Morishima Manabu, Marui Akira, Yanagi Shigeki, Nomura Takamasa, Nakajima Naoki, Hyon Suong-Hyu, Ikeda Tadashi, Sakata Ryuzo
Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Interact Cardiovasc Thorac Surg. 2010 Jul;11(1):52-5. doi: 10.1510/icvts.2010.232447. Epub 2010 Apr 1.
Prosthetic graft infection with methicillin-resistant Staphylococcus aureus (MRSA) is one of the most serious complications of cardiovascular surgery. Seeking to prevent graft infection, we evaluated the efficacy of a new biodegradable hydrogel glue (new-glue) composed of aldehyded dextran and epsilon-poly(L-lysine) which acts as a local sustained-release carrier of vancomycin. Rats (n=40) were implanted with 1-cm(2) Dacron grafts in the subcutaneous pockets. Groups (n=10 each) were as follows: no treatment (group A), topical vancomycin solution (group B), new-glue without vancomycin (group C) or new-glue containing 1 mg of vancomycin (group D). Twenty-four h after the implantation, 2.0x10(7) colony-forming units of MRSA was inoculated onto the graft surface. Seven days thereafter, the graft was sampled and cultured. The quantity of MRSA was significantly lower in group D than in the other groups (P<0.0001). About 95% of the total vancomycin was released from the new-glue over the 72 h experimental period, and the tissue concentration of vancomycin remained above the minimum inhibitory concentration for the MRSA strain throughout the experiment. This new vancomycin-containing glue effectively prevented prosthetic graft infection and thus may be a promising biodegradable drug vehicle.
耐甲氧西林金黄色葡萄球菌（MRSA）所致的人工血管移植物感染是心血管手术最严重的并发症之一。为预防移植物感染，我们评估了一种新型可生物降解水凝胶胶水（新型胶水）的疗效，该胶水由醛化葡聚糖和ε-聚（L-赖氨酸）组成，可作为万古霉素的局部缓释载体。将大鼠（n = 40）在皮下囊袋植入1 cm²的涤纶移植物。分组（每组n = 10）如下：不治疗（A组）、局部应用万古霉素溶液（B组）、不含万古霉素的新型胶水（C组）或含1 mg万古霉素的新型胶水（D组）。植入后24小时，将2.0×10⁷个MRSA菌落形成单位接种到移植物表面。此后7天，对移植物进行取样培养。D组的MRSA数量显著低于其他组（P < 0.0001）。在72小时的实验期内，约95%的总万古霉素从新型胶水中释放出来，并且在整个实验过程中，万古霉素的组织浓度保持在高于MRSA菌株最低抑菌浓度的水平。这种新型含万古霉素胶水有效预防了人工血管移植物感染，因此可能是一种有前景的可生物降解药物载体。
