Jarrett Michael J, Vázquez-Torres Andres, Frank Daniel N, McCollister Bruce D, Henthorn Patrick K, Ir Diana, Sheeder Jeanelle, Guy Michael S, Anwar Hiba Q, Behbakht Kian
Research Track, University of Colorado School of Medicine, Aurora, CO 80045, USA.
Department of Immunology and Microbiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
Infect Dis Obstet Gynecol. 2016;2016:2649708. doi: 10.1155/2016/2649708. Epub 2016 Apr 21.
Objective. Gelatin-thrombin matrix (GTM) tissue sealant use was previously identified as an independent predictor of pelvic infection following hysterectomies. We aim to elucidate contributing factors by assessing influence of GTM on bacterial colony formation and characterizing bacteria present at the vaginal cuff. Methods. Escherichia coli was incubated in phosphate-buffered saline (PBS) and pelvic washings with and without GTM to assess influence on colony formation. Pelvic washings of the vaginal cuff were collected from hysterectomies occurring from June through October 2015. In vitro techniques, 16S rRNA gene qPCR, and 16S amplicon sequencing were performed with washings to characterize bacteria at the vaginal cuff. Results. Mean bacterial colony formation in PBS was greater for E. coli incubated in the presence of GTM (1.48 × 10(7) CFU/mL) versus without (9.95 × 10(5) CFU/mL) following 20-hour incubation (p = 0.001). Out of 61 pelvic washings samples, 3 were culture positive (≥5000 CFU/mL) with Enterococcus faecalis. Conclusion. In vitro experiments support a facilitating role of GTM on colony formation of E. coli in PBS. However, given the negative results of surgical site washings following adequate disinfection, the role of GTM in promoting posthysterectomy pelvic infections may be limited. Analysis of pelvic washings revealed presence of E. faecalis, but results were inconclusive. Further studies are recommended.
目的。明胶-凝血酶基质（GTM）组织密封剂的使用先前被确定为子宫切除术后盆腔感染的独立预测因素。我们旨在通过评估GTM对细菌菌落形成的影响并鉴定阴道残端存在的细菌来阐明促成因素。方法。将大肠杆菌在含和不含GTM的磷酸盐缓冲盐水（PBS）和盆腔冲洗液中孵育，以评估对菌落形成的影响。收集2015年6月至10月进行子宫切除术的阴道残端的盆腔冲洗液。对冲洗液进行体外技术、16S rRNA基因定量PCR和16S扩增子测序，以鉴定阴道残端的细菌。结果。在20小时孵育后，在GTM存在下孵育的大肠杆菌在PBS中的平均细菌菌落形成（1.48×10⁷CFU/mL）高于不存在GTM的情况（9.95×10⁵CFU/mL）（p = 0.001）。在61份盆腔冲洗液样本中，3份粪肠球菌培养阳性（≥5000 CFU/mL）。结论。体外实验支持GTM在PBS中对大肠杆菌菌落形成有促进作用。然而，鉴于充分消毒后手术部位冲洗液的阴性结果，GTM在促进子宫切除术后盆腔感染中的作用可能有限。盆腔冲洗液分析显示存在粪肠球菌，但结果尚无定论。建议进一步研究。
