Ohara Hiroshi
Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Ohu University.
Yakugaku Zasshi. 2022;142(4):303-315. doi: 10.1248/yakushi.21-00184.
Among healthcare-associated infections, catheter-related bloodstream infection (CRBSI) shows a high case fatality rate and is serious threat. CRBSI are a problem to be eradicated. This study was conducted to reveal the growth characteristics of the causative microorganisms of CRBSI and investigate relevant control methods. The effects of biotin on growth of Candida albicans (C. albicans) in the nutrient solutions were investigated. Upon comparing general solutions and biotin-containing solutions, C. albicans showed auxotrophy against biotin, resulting in significant proliferative potential. CRBSI is caused by biofilm formation in the catheter lumen and subsequent proliferation. The effect of biotin on the colonization of C. albicans in the catheter lumen was evaluated. Candida albicans colonization in the catheter lumen and subsequent proliferation were significantly higher than those in control solutions. To investigate methods for CRBSI control, effects on pathogenic microorganisms were examined by screening for nutrient solutions with antimicrobial activity, using a catheter-lumen contamination model. A commercially available solution (PLAS-AMINO injection; PA) containing the highest amount of sodium bisulfite was selected. Gram-positive or negative bacteria and C. albicans were used as the causative microorganisms of CRBSI in the study. Dripping PA into each catheter-lumen contamination model demonstrated bactericidal effects against all bacteria tested and strong growth-inhibitory effects on C. albicans. By using PA for contamination inside the catheter, sterilization and suppression of bacterial growth can be expected without having to remove central venous catheters and/or central venous access devices. This review provides valuable findings for the development of novel control methods for CRBSI.
在医疗保健相关感染中,导管相关血流感染(CRBSI)显示出较高的病死率,是一个严重威胁。CRBSI是一个亟待根除的问题。本研究旨在揭示CRBSI致病微生物的生长特性,并研究相关的控制方法。研究了生物素对白色念珠菌在营养液中生长的影响。比较普通溶液和含生物素溶液后发现,白色念珠菌对生物素具有营养缺陷型,从而具有显著的增殖潜力。CRBSI是由导管腔内生物膜形成及随后的增殖引起的。评估了生物素对白色念珠菌在导管腔内定植的影响。白色念珠菌在导管腔内的定植及随后的增殖明显高于对照溶液。为了研究CRBSI的控制方法,使用导管腔污染模型,通过筛选具有抗菌活性的营养液来检测其对致病微生物的影响。选择了一种含有最高量亚硫酸氢钠的市售溶液(PLAS-AMINO注射液;PA)。革兰氏阳性或阴性细菌以及白色念珠菌被用作本研究中CRBSI的致病微生物。将PA滴入每个导管腔污染模型中,显示出对所有测试细菌的杀菌作用以及对白色念珠菌的强烈生长抑制作用。通过将PA用于导管内部的污染,可以预期在不必移除中心静脉导管和/或中心静脉通路装置的情况下实现杀菌和抑制细菌生长。本综述为CRBSI新型控制方法的开发提供了有价值的发现。