Center of Excellence on Ageing, G. d'Annunzio, University, Chieti, Italy.
Perit Dial Int. 2012 Sep-Oct;32(5):552-7. doi: 10.3747/pdi.2011.00089. Epub 2012 Feb 1.
We evaluated the ability of a recently developed peritoneal dialysis (PD) connector to prevent the risk of bacterial transfer to the fluid path after simulated touch and airborne contamination.
Staphylococcus epidermidis ATCC1228 and Pseudomonas aeruginosa ATCC27853 strains were used. For touch contamination, 2 μL of a standardized inoculum [1×10(8) colony-forming units (CFU) per milliliter] were deposited on top of the pin closing the fluid path of the patient connector. For airborne contamination, the patient connector was exposed for 15 seconds to a nebulized standardized inoculum. To simulate the patient peritoneum and effluent, the patient connector was pre-attached to a 2-L bag of sterile PD solution. After contamination, the patient connector was attached to the transfer set, the pin was captured, flow control was turned to simulate "patient drain" into the empty bag, and then "patient fill" using the bag pre-attached to the connector. Finally, a new pin was recaptured. The PD solution collected in the bag pre-attached to the connector was run through a 0.20-μm filter for colony counts.
No infected connector transferred bacteria to the fluid path, regardless of the challenge procedure or the strain used.
Our results show that the new PD connector may fully obviate the risk of bacterial infection, even in the presence of heavy contamination. Further studies are in progress to test our PD connector in a clinical setting.
评估一种新开发的腹膜透析(PD)连接器在模拟接触和空气传播污染后防止细菌转移到液体通路的风险的能力。
使用表皮葡萄球菌 ATCC1228 和铜绿假单胞菌 ATCC27853 菌株。对于接触污染,将 2 μL 标准化接种物(每毫升 1×10(8)个菌落形成单位(CFU))沉积在封闭患者连接器液体通路的针头上。对于空气传播污染,将患者连接器暴露于雾化标准化接种物 15 秒。为了模拟患者的腹膜和流出液,将患者连接器预先连接到 2-L 袋无菌 PD 溶液中。污染后,将患者连接器连接到转移套件上,捕获针,打开流量控制以模拟“患者引流”进入空袋,然后使用连接到连接器的预附袋进行“患者填充”。最后,重新捕获新的针。将收集在连接到连接器的预附袋中的 PD 溶液通过 0.20-μm 过滤器进行菌落计数。
无论挑战程序或使用的菌株如何,没有感染的连接器都没有将细菌转移到液体通路中。
我们的结果表明,即使在严重污染的情况下,新的 PD 连接器也可能完全消除细菌感染的风险。正在进行进一步的研究,以在临床环境中测试我们的 PD 连接器。