Shimomura A, Tahara D, Tominaga M, Uchigiri S, Yamaguchi Y, Ishioka H, Nakahata A
Hamamatsu Medical Center, Division of Nephrology, Japan.
Adv Perit Dial. 1995;11:152-6.
The aim of this study was to show that ultraviolet (UV) irradiation to the skin around the catheter exit site (ES) could inhibit its infection. First, bacterial cultures of swabbed fluid from the ES were obtained from 68 continuous ambulatory peritoneal dialysis (CAPD) outpatients six times during the 24-month observation period. Second, the bactericidal effects of UV irradiation on the catheter ES were examined. The results were as follows: (1) In spite of disinfection of the catheter ES by the strict application of povidone-iodine once or twice a day, 23%-45% of the cases were found to be micro-organism positive. The most prevalent micro-organisms from the catheter ES were, in order of highest to lowest prevalence, Staphylococcus epidermidis (SE), Staphylococcus aureus (SA), and Pseudomonas aeruginosa (PA). (2) In the nasal cavity SA was detected in 20%-25% of patients. There was a high incidence of ES infection among the SA nasal carriers. (3) UV irradiation was performed in 18 cases that constantly revealed bacteria on culture at the catheter ES. Ten cases (55%) became culture-negative, 3 cases showed a microbial decrease, and 5 cases remained unchanged. These results suggest that UV irradiation can eliminate bacteria and can be of prophylactic use for ES infections.
本研究的目的是表明对导管出口部位（ES）周围皮肤进行紫外线（UV）照射可抑制其感染。首先，在24个月的观察期内，从68例持续性非卧床腹膜透析（CAPD）门诊患者的ES擦拭液中获取细菌培养物，共进行了6次。其次，检测了紫外线照射对导管ES的杀菌效果。结果如下：（1）尽管每天严格使用聚维酮碘对导管ES进行一到两次消毒，但仍有23%-45%的病例被发现微生物呈阳性。导管ES中最常见的微生物按流行率从高到低依次为表皮葡萄球菌（SE）、金黄色葡萄球菌（SA）和铜绿假单胞菌（PA）。（2）在鼻腔中，20%-25%的患者检测到SA。SA鼻腔携带者中ES感染的发生率很高。（3）对18例在导管ES培养中持续显示有细菌的病例进行了紫外线照射。10例（55%）培养结果转为阴性，3例微生物数量减少，5例保持不变。这些结果表明紫外线照射可以消除细菌，可用于预防ES感染。
