Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, United States.
Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, United States.
J Sex Med. 2024 Sep 3;21(9):823-826. doi: 10.1093/jsxmed/qdae093.
0.05% Chlorhexidine gluconate (CHG; Irrisept [IrriMax]) is a commercial wound irrigation solution approved by the Food and Drug Administration that has seen recent adoption in the field of prosthetic urology; however, no study has evaluated whether 0.05% CHG is compatible with the minocycline-rifampin-impregnated surface (InhibiZone) of the AMS 700 penile prosthesis (Boston Scientific).
To evaluate whether 0.05% CHG alters the antibiotic efficacy of the minocycline-rifampin-impregnated penile prosthesis surface.
Discs (8 mm) were taken by a punch biopsy (Sklar) from sterile penile prosthesis reservoirs whose surfaces had been impregnated with rifampin and minocycline. Discs (n = 10) were suspended in 0.05% CHG, vancomycin and gentamicin, or normal saline for 2 minutes to simulate intraoperative irrigation. Discs were then rinsed in normal saline to remove any unbound solution and incubated with methicillin-sensitive Staphylococcus aureus for 48 hours. Adherent surface bacteria were suspended by shaking in a 0.3% Tween 20 solution, serially diluted, plated onto 3M PetriFilms, and counted. Kirby-Bauer disc diffusion assays were conducted to generalize findings across various organisms.
Outcomes included (1) bacterial adherence to the implant surface measured as bacterial counts (in colony-forming units per milliliter) and (2) bacterial growth reduction measured as zones of inhibitions (in millimeters).
Incubation of implant surfaces in 0.05% CHG did not alter recovered bacterial counts as compared with normal saline and vancomycin/gentamycin. Similarly, within a single bacterial species, 0.05% CHG and vancomycin/gentamycin did not alter zone-of-inhibition measurements in Kirby-Bauer disc diffusion studies.
This study demonstrates in vitro that 0.05% CHG may be used directly on the minocycline-rifampin-impregnated surface without altering the antibiotic efficacy of the coating.
Strengths include that this is the first study to evaluate if 0.05% CHG affected the minocycline-rifampin-impregnated surface. Limitations include the use of in vitro studies, which serve as a proxy for in vivo practices and may not be entirely accurate or translatable in a clinical setting.
0.05% CHG does not alter the antimicrobial activity of the minocycline-rifampin-impregnated surface as compared with vancomycin/gentamycin and normal saline in vitro; however, its efficacy in clinical practice remains to be evaluated.
0.05%葡萄糖酸氯己定（CHG；Irisept[IrriMax]）是一种经美国食品和药物管理局批准的商用伤口冲洗液，最近已在假体泌尿科领域得到应用；然而，尚无研究评估 0.05%CHG 是否与 AMS 700 阴茎假体（波士顿科学公司）的米诺环素-利福平浸渍表面（InhibiZone）兼容。
评估 0.05%CHG 是否会改变米诺环素-利福平浸渍阴茎假体表面的抗生素疗效。
使用 Sklar 打孔活检器从已浸渍利福平与米诺环素的无菌阴茎假体储液器中取出（8mm）圆盘。将圆盘（n=10）浸泡在 0.05%CHG、万古霉素和庆大霉素或生理盐水 2 分钟，以模拟术中冲洗。然后将圆盘在生理盐水中冲洗以去除任何未结合的溶液，并与甲氧西林敏感的金黄色葡萄球菌孵育 48 小时。通过在 0.3%吐温 20 溶液中摇动将附着于表面的细菌悬浮，连续稀释，接种至 3M PetriFilms 并计数。进行 Kirby-Bauer 圆盘扩散测定以将研究结果推广到各种生物体。
结果包括（1）细菌对植入物表面的粘附，以细菌计数（每毫升菌落形成单位）表示，以及（2）细菌生长减少，以抑菌环测量（毫米）表示。
在 0.05%CHG 孵育的植入物表面与生理盐水和万古霉素/庆大霉素相比，并未改变回收的细菌计数。同样，在单一细菌物种中，0.05%CHG 和万古霉素/庆大霉素并未改变 Kirby-Bauer 圆盘扩散研究中的抑菌环测量值。
本研究在体外证明，0.05%CHG 可直接用于米诺环素-利福平浸渍表面，而不会改变涂层的抗生素功效。
优势包括这是第一项评估 0.05%CHG 是否影响米诺环素-利福平浸渍表面的研究。局限性包括使用体外研究，这是体内实践的替代方法，可能不完全准确或在临床环境中无法完全转化。
与万古霉素/庆大霉素和生理盐水相比，0.05%CHG 不会改变米诺环素-利福平浸渍表面的抗菌活性，但其在临床实践中的疗效仍有待评估。
