Berard X, Stecken L, Pinaquy J-B, Cazanave C, Puges M, Pereyre S, Bordenave L, M'Zali F
Vascular Surgery Department, CHU de Bordeaux, Bordeaux, France; University of Bordeaux, Faculté de Médecine, Bordeaux, France.
Anesthesiology Department, CHU de Bordeaux, Bordeaux, France.
Eur J Vasc Endovasc Surg. 2016 Feb;51(2):285-92. doi: 10.1016/j.ejvs.2015.10.016. Epub 2015 Dec 9.
The aim was to compare the antimicrobial efficacy of the silver impregnated collagen coated polyester vascular graft (IGS) with an identical graft combining silver and triclosan (IGSy).
This was an in vitro study. A non-antimicrobial collagen polyester vascular graft served as control (IG). The IG, IGS, and IGSy grafts were contaminated separately with inoculates of each of the following micro-organisms: Staphylococcus epidermidis (SE), methicillin resistant Staphylococcus aureus (MRSA), and Escherichia coli producing extended spectrum beta-lactamase (ESBL-EC) or Candida albicans (CA). MRSA, ESBL-EC, and CA were obtained from retrieved infected grafts. The in vitro antimicrobial efficacies of the contaminated grafts were evaluated by time to kill assays over a 24 hour period in accordance with CLSI Guideline M26-A. All assays were repeated six times. Bacterial survival numbers were obtained at 1, 4, 8, and 24 hours using a standard plate count procedure. Bactericidal activity was defined as a 3 log10 reduction factor (logRF). To calculate the overall difference in the mean log10 CFU/mL within 24 hours, a one way ANOVA with a Bonferroni correction was calculated separately for each graft.
The IG graft showed an increase in the number of viable organisms for the four strains tested. IGSy offered better antimicrobial properties than IGS for both ESBL-EC and MRSA, since only the IGSy graft achieved > 3 logRF and fulfilled the standard criteria for bactericidal activity at 24 hours with 3.78 and 4.08 logRF, respectively. For samples inoculated with SE and CA, both antimicrobial grafts achieved 24 hour bactericidal activity with > 3 logRF. However, for CA the one-way ANOVA analysis demonstrated that the IGSy graft performed differently in terms of speed of antimicrobial action, appearing more active as early as 4 hours following inoculation (p = .007).
In the in vitro conditions, the Synergy vascular graft combining silver with triclosan demonstrated better short-term antimicrobial activity than the silver graft for all micro-organisms tested.
比较含银胶原蛋白涂层聚酯血管移植物（IGS）与含银和三氯生的相同移植物（IGSy）的抗菌效果。
这是一项体外研究。一种非抗菌性胶原蛋白聚酯血管移植物用作对照（IG）。将IG、IGS和IGSy移植物分别用以下每种微生物的接种物污染：表皮葡萄球菌（SE）、耐甲氧西林金黄色葡萄球菌（MRSA）、产超广谱β-内酰胺酶的大肠杆菌（ESBL-EC）或白色念珠菌（CA）。MRSA、ESBL-EC和CA取自回收的感染移植物。根据CLSI指南M26-A，通过24小时的杀菌时间测定评估污染移植物的体外抗菌效果。所有测定重复六次。使用标准平板计数程序在1、4、8和24小时获得细菌存活数。杀菌活性定义为3个对数10减少因子（logRF）。为计算24小时内平均log10 CFU/mL的总体差异，对每个移植物分别计算经Bonferroni校正的单因素方差分析。
IG移植物对所测试的四种菌株显示出活菌数量增加。对于ESBL-EC和MRSA，IGSy比IG具有更好的抗菌性能，因为只有IGSy移植物在24小时时达到> 3 logRF并满足杀菌活性的标准标准，分别为3.78和4.08 logRF。对于接种SE和CA的样本，两种抗菌移植物均以> 3 logRF实现24小时杀菌活性。然而，对于CA，单因素方差分析表明IGSy移植物在抗菌作用速度方面表现不同，早在接种后4小时就显得更活跃（p = .007）。
在体外条件下，含银和三氯生的协同血管移植物对所有测试微生物显示出比含银移植物更好的短期抗菌活性。
