Rosman Brian M, Barbosa Joao A B A, Passerotti Carlo P, Cendron Marc, Nguyen Hiep T
Department of Urology, Boston Children's Hospital, 300 Longwood Avenue, Hunnewell-353, Boston, MA, 02115, USA.
Int Urol Nephrol. 2014 Jun;46(6):1053-8. doi: 10.1007/s11255-013-0636-3. Epub 2013 Dec 24.
Current ureteral stents, while effective at maintaining a ureteral lumen, provide a substrate for bacterial growth. This propensity for biofilm formation may be a nidus for bacterial growth leading to infection and a reason for early removal of a stent before it is clinically indicated. A newly devised stent, composed of a highly hydrated, partially hydrolyzed polyacrylonitrile polymer, is believed to have bacterial resistant properties. The objective of this study is to evaluate the biofilm growth and bacterial resistant properties of this novel stent.
Multiple 1 cm sections of the pAguaMedicina™ Pediatric Ureteral Stent (pAMS) (Q Urological, Natick, MA) and the conventional polymer stent (SS) (Boston Scientific, Natick, MA) were incubated for 3 days in the 3 different growth media. Afterward, J96 human pathogenic Escherichia coli was added. At 3, 6, 9, 12, and 15 days following bacterial inoculation, the stent segments were washed, sonicated, and analyzed for bacterial growth. Scanning electron microscopy (SEM) imaging was performed to assess biofilm formation.
pAMS demonstrated significant reductions (43-71 %) in bacterial counts when compared to standard stents in all conditions tested. SEM imaging demonstrated biofilm formation on both types of stents in all media, with a relative reduction in apparent cell debris and bacteria on the pAMS.
In this study, the gel-based stent shows a demonstrable reduction in bacterial counts and biofilm formation. The use of the pAMS may reduce the risk of infection associated with stent usage.
目前的输尿管支架虽然在维持输尿管腔通畅方面有效,但却为细菌生长提供了基质。这种形成生物膜的倾向可能是细菌生长的病灶,导致感染,也是在临床指征出现之前提前取出支架的一个原因。一种新设计的由高度水合的部分水解聚丙烯腈聚合物组成的支架,被认为具有抗菌性能。本研究的目的是评估这种新型支架的生物膜生长和抗菌性能。
将多个1厘米长的pAguaMedicina™小儿输尿管支架(pAMS)(Q泌尿外科,马萨诸塞州纳蒂克)和传统聚合物支架(SS)(波士顿科学公司,马萨诸塞州纳蒂克)在3种不同的生长培养基中孵育3天。之后,加入J96人致病性大肠杆菌。在细菌接种后的第3、6、9、12和15天,对支架段进行冲洗、超声处理,并分析细菌生长情况。进行扫描电子显微镜(SEM)成像以评估生物膜形成。
在所有测试条件下,与标准支架相比,pAMS的细菌计数显著降低(43%-71%)。SEM成像显示,在所有培养基中,两种类型的支架上均形成了生物膜,pAMS上的明显细胞碎片和细菌相对减少。
在本研究中,基于凝胶的支架显示出细菌计数和生物膜形成明显减少。使用pAMS可能会降低与支架使用相关的感染风险。