Biel Merrill A, Sievert Chet, Usacheva Marina, Teichert Matthew, Wedell Eric, Loebel Nicolas, Rose Andreas, Zimmermann Ron
Advanced Photodynamic Technologies, Inc., 2929 University Avenue SE, Suite 208, Minneapolis, MN 55414.
Lasers Surg Med. 2011 Sep 1;43(7):586-590. doi: 10.1002/lsm.21103.
Ventilator-associated pneumonia (VAP) is reported to occur in 12 to 25% of patients who require mechanical ventilation with a mortality rate of 24 to 71%. The endotracheal (ET) tube has long been recognized as a major factor in the development of VAP since biofilm harbored within the ET tube become dislodged during mechanical ventilation and have direct access to the lungs. The objective of this study was to demonstrate the safety and effectiveness of a non-invasive antimicrobial photodynamic therapy (aPDT) treatment method of eradicating antibiotic resistant biofilms from ET tubes in an in vitro model. METHODS: Antibiotic resistant polymicrobial biofilms of Pseudomonas aerugenosa and MRSA were grown in ET tubes and treated, under standard ventilator conditions, with a methylene blue (MB) photosensitizer and 664nm non-thermal activating light. Cultures of the lumen of the ET tube were obtained before and after light treatment to determine efficacy of biofilm reduction. RESULTS: The in vitro ET tube biofilm study demonstrated that aPDT reduced the ET tube polymicrobial biofilm by >99.9% (p<0.05%) after a single treatment. CONCLUSIONS: MB aPDT can effectively treat polymicrobial antibiotic resistant biofilms in an ET tube.
据报道，在需要机械通气的患者中，呼吸机相关性肺炎（VAP）的发生率为12%至25%，死亡率为24%至71%。气管内（ET）导管长期以来一直被认为是VAP发生的主要因素，因为ET导管内形成的生物膜在机械通气过程中会脱落，并直接进入肺部。本研究的目的是在体外模型中证明一种非侵入性抗菌光动力疗法（aPDT）治疗方法从ET导管中根除耐抗生素生物膜的安全性和有效性。方法：在ET导管中培养铜绿假单胞菌和耐甲氧西林金黄色葡萄球菌的耐抗生素多微生物生物膜，并在标准通气条件下，用亚甲蓝（MB）光敏剂和664nm非热激活光进行处理。在光照处理前后获取ET导管管腔的培养物，以确定生物膜减少的效果。结果：体外ET导管生物膜研究表明，单次治疗后，aPDT可使ET导管多微生物生物膜减少>99.9%（p<0.05%）。结论：MB aPDT可有效治疗ET导管中的多微生物耐抗生素生物膜。
