Madden Jonathan F, Henrichs Lori, Ervin Mark D, Lospinoso Joshua, Beachkofsky Thomas M, Hardin Carolyn A
Department of Graduate Medical Education, San Antonio Uniformed Services Health Education Consortium, United States Air Force, 2200 Bergquist Dr. Suite 1, JBSA-Lackland, TX.
59th Clinical Research Division, Joint Base San Antonio-Lackland, United States Air Force, 1255 Wilford Hall Loop, JBSA-Lackland, TX.
Mil Med. 2018 Nov 1;183(11-12):e348-e353. doi: 10.1093/milmed/usy039.
A safe, easy-to-use, permanently bonded antiseptic that does not require post-exposure bioload reduction but maintains effectiveness over time would have far-reaching implications across multiple industries. Health care is one such arena, particularly in austere military settings where resources are at a premium. MicrobeCare XLP (MicrobeCare, Buffalo Grove, IL, USA) is a commercially available spray-on agent that is advertised to covalently bond to surfaces and provide a long-lasting antimicrobial coating inhospitable to >99.99% of surface microorganisms. A pilot study was devised to gather baseline data regarding product efficacy and laboratory parameters before consideration of extended investigations and military utilization. The product manufacturer recommends bioload reductions before product application, following product application, and after each pathogenic exposure. To investigate the product's efficacy in circumstances more closely simulating a military operational setting in which post-pathogenic exposure bioload reduction would not be possible, this step was deliberately excluded from the test sequences.
Using autoclaved surgical forceps, growth of Staphylococcus aureus and Acinetobacter baumannii was evaluated in a controlled manner under multiple conditions. Test variations included duration of submersion in the MicrobeCare XLP solution and air-drying and a second autoclave sterilization. Control and treated forceps were exposed to a bacterial suspension and air-dried before being submerged in sterile saline and vortex mixed. The saline solution was serially diluted and plated on tryptic soy agar (TSA) II plates. Plates were incubated for 24 h and bacterial colony-forming units (CFU)/mL were counted.
Statistical significance was defined according to the American Society for Testing and Materials (ASTM) International passing criteria of 3 Log10 or 99.9% reduction of microorganisms. Additionally, p-values were calculated using two-tailed unpaired two-sample t-tests with unequal variance with a threshold of 0.05. In the S. aureus tests, none of the reduction calculations met the ASTM International passing criteria. In addition, the difference between the means of the colony counts in the MicrobeCare XLP-treated forceps and untreated control forceps was not statistically significant (p-value 0.109). Conversely, in the A. baumannii tests, each of the percent reduction calculations met the ASTM International passing criteria; the difference between the means of the colony counts in the treatment and control groups was statistically significant (p-value 0.008).
In these independent tests, MicrobeCare XLP effectively prevented growth of A. baumannii but had unpredictable results suppressing S. aureus. These results may relate to inherent properties of the bacteria or autoclave exposure, although the manufacturer asserts that the coating withstands such degradation. Additional testing could be performed using a broader range of microorganisms and exposure to varying conditions including other sterilization methods.
一种安全、易用、永久性粘结的防腐剂,无需在接触后降低生物负载量且能长期保持有效性,将对多个行业产生深远影响。医疗保健领域就是其中之一,尤其是在资源稀缺的严峻军事环境中。MicrobeCare XLP(美国伊利诺伊州布法罗格罗夫的MicrobeCare公司生产)是一种市售的喷雾型制剂,宣称能与表面共价结合,提供持久的抗菌涂层,对超过99.99%的表面微生物具有抑制作用。在考虑进行进一步研究和军事应用之前,设计了一项初步研究以收集有关产品功效和实验室参数的基线数据。产品制造商建议在产品应用前、应用后以及每次病原体暴露后降低生物负载量。为了研究该产品在更接近模拟军事行动环境(即病原体暴露后无法降低生物负载量)的情况下的功效,此步骤被特意排除在测试序列之外。
使用经高压灭菌的手术镊子,在多种条件下以可控方式评估金黄色葡萄球菌和鲍曼不动杆菌的生长情况。测试变量包括在MicrobeCare XLP溶液中的浸泡时间、风干以及第二次高压灭菌。将对照镊子和处理过的镊子暴露于细菌悬液中并风干,然后浸入无菌盐水中并涡旋混合。将盐水溶液进行系列稀释并接种在胰蛋白胨大豆琼脂(TSA)II平板上。平板培养24小时后,计数细菌菌落形成单位(CFU)/毫升。
根据美国材料与试验协会(ASTM)国际标准的通过标准,即微生物减少3个对数级或99.9%来定义统计学显著性。此外,使用双尾不成对双样本t检验(方差不等,阈值为0.05)计算p值。在金黄色葡萄球菌测试中,没有一个减少量计算符合ASTM国际通过标准。此外,MicrobeCare XLP处理过的镊子和未处理的对照镊子的菌落计数平均值之间的差异无统计学显著性(p值为0.109)。相反,在鲍曼不动杆菌测试中,每个减少百分比计算都符合ASTM国际通过标准;处理组和对照组的菌落计数平均值之间的差异具有统计学显著性(p值为0.008)。
在这些独立测试中,MicrobeCare XLP有效抑制了鲍曼不动杆菌的生长,但在抑制金黄色葡萄球菌方面结果不可预测。这些结果可能与细菌的固有特性或高压灭菌暴露有关,尽管制造商声称该涂层能耐受这种降解。可以使用更广泛的微生物并在包括其他灭菌方法在内的不同条件下进行额外测试。