Dasgupta M K, Lam K, Ulan R A, Bettcher K B, Burns V, Tyrrell D L, Dossetor J B, Costerton J W
Department of Medicine, University of Alberta, Edmonton, Canada.
Am J Nephrol. 1988;8(2):118-22. doi: 10.1159/000167569.
We have developed an extracorporeal system for investigating in vitro the biofilm-adherent bacterial microcolonies (BABM) that grow on Tenckhoff catheters (TC), to study peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). A modified Robbins' device, attached to sampling plugs with TC discs and connected to the dialysate via a peristaltic pump, is run for 24 h; scrapings from pairs of TC discs are processed for assessment of viable BABM, one of each pair for culture by routine microbiology techniques and the other for examination by scanning and transmission electron microscopy (EM). No colonization was noted with fresh dialysis solutions and spent dialysates from patients without clinical peritonits; but, when bacterial suspensions were added to aliquots of the same dialysates, BABM were noted on both culture and EM. In a study of 4 patients on CAPD treatment, who had clinically evident peritonitis, routine cultures of spent dialysate were positive in only 2, but BABM were found in cultures and EM preparations of disc scrapings in all 4 cases. We conclude from these preliminary findings that this extracorporeal system is reliable, and well suited for studying the role of BABM in CAPD-associated peritonitis in vitro.
我们开发了一种体外系统，用于在体外研究在Tenckhoff导管（TC）上生长的生物膜粘附细菌微菌落（BABM），以研究持续非卧床腹膜透析（CAPD）患者的腹膜炎。一种改良的Robbins装置，连接到带有TC盘的采样塞上，并通过蠕动泵与透析液相连，运行24小时；从成对的TC盘上刮取的样本用于评估存活的BABM，每对中的一个通过常规微生物学技术进行培养，另一个通过扫描和透射电子显微镜（EM）进行检查。未发现无临床腹膜炎患者的新鲜透析液和用过的透析液中有定植现象；但是，当将细菌悬液加入相同透析液的等分试样中时，在培养和EM检查中均发现了BABM。在一项对4例接受CAPD治疗且有临床明显腹膜炎的患者的研究中，用过的透析液的常规培养仅2例呈阳性，但在所有4例患者的盘刮取物培养和EM制剂中均发现了BABM。我们从这些初步发现中得出结论，该体外系统可靠，非常适合在体外研究BABM在CAPD相关腹膜炎中的作用。
