Steczko Janusz, Ash Stephen R, Nivens David E, Brewer Lloyd, Winger Roland K
R&D, Ash Access Technology, Inc., Lafayette, IN, USA.
Nephrol Dial Transplant. 2009 Jun;24(6):1937-45. doi: 10.1093/ndt/gfn776. Epub 2009 Jan 30.
Microbial infections are the most serious complications associated with indwelling central venous catheters. A catheter lock solution that is both antibacterial and antithrombotic is needed. The goal of this study was to determine whether a new catheter lock solution containing citrate, methylene blue and parabens has antimicrobial properties against planktonic bacteria and against sessile bacteria within a biofilm. These effects were compared to the antimicrobial properties of heparin at 2500 units/ml.
The tested solution (C/MB/P comprising 7% sodium citrate, 0.05% methylene blue and 0.165% parabens) and individual components were challenged against gram-positive and gram-negative organisms and fungi. Control solutions were heparin with preservatives. Studies included evaluation of eradication of planktonic bacteria and sessile organisms in a biofilm grown on polymeric and glass coupons. Biofilm samples were inspected by scanning electron microscopy, atomic force microscopy and vital stains.
The C/MB/P solution, contrary to heparin, kills most tested planktonic microorganisms within 1 h of incubation. All tested organisms have an MIC of 25% or less of the original concentration of a new catheter lock. Bacteria strains did not develop resistance over more than 40 passages of culture suspensions. The C/MB/P solution is able to kill nearly all sessile bacteria in biofilm growth on plastic or glass discs in 1 h. Microscopic methods demonstrated extensive physical elimination of biofilm deposits from treated coupons. In contrast, heparin had a minimal effect on planktonic or biofilm organisms.
The new multicomponent lock solution has strong antimicrobial properties against both planktonic and sessile microorganisms. By comparison, heparin with preservative has weak antibacterial properties against planktonic and biofilm bacteria. The tested catheter lock may have usefulness in preventing bacterial colonization of haemodialysis catheters and diminishing the incidence of catheter-related bacteraemia.
微生物感染是与留置中心静脉导管相关的最严重并发症。需要一种兼具抗菌和抗血栓形成作用的导管封管液。本研究的目的是确定一种含有柠檬酸盐、亚甲蓝和对羟基苯甲酸酯的新型导管封管液对浮游细菌和生物膜内的固着细菌是否具有抗菌特性。将这些效果与2500单位/毫升肝素的抗菌特性进行比较。
测试溶液（由7%柠檬酸钠、0.05%亚甲蓝和0.165%对羟基苯甲酸酯组成的C/MB/P）和各成分分别与革兰氏阳性菌、革兰氏阴性菌及真菌进行挑战试验。对照溶液为含防腐剂的肝素。研究包括评估对在聚合物和玻璃试片上生长的生物膜中浮游细菌和固着生物的根除情况。通过扫描电子显微镜、原子力显微镜和活体染色对生物膜样本进行检查。
与肝素相反，C/MB/P溶液在孵育1小时内可杀死大多数测试的浮游微生物。所有测试生物的最低抑菌浓度为新型导管封管液原始浓度的25%或更低。细菌菌株在超过40代培养悬液中未产生耐药性。C/MB/P溶液能够在1小时内杀死塑料或玻璃盘上生物膜生长中的几乎所有固着细菌。显微镜方法显示处理后的试片上生物膜沉积物大量物理性清除。相比之下，肝素对浮游或生物膜生物的影响极小。
这种新型多成分封管液对浮游和固着微生物均具有强大的抗菌特性。相比之下，含防腐剂的肝素对浮游和生物膜细菌的抗菌特性较弱。所测试的导管封管液可能有助于预防血液透析导管的细菌定植并降低导管相关菌血症的发生率。
