Ruggieri M R, Hanno P M, Levin R M
J Urol. 1987 Aug;138(2):423-6. doi: 10.1016/s0022-5347(17)43177-6.
Despite many advances in catheter design and use, the most common cause of hospital-acquired infections is catheterization of the urinary tract. In the present investigation the adherence of bacteria to catheters coated with heparin was studied. Since heparin itself does not coat the plastic catheter surface, a complex of heparin with tridodecylmethylammonium chloride (TDMAC) was used which results in hydrophobic association of hydrocarbon chains of the TDMAC with the catheter leaving the quaternary ammonium moiety of TDMAC exposed to the surface forming ionic bonds with the highly anionic sulfate groups of heparin. Coating latex catheter material with TDMAC without heparin resulted in 3.6-fold higher adherence whereas coating with the TDMAC-heparin complex reduced adherence to less than 10% of control untreated latex. TDMAC-heparin also significantly reduced bacterial adherence to teflon coated latex (Bardex) and vinyl catheter material. Less than 30% of the original heparin was removed after wash periods of up to one week. These results indicate that TDMAC-heparin coating of urethral catheters reduces bacterial adherence and thereby may delay the acquisition of catheter associated urinary tract infection.
尽管在导管设计和使用方面取得了许多进展，但医院获得性感染最常见的原因是泌尿道插管。在本研究中，对细菌在涂有肝素的导管上的黏附情况进行了研究。由于肝素本身不会覆盖塑料导管表面，因此使用了肝素与三（十二烷基）甲基氯化铵（TDMAC）的复合物，这会导致TDMAC的烃链与导管发生疏水缔合，使TDMAC的季铵部分暴露于表面，与肝素的高阴离子硫酸根形成离子键。用不含肝素的TDMAC涂覆乳胶导管材料会使黏附增加3.6倍，而用TDMAC-肝素复合物涂覆则会使黏附降低至未处理对照乳胶的不到10%。TDMAC-肝素还显著降低了细菌对聚四氟乙烯涂层乳胶（巴德克斯）和乙烯基导管材料的黏附。在长达一周的冲洗期后，不到30%的原始肝素被去除。这些结果表明，尿道导管的TDMAC-肝素涂层可减少细菌黏附，从而可能延迟导管相关尿路感染的发生。
