Leyden J J, McGinley K J, Foglia A N, Wahrman J E, Gropper C N, Vowels B R
Department of Dermatology, University of Pennsylvania, 19104, Philadelphia, U
Skin Pharmacol. 1996;9(1):60-8. doi: 10.1159/000211391.
Previously, we described methods for measuring in vivo antimicrobial activity in which the resident bacterial flora of the forearm is expanded by occlusion with an impermeable plastic film, test agents are applied and quantitative cultures are obtained at varying time points. This methodology allows for an in vivo quantitative assessment of antimicrobial effects directed against a dense flora comprised primarily of staphylococci. This method may not be applicable to situations in which there is a high density of multiple species of bacteria. We describe herein new methods which permit in vivo determination of antimicrobial activity against a dense, mixed flora. Swabs moistened with a dilute nonionic detergent are used to remove bacteria from the subject's axilla or groin which are then translocated to the subject's forearm. Occlusion of the forearm with a large, sterile plastic chamber provides the necessary humid environment to yield a dense flora (10(5)-10(6) CFU) consisting of gram-positive cocci, gram-positive coryneforms and gram-negative rods. In this manner, multiple test sites are created on each forearm allowing for the simultaneous evaluation of multiple antimicrobial agents in a single subject. This method allows for the evaluation of the immediate, as well as sustained, in vivo bactericidal effect of an antimicrobial agent against a dense mixed flora with quantitative cultures obtained at varying time points after application of the test agent. Furthermore, ecological pressures which select for resistant organisms or allow for an overgrowth of nonsensitive bacteria can be evaluated by determining the composition of the flora after single or repeated applications of a test agent. The testing methodologies described herein can provide relevant information regarding the antimicrobial effectiveness of an agent in a variety of situations such as use against the axillary flora (including its utility as a deodorant), use as a perineal cleanser for critically ill, hospitalized patients and use in situations where a dense mixed flora exists, e.g. stasis ulcers and infected intertriginous dermatoses.
此前，我们描述了测量体内抗菌活性的方法，即通过用不透水的塑料薄膜封闭来扩大前臂的常驻细菌菌群，施加测试剂，并在不同时间点进行定量培养。该方法能够对主要由葡萄球菌组成的密集菌群的抗菌效果进行体内定量评估。此方法可能不适用于存在多种高密度细菌的情况。我们在此描述了新的方法，可用于体内测定针对密集混合菌群的抗菌活性。用稀释的非离子洗涤剂浸湿的拭子用于从受试者的腋窝或腹股沟去除细菌，然后将其转移到受试者的前臂。用一个大的无菌塑料腔室封闭前臂可提供必要的潮湿环境，以产生由革兰氏阳性球菌、革兰氏阳性棒状杆菌和革兰氏阴性杆菌组成的密集菌群（10⁵ - 10⁶ CFU）。通过这种方式，在每个前臂上创建多个测试部位，以便在单个受试者中同时评估多种抗菌剂。该方法能够通过在施加测试剂后的不同时间点进行定量培养，评估抗菌剂对密集混合菌群的即时以及持续的体内杀菌效果。此外，通过在单次或重复应用测试剂后确定菌群的组成，可以评估选择耐药菌或允许非敏感细菌过度生长的生态压力。本文所述的测试方法可以提供有关药剂在多种情况下的抗菌有效性的相关信息，例如用于腋窝菌群（包括其作为除臭剂的效用）、用作重症住院患者的会阴清洁剂以及用于存在密集混合菌群的情况，如淤积性溃疡和感染性擦烂性皮肤病。
