Gorman S P, Adair C G, Mawhinney W M
School of Pharmacy, Queen's University of Belfast, UK.
Epidemiol Infect. 1994 Jun;112(3):551-9. doi: 10.1017/s0950268800051256.
Thirty-two Tenckhoff catheters retrieved from continuous ambulatory peritoneal dialysis patients with a history of peritonitis were examined for microbial biofilm. Confocal laser scanning microscopy was successfully employed to visualize bacteria in biofilm occluded from view by scanning electron microscopy. Occluded but viable microbial biofilm was associated with 17 (81%) catheters from patients free from infection following renal transplant. Mixed isolate biofilm with two or more isolates of coagulase-negative staphylococci or Staphylococcus aureus was found on 41% of these catheters. Clearly visible viable biofilm consisting exclusively of Pseudomonas aeruginosa occurred on all four catheters removed due to recurrent peritonitis. Five (71%) catheters retrieved from patients transferred to haemodialysis had viable biofilm. Antibiotic sensitivities of the biofilm isolates were similar in profile to those reported for non-biofilm isolates from infected dialysate. Persistence of catheter biofilm despite direct contact with therapeutic levels of antibiotics in peritoneal dialysate requires that attention be directed towards improving antibiotic efficacy against peritonitis-causing bacteria in biofilm form.
对32根从有腹膜炎病史的持续性非卧床腹膜透析患者体内取出的Tenckhoff导管进行了微生物生物膜检查。共聚焦激光扫描显微镜成功用于观察扫描电子显微镜无法看到的生物膜中的细菌。封闭但仍存活的微生物生物膜与17根（81%）来自肾移植后无感染患者的导管相关。在41%的这些导管上发现了含有两种或更多凝固酶阴性葡萄球菌或金黄色葡萄球菌分离株的混合分离生物膜。在因复发性腹膜炎而取出的所有4根导管上都出现了仅由铜绿假单胞菌组成的清晰可见的存活生物膜。从转为血液透析的患者体内取出的5根（71%）导管有存活生物膜。生物膜分离株的抗生素敏感性与感染透析液中未形成生物膜的分离株报告的敏感性相似。尽管腹膜透析液中的抗生素处于治疗水平，但导管生物膜仍持续存在，这就需要关注提高抗生素对生物膜形式的致腹膜炎细菌的疗效。
