Lachapelle K, Graham A M, Symes J F
Cardiovascular Research Unit, Royal Victoria Hospital, McGill University, Montréal, Québec, Canada.
J Vasc Surg. 1994 Apr;19(4):675-82. doi: 10.1016/s0741-5214(94)70041-9.
A gelatin-sealed porous Dacron graft impregnated with rifampin was evaluated in a two-part study of its use in preventing prosthetic infection.
The graft was impregnated by soaking it for 15 minutes in rifampin (1 mg/ml). In part 1 its antibacterial activity and rifampin retention over time were determined. Infrarenal aortic replacement was performed in pigs, and the rifampin concentration of the graft, serum, and perigraft space was assayed up to 96 hours after surgery. In part 2, infection resistance was tested in pigs in which the retroperitoneum was contaminated with Staphylococcus aureus after graft replacement. The postoperative infection rate was compared in three groups: pigs given gelatin-sealed grafts without rifampin (controls), pigs receiving nonimpregnated grafts and intravenous rifampin (15 mg/kg) for 3 days after surgery, and those given the rifampin grafts.
Rifampin was present in the grafts for up to 72 hours after surgery and in the perigraft fluid for 24 hours but was never detected in the serum. The grafts had inhibitory activity in vitro against S. aureus and the biofilm phase of Staphylococcus epidermidis for up to 3 days and against Escherichia coli for 2 days. Pigs given intravenous rifampin had a significantly lower infection rate than had control pigs (7/12 vs 13/13; p = 0.02); those receiving the rifampin graft had a lower rate (2/13) than had either the control pigs (p < 0.001) or those given intravenous rifampin (p < 0.04).
This simple method of graft impregnation resulted in antibiotic retention for 3 days and appeared to be superior to intravenous antibiotic administration in preventing perioperative graft infection.
在一项关于其预防人工假体感染用途的两部分研究中，对一种浸渍有利福平的明胶密封多孔涤纶移植物进行了评估。
将移植物在利福平（1毫克/毫升）中浸泡15分钟进行浸渍。在第一部分中，测定了其抗菌活性和利福平随时间的保留情况。对猪进行肾下腹主动脉置换，并在术后96小时内测定移植物、血清和移植物周围间隙中的利福平浓度。在第二部分中，在移植物置换后后腹膜被金黄色葡萄球菌污染的猪中测试抗感染能力。比较了三组的术后感染率：给予无利福平的明胶密封移植物的猪（对照组）、接受未浸渍移植物并在术后3天静脉注射利福平（15毫克/千克）的猪以及给予利福平移植物的猪。
术后长达72小时移植物中仍有利福平，移植物周围液中24小时有利福平，但血清中从未检测到。移植物在体外对金黄色葡萄球菌和表皮葡萄球菌的生物膜阶段具有长达3天的抑制活性，对大肠杆菌具有2天的抑制活性。静脉注射利福平的猪的感染率明显低于对照组猪（7/12对13/13；p = 0.02）；接受利福平移植物的猪的感染率（2/13）低于对照组猪（p < 0.001）或静脉注射利福平的猪（p < 0.04）。
这种简单的移植物浸渍方法使抗生素保留了3天，在预防围手术期移植物感染方面似乎优于静脉注射抗生素。
