Gilsdorf J R, Wilson K, Beals T F
Department of Surgery, Ann Arbor Veterans Administration Medical Center, MI 48105.
Surgery. 1989 Jul;106(1):37-44.
Four different intravenous catheter materials, brands Teflon, Silastic, Vialon, and Tecoflex, were evaluated in vitro for bacterial adherence after 2 and 24 hours' incubation in trypticase soy broth and after 2 hours' incubation in nutrient-free phosphate buffer (pH 7.2). The organisms used were Pseudomonas aeruginosa, Enterobacter aerogenes, Escherichia coli, and Staphylococcus epidermidis. The significant differences in in vitro adherence of the different bacterial species to the various catheters were then evaluated in vivo by intravenous injection of a single bolus of 1 X 10(5) organisms via tail vein of rats with previously placed catheters in their superior venae cavae. There was no association between the in vitro bacterial adherence and the tendency of the in vivo catheters to become colonized. Results of scanning electron microscopy of clean catheters and those removed from the rats showed obvious differences in surface characteristics and in clot adhesion between the catheters. These characteristics did not correlate with bacterial adherence in vitro or colonization in vivo. It is concluded that laboratory studies of bacterial adherence to, physical characteristics of, and thrombogenicity of intravenous catheters do not necessarily translate into resistance to clinical catheter sepsis.
对四种不同的静脉导管材料(品牌分别为聚四氟乙烯、硅橡胶、维阿隆和泰科弗lex)进行了体外评估,观察它们在胰蛋白酶大豆肉汤中孵育2小时和24小时后以及在无营养磷酸盐缓冲液(pH 7.2)中孵育2小时后的细菌黏附情况。所使用的微生物为铜绿假单胞菌、产气肠杆菌、大肠杆菌和表皮葡萄球菌。然后,通过经尾静脉向已在上腔静脉中预先放置导管的大鼠静脉注射1×10⁵个单一剂量的微生物,在体内评估不同细菌种类对各种导管的体外黏附的显著差异。体外细菌黏附与体内导管被定植的倾向之间没有关联。对清洁导管以及从大鼠体内取出的导管进行扫描电子显微镜检查的结果显示,导管之间在表面特征和血栓黏附方面存在明显差异。这些特征与体外细菌黏附或体内定植均无相关性。得出的结论是,关于静脉导管细菌黏附、物理特性和血栓形成性的实验室研究不一定能转化为对临床导管败血症的抵抗力。