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[硬膜外细菌过滤器通透性的体外比较及筛选扫描电子显微镜观察]

[In vitro comparison of epidural bacteria filters permeability and screening scanning electron microscopy].

作者信息

Sener Aysin, Erkin Yuksel, Sener Alper, Tasdogen Aydin, Dokumaci Esra, Elar Zahide

机构信息

Departamento de Anestesiologia e Reanimação, Hospital Municipal de Canakkale, Canakkale, Turquia.

Departamento de Anestesiologia e Reanimação, Universidade Dokuz Eylul, Faculdade de Medicina, Izmir, Turquia.

出版信息

Rev Bras Anestesiol. 2015 Nov-Dec;65(6):491-6. doi: 10.1016/j.bjan.2013.08.004. Epub 2014 Nov 15.

Abstract

BACKGROUND AND OBJECTIVES

Epidural catheter bacteria filters are barriers in the patient-controlled analgesia/anaesthesia for preventing contamination at the epidural insertion site. The efficiency of these filters varies according to pore sizes and materials.

METHOD

The bacterial adhesion capability of the two filters was measured in vitro experiment. Adhesion capacities for standard Staphylococcus aureus (ATCC 25923) and Pseudomonas aeruginosa (ATCC 27853) strains of the two different filters (Portex and Rusch) which have the same pore size were examined. Bacterial suspension of 0.5 Mc Farland was placed in the patient-controlled analgesia pump, was filtered at a speed of 5mL/h. in continuous infusion for 48h and accumulated in bottle. The two filters were compared with colony counts of bacteria in the filters and bottles. At the same time, the filters and adhered bacteria were monitored by scanning electron microscope.

RESULTS

Electron microscopic examination of filters showed that the Portex filter had a granular and the Rusch filter fibrillary structure. Colony counting from the catheter and bottle showed that both of the filters have significant bacterial adhesion capability (p<0.001). After the bacteria suspension infusion, colony countings showed that the Portex filter was more efficient (p<0.001). There was not any difference between S. aureus and P. aeruginosa bacteria adhesion. In the SEM monitoring after the infusion, it was physically shown that the bacteria were adhered efficiently by both of the filters.

CONCLUSION

The granular structured filter was found statistically and significantly more successful than the fibrial. Although the pore sizes of the filters were same - of which structural differences shown by SEM were the same - it would not be right to attribute the changes in the efficiencies to only structural differences. Using microbiological and physical proofs with regard to efficiency at the same time has been another important aspect of this experiment.

摘要

背景与目的

硬膜外导管细菌过滤器是患者自控镇痛/麻醉中防止硬膜外穿刺部位污染的屏障。这些过滤器的效率因孔径和材料而异。

方法

在体外实验中测量两种过滤器的细菌黏附能力。检测了两种孔径相同的不同过滤器(Portex和Rusch)对标准金黄色葡萄球菌(ATCC 25923)和铜绿假单胞菌(ATCC 27853)菌株的黏附能力。将0.5麦氏浊度的细菌悬液置于患者自控镇痛泵中,以5mL/h的速度过滤,持续输注48小时并收集在瓶中。比较两种过滤器在过滤器和瓶中的细菌菌落计数。同时,通过扫描电子显微镜监测过滤器和黏附的细菌。

结果

过滤器的电子显微镜检查显示,Portex过滤器具有颗粒状结构,Rusch过滤器具有纤维状结构。导管和瓶中的菌落计数显示,两种过滤器均具有显著的细菌黏附能力(p<0.001)。细菌悬液输注后,菌落计数显示Portex过滤器更有效(p<0.001)。金黄色葡萄球菌和铜绿假单胞菌的细菌黏附之间没有差异。输注后的扫描电子显微镜监测从物理上显示,两种过滤器均能有效黏附细菌。

结论

从统计学上发现,颗粒结构的过滤器比纤维状过滤器更成功。尽管过滤器的孔径相同——扫描电子显微镜显示的结构差异相同——但仅将效率变化归因于结构差异是不正确的。同时使用关于效率的微生物学和物理学证据是本实验的另一个重要方面。

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