Findon G, Miller T
Department of Medicine, University of Auckland, New Zealand.
Am J Kidney Dis. 1995 Nov;26(5):765-73. doi: 10.1016/0272-6386(95)90440-9.
We have used an experimental model of continuous ambulatory peritoneal dialysis (CAPD) to investigate the effect of dialysis on host defense mechanisms in the peritoneal cavity. Laboratory rats undergoing regular dialysis were challenged with a single bolus of Staphylococcus epidermidis, Staphylococcus aureus, Candida albicans, and Pseudomonas aeruginosa. Intraperitoneal challenges with all four microbial strains underwent a rapid clearance during the first 4 hours, irrespective of whether the host was undergoing dialysis. Studies using S epidermidis showed that the rapid clearance was not mediated by the diaphragmatic stomata as might have been expected. Dialysis did, however, cause delays over the following 48 hours with all of the pathogens except C albicans. Bacterial clearance over a 10-day period was strain dependant, and microbial persistence was related to adhesion formation around the cannula. Again C albicans was an exception. Our conclusions are that dialysis does not affect the innate defense mechanisms involved in the early clearance of a bolus challenge to the peritoneal cavity but can cause delays in eradicating microorganisms that survive this phase. Because these experiments were carried out using a bolus inoculum, it may be necessary to reevaluate the effect of dialysis on host defenses in the peritoneal cavity under conditions in which the challenge more closely approximates a touch contamination event.
我们使用持续非卧床腹膜透析（CAPD）的实验模型来研究透析对腹膜腔宿主防御机制的影响。对接受定期透析的实验大鼠单次注射表皮葡萄球菌、金黄色葡萄球菌、白色念珠菌和铜绿假单胞菌进行攻击。无论宿主是否正在进行透析，腹腔内注射这四种微生物菌株后，在前4小时内均迅速被清除。使用表皮葡萄球菌的研究表明，这种快速清除并非如预期那样由膈肌小孔介导。然而，透析确实在接下来的48小时内导致除白色念珠菌外的所有病原体清除延迟。10天内的细菌清除情况因菌株而异，微生物持续存在与套管周围粘连形成有关。白色念珠菌再次是个例外。我们的结论是，透析不影响腹膜腔单次注射攻击早期清除所涉及的固有防御机制，但可能会导致清除在此阶段存活的微生物出现延迟。由于这些实验是使用单次接种物进行的，在挑战更接近接触污染事件的条件下，可能有必要重新评估透析对腹膜腔宿主防御的影响。
