Anderson R L, Vess R W, Carr J H, Bond W W, Panlilio A L, Favero M S
Hospital Infections Program, Centers for Disease Control (CDC), Atlanta, GA 30333.
Infect Control Hosp Epidemiol. 1991 May;12(5):297-302. doi: 10.1086/646342.
Laboratory investigations were initiated with a povidone-iodine antiseptic solution that was intrinsically contaminated with Pseudomonas cepacia. These investigations were helpful in understanding the microbicidal and chemical properties of iodophor solutions and the mechanism by which P cepacia can survive in iodine-containing antiseptics.
Included in these studies were: prolonged survival of P cepacia; available and free iodine determinations; microbial challenge studies; and scanning electron microscopic examination of contaminated antiseptic.
P cepacia survived in this iodophor antiseptic up to 68 weeks from the date of manufacture. A uniform concentration of 1% available iodine was found in all lots of povidone-iodine tested as specified on the product label, but free iodine (I2) values varied greatly. Low free iodine levels of 0.23 to 0.46 ppm were associated with the contaminated lot of povidone-iodine. Solutions of povidone-iodine with varying levels of free iodine were rapidly microbicidal when challenged with cells of P cepacia derived from culture broth and washed or adapted to growth in water. P cepacia cells taken directly from contaminated povidone-iodine survived for significantly longer periods of time. Large numbers of P cepacia were found embedded in extracellular material and among strands of glycocalyx between cells as shown by scanning electron microscopy.
The physical thickness of cellular and extracellular material that forms on surfaces could protect embedded organisms from the microbicidal action of disinfectants and antiseptics and subsequently allow for extended microbial survival times. Manufacturers should be aware that distribution piping surfaces colonized with bacteria may be a source of product contamination and resistant organisms.
使用一种本已被洋葱伯克霍尔德菌污染的聚维酮碘消毒溶液开展实验室研究。这些研究有助于了解碘伏溶液的杀菌和化学性质,以及洋葱伯克霍尔德菌在含碘消毒剂中存活的机制。
这些研究包括:洋葱伯克霍尔德菌的长期存活;有效碘和游离碘的测定;微生物挑战研究;以及对受污染消毒剂的扫描电子显微镜检查。
从生产日期起,洋葱伯克霍尔德菌在这种碘伏消毒剂中存活长达68周。在按照产品标签规定测试的所有聚维酮碘批次中,均发现有效碘浓度统一为1%,但游离碘(I2)值差异很大。游离碘水平低至0.23至0.46 ppm与受污染的聚维酮碘批次相关。当用源自培养液并经洗涤或适应在水中生长的洋葱伯克霍尔德菌细胞进行挑战时,游离碘水平不同的聚维酮碘溶液具有快速杀菌作用。直接从受污染的聚维酮碘中获取的洋葱伯克霍尔德菌细胞存活时间明显更长。扫描电子显微镜显示,大量洋葱伯克霍尔德菌嵌入细胞外物质中以及细胞间的糖萼丝之间。
在表面形成的细胞和细胞外物质的物理厚度可保护嵌入其中的微生物免受消毒剂和防腐剂的杀菌作用,从而使微生物存活时间延长。制造商应意识到,被细菌定殖的分配管道表面可能是产品污染和耐药菌的一个来源。