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氯己定血管内导管部位凝胶敷贴的抗菌活性。

Antimicrobial activity of a chlorhexidine intravascular catheter site gel dressing.

机构信息

Department of Clinical Microbiology and Infection Control, University Hospitals Birmingham NHS Foundation Trust, UK.

出版信息

J Antimicrob Chemother. 2011 Aug;66(8):1777-84. doi: 10.1093/jac/dkr191. Epub 2011 May 24.

Abstract

OBJECTIVES

The antimicrobial efficacy of a chlorhexidine gluconate (CHG) intravascular catheter gel dressing was evaluated against methicillin-resistant Staphylococcus aureus (MRSA) and an extended-spectrum β-lactamase (ESBL)-producing Escherichia coli. Chlorhexidine deposition on the skin surface and release from the gel were determined.

METHODS

The antimicrobial efficacy was evaluated in in vitro studies following microbial inoculation of the dressing and application of the dressing on the inoculated surface of a silicone membrane and donor skin [with and without a catheter segment and/or 10% (v/v) serum] on diffusion cells. Antimicrobial activity was evaluated for up to 7 days. Chlorhexidine skin surface deposition and release were also determined.

RESULTS

MRSA and E. coli were not detectable within 5 min following direct inoculation onto the CHG gel dressing. On the silicone membrane, 3 log and 6 log inocula of MRSA were eradicated within 5 min and 1 h, respectively. Time to kill was prolonged in the presence of serum and a catheter segment. Following inoculation of donor skin with 6 log cfu of MRSA, none was detected after 24 h. Chlorhexidine was released from the gel after a lag time of 30 min and increasing amounts were detected on the donor skin surface over the 48 h test period. The CHG gel dressing retained its antimicrobial activity on the artificial skin for 7 days.

CONCLUSIONS

The CHG intravascular catheter site gel dressing had detectable antimicrobial activity for up to 7 days, which should suppress bacterial growth on the skin at the catheter insertion site, thereby reducing the risk of infection.

摘要

目的

评估葡萄糖酸氯己定(CHG)血管内导管胶敷料对耐甲氧西林金黄色葡萄球菌(MRSA)和产超广谱β-内酰胺酶(ESBL)的大肠杆菌的抗菌效果。测定了皮肤表面的氯己定沉积和从凝胶中的释放情况。

方法

在体外研究中,将微生物接种到敷料上,并将敷料应用于硅橡胶膜和供体皮肤(有和没有导管段和/或 10%(v/v)血清)的接种表面,在扩散细胞上进行评估。评价抗菌活性的时间长达 7 天。还测定了氯己定的皮肤表面沉积和释放。

结果

MRSA 和大肠杆菌在直接接种到 CHG 凝胶敷料后 5 分钟内无法检测到。在硅橡胶膜上,MRSA 的 3 对数和 6 对数接种物分别在 5 分钟和 1 小时内被消除。在存在血清和导管段的情况下,杀菌时间延长。在供体皮肤上接种 6 对数 cfu 的 MRSA 后,24 小时后未检测到。氯己定在 30 分钟的滞后时间后从凝胶中释放出来,在 48 小时的测试期间,在供体皮肤表面检测到的量逐渐增加。CHG 血管内导管部位凝胶敷料在人造皮肤上保持其抗菌活性长达 7 天。

结论

CHG 血管内导管部位凝胶敷料具有长达 7 天的可检测抗菌活性,这应该抑制导管插入部位皮肤的细菌生长,从而降低感染风险。

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