Leport C, Goéau-Brissonnière O, Lebrault C, Guidoin R, Vildé J L, Bacourt F, Péchère J C
Department of Infectious and Tropical Diseases, Claude Bernard Hospital, Paris, France.
J Vasc Surg. 1988 Jul;8(1):1-9. doi: 10.1067/mva.1988.avs0080001.
Colonization of a polyester (Dacron) vascular graft by Staphylococcus aureus 209P-R was studied. Twenty-five dogs had thoracoabdominal aortic bypass. After intervals of 2 hours (three dogs), 8 days (five dogs), 1 month (six dogs), 2 months (six dogs), or 6 months (five dogs), a bacteremic challenge was produced by intravenous injection of 6 x 10(8) colony-forming units of S. aureus. Two hours later grafts were removed and cut into 10 fragments, each submitted to bacterial counts and scanning electron microscopic studies. Results of bacterial counts were expressed in colony-forming units (CFU) per square centimeter of graft segment (median [lower to upper quartiles]). Normal canine aortas (n = 2) used as controls trapped no bacteria. Colonization of Dacron grafts varied according to the duration of graft function (p less than 0.01): after 2 hours, 4416.5 CFU (1158 to 9073 CFU); after 8 days, 1515 CFU (963 to 2893 CFU); after 1 month, 199 CFU (86 to 538 CFU); after 2 months, 615 CFU (243 to 1407 CFU); and after 6 months, 1 CFU (1 to 5 CFU). Heavily colonized fragments were observed for duration of graft function of 2 months or less, whereas at 6 months all the fragments trapped fewer than 50 CFU/cm2 of graft segment. Scanning electron microscopy showed that colonization was closely associated with healing. Staphylococcal entrapment was related to the amount of fibrin deposits, which were especially abundant where the thrombotic matrix was unorganized and on bare polyester filaments. Graft colonization is especially to be feared in the first weeks after graft implantation, an observation which may help to define guidelines for preventing hematogenous vascular graft infection.
对金黄色葡萄球菌209P - R在聚酯（涤纶）血管移植物上的定植情况进行了研究。25只犬接受了胸腹主动脉旁路移植术。在术后2小时（3只犬）、8天（5只犬）、1个月（6只犬）、2个月（6只犬）或6个月（5只犬）的时间间隔后，通过静脉注射6×10⁸个金黄色葡萄球菌菌落形成单位引发菌血症挑战。两小时后取出移植物并切成10个片段，每个片段进行细菌计数和扫描电子显微镜研究。细菌计数结果以每平方厘米移植物片段的菌落形成单位（CFU）表示（中位数[下四分位数至上四分位数]）。用作对照的正常犬主动脉（n = 2）未捕获到细菌。涤纶移植物的定植情况根据移植物功能持续时间而有所不同（p＜0.01）：2小时后，4416.5 CFU（1158至9073 CFU）；8天后，1515 CFU（963至2893 CFU）；1个月后，199 CFU（86至538 CFU）；2个月后，615 CFU（243至1407 CFU）；6个月后，1 CFU（1至5 CFU）。在移植物功能持续2个月或更短时间的片段中观察到大量定植，而在6个月时，所有片段捕获的细菌少于50 CFU/cm²移植物片段。扫描电子显微镜显示，定植与愈合密切相关。葡萄球菌的截留与纤维蛋白沉积量有关，在血栓基质无组织的地方和裸露的涤纶丝上纤维蛋白沉积尤为丰富。移植物植入后的最初几周尤其要担心移植物定植，这一观察结果可能有助于确定预防血源性血管移植物感染的指导原则。
