Smock Elliott, Demertzi E, Abdolrasouli A, Azadian B, Williams Greg
Burns Unit, Department of Plastic Surgery, Chelsea and Westminster NHS Foundation Trust, London, United Kingdom.
Department of Medical Microbiology, Imperial College Healthcare NHS Trust, London, United Kingdom.
J Burn Care Res. 2018 Apr 20;39(3):440-444. doi: 10.1097/BCR.0000000000000621.
The authors devised a comparative prospective study to determine the in vitro microbicidal efficacy of skin preparation solutions in the concentrations and temperatures used in the burns theatre against common bacterial and fungal microorganisms. A panel of 10 microorganisms Staphylococcus aureus, streptococcus pyogenes, enterococcus faecalis, escherichia coli, pseudomonas aeruginosa, candida albicans, bacillus cereus were assembled comprising 8 common strains of S. aureus (including methicillin resistant staphylococcus aureus (MRSA)), S. pyogenes, E. faecalis, E. coli, P. aeruginosa, C. albicans, B. cereus, and multi-drug resistant Klebsiella and Acinetobacter. These were cultured in the following formulations: 1) povidone iodine (PVP-iodine) 10% stored at room temperature (250C), 2) PVP-iodine stored at 40 to 420C, 3) chlorhexidine digluconate stored at room temperature diluted with warmed saline to concentrations of 4%, 2%, 1%, 0.8%, and 0.5%. All 3 formulations met DIN EN (Deutsches Institut für Normung) (European Standards) requirements for antiseptics. Both antiseptics showed the same high bactericidal and fungicidal efficacy (P = < 0.05). For chlorhexidine, all minimum inhibitory concentrations at both 24 and 48 hours were very low (< 0.5mg/L), but for PVP-iodine the minimum inhibitory concentrations were much higher and ranged from 64 to 512 mg/L. All concentrations of chlorhexidine tested were superior to PVP-iodine with no bacterial growth. There was a small amount of growth in some of the PVP-iodine treated groups, but this was not clinically significant.
作者设计了一项比较性前瞻性研究，以确定烧伤手术室使用的不同浓度和温度的皮肤准备溶液对常见细菌和真菌微生物的体外杀菌效果。组建了一个包含10种微生物的小组，其中有金黄色葡萄球菌、化脓性链球菌、粪肠球菌、大肠杆菌、铜绿假单胞菌、白色念珠菌、蜡样芽孢杆菌，包括8种常见的金黄色葡萄球菌菌株（包括耐甲氧西林金黄色葡萄球菌（MRSA））、化脓性链球菌、粪肠球菌、大肠杆菌、铜绿假单胞菌、白色念珠菌、蜡样芽孢杆菌，以及耐多药的克雷伯菌和不动杆菌。这些微生物在以下制剂中培养：1）10%聚维酮碘（PVP-碘），室温（25℃）储存；2）40至42℃储存的PVP-碘；3）室温储存的葡萄糖酸洗必泰，用温热盐水稀释至4%、2%、1%、0.8%和0.5%的浓度。所有3种制剂均符合德国标准化学会（DIN EN）（欧洲标准）对防腐剂的要求。两种防腐剂均显示出相同的高杀菌和杀真菌效果（P = <0.05）。对于洗必泰，24小时和48小时的所有最低抑菌浓度都非常低（<0.5mg/L），但对于PVP-碘，最低抑菌浓度要高得多，范围为64至512mg/L。所有测试浓度的洗必泰均优于PVP-碘，无细菌生长。在一些PVP-碘处理组中有少量生长，但这在临床上并不显著。
