Brydon H L, Bayston R, Hayward R, Harkness W
Department of Neurosurgery, Hospital for Children, London, UK.
J Neurol Neurosurg Psychiatry. 1996 Jun;60(6):671-5. doi: 10.1136/jnnp.60.6.671.
Prosthetic infections are a major problem, requiring complex and lengthy management. The role of blood proteins in the pathogenesis of implant infection has been investigated, but research into the role of CSF protein in shunt infections has not been undertaken, even though a high CSF protein has been assumed to increase the risk of such infections.
New shunt catheters were exposed to either CSF or individual protein solutions, and the numbers of radiolabelled staphylococci that adhered to them were compared with controls that had been exposed to saline only.
A significant reduction in bacteria adhering to the test catheter was found in each instance. Furthermore, the CSF with the highest protein content, from a patient with intraventricular haemorrhage, had the greatest inhibitory effect on bacterial adhesion. The effect of the solutions on the hydrophobicity of the silicone rubber was also investigated. The silicone rubber was more hydrophilic, and bacterial adhesion was less, with solutions containing a higher protein content, and these findings were in keeping with the current theories on the mechanism of bacterial adhesion to polymers.
A high CSF protein content does not predispose to the development of shunt infections.
假体感染是一个重大问题,需要复杂且漫长的治疗。血液蛋白在植入物感染发病机制中的作用已得到研究,但尽管人们认为脑脊液蛋白含量高会增加分流感染的风险,但尚未对脑脊液蛋白在分流感染中的作用进行研究。
将新的分流导管暴露于脑脊液或单独的蛋白质溶液中,并将附着在导管上的放射性标记葡萄球菌数量与仅暴露于生理盐水的对照组进行比较。
在每种情况下,均发现附着在测试导管上的细菌数量显著减少。此外,来自一名脑室内出血患者的蛋白质含量最高的脑脊液对细菌黏附的抑制作用最大。还研究了这些溶液对硅橡胶疏水性的影响。含有较高蛋白质含量的溶液使硅橡胶更具亲水性,细菌黏附减少,这些发现与目前关于细菌黏附到聚合物上的机制的理论一致。
脑脊液蛋白含量高不会引发分流感染。