experiments in rats.
The in vitro experiment was performed using seven strips each of polyvinylpyrrolidone (PVP)-coated and uncoated polyurethane. These strips were dipped in saline for 5 minutes followed by incubation in a suspension of Staphylococcus epidermidis (SE) for a period of 10 minutes. Colony counts were determined after sonication of strips. For the in vitro experiments, 60 rats were used. Thirty animals each had uncoated or coated polyurethane implanted subcutaneously. In each group, strips were implanted after dipping them in either saline (N = 15) or an antibiotic solution (N = 15) consisting of 1 g/L vancomycin and 160 mg/L gentamicin. A bacterial suspension containing SE was then directly introduced into the subcutaneous pockets of all the animals prior to closure. After 7 days, strips were explanted along with 0.5 x 0.5 cm of surrounding tissue, and sonicated. Colony counts were performed on each sonicate. The data were analysed using Student's t-test. A P-value less than or equal to 0.05 was considered to be statistically significant.
The in vitro study demonstrated a statistically significant (41%) reduction in the colony count of SE within the coated polyurethane strips compared to the uncoated Bioflex strips (150 +/- 44.7 CFU vs. 253 +/- 45.0 CFU, respectively, P-value < 0.05). Animal studies showed that bacterial CFU was highest in the uncoated Bioflex strip (29 +/- 24.5 CFU), followed by uncoated Bioflex with antibiotic treatment (24 +/- 28.1 CFU), coated Bioflex (17 +/- 25.2 CFU) and coated Bioflex with antibiotic treatment (13 +/- 16.1 CFU). Antibiotic treatment of coated Bioflex caused a significant reduction in the bacterial CFU compared to uncoated Bioflex (13 +/- 16.1 vs. 29 +/- 24.5 CFU, respectively, P = 0.04). This represents a 55% reduction in the bacterial count. While the reduction in the bacterial count in the coated Bioflex strip was not statistically different from that in the uncoated strip, a trend towards significance was noted with a 41% reduction (P > 0.05) in bacterial count in the coated Bioflex group compared to uncoated Bioflex.
In conclusion, in vitro studies demonstrate a significant (41%) reduction in the colony count of SE in PVP-coated polyurethane compared to uncoated polyurethane. In vivo study in rats showed that antibiotic treatment of PVP-coated Bioflex resulted in a statistically significant reduction (55%) in colony count of SE compared to uncoated Bioflex.
为了找到降低阴茎假体感染易感性的条件，我们研究了用含抗生素和不含抗生素的亲水材料涂覆聚氨酯（Bioflex）表面对体外及大鼠实验中细菌菌落计数减少的影响。
体外实验使用了七条聚乙烯吡咯烷酮（PVP）涂覆和未涂覆的聚氨酯条带。将这些条带浸入盐水中5分钟，然后在表皮葡萄球菌（SE）悬液中孵育10分钟。条带超声处理后测定菌落计数。体外实验使用了60只大鼠。每组30只动物，皮下植入未涂覆或涂覆的聚氨酯。在每组中，条带浸入盐水（N = 15）或由1 g/L万古霉素和160 mg/L庆大霉素组成的抗生素溶液（N = 15）后植入。在闭合切口前，将含有SE的细菌悬液直接注入所有动物的皮下囊袋。7天后，连同0.5×0.5 cm的周围组织一起取出条带并进行超声处理。对每个超声处理后的样本进行菌落计数。数据采用Student's t检验进行分析。P值小于或等于0.05被认为具有统计学意义。
体外研究表明，与未涂覆的Bioflex条带相比，涂覆的聚氨酯条带内SE菌落计数有统计学意义的降低（41%）（分别为150±44.7 CFU和253±45.0 CFU，P值<0.05）。动物研究表明，未涂覆的Bioflex条带中细菌CFU最高（29±24.5 CFU），其次是未涂覆的Bioflex条带经抗生素处理（24±28.1 CFU）、涂覆的Bioflex条带（17±25.2 CFU）和涂覆的Bioflex条带经抗生素处理（13±16.1 CFU）。与未涂覆的Bioflex条带相比，涂覆的Bioflex条带经抗生素处理后细菌CFU显著降低（分别为13±16.1和29±24.5 CFU，P = 0.04）。这代表细菌计数降低了55%。虽然涂覆的Bioflex条带中细菌计数的降低与未涂覆条带相比无统计学差异，但与未涂覆的Bioflex条带相比，涂覆的Bioflex组细菌计数降低41%（P>0.05），有显著趋势。
总之，体外研究表明，与未涂覆的聚氨酯相比，PVP涂覆的聚氨酯中SE菌落计数显著降低（41%）。大鼠体内研究表明，与未涂覆的Bioflex相比，PVP涂覆的Bioflex经抗生素处理后SE菌落计数有统计学意义的降低（55%）。
