Hamilton A J, Orozco J, Narotam P, Bowersock T
Department of Surgery, University of Arizona Health Sciences Center, Tucson, USA.
Neurosurgery. 1997 May;40(5):1043-9. doi: 10.1097/00006123-199705000-00031.
The biotoxicity of tri-iododecyclemethyl ammonium chloride (TDMAC)-coated catheters in the brain was tested, as was the efficacy of the vancomycin-bonded, TDMAC-coated catheters to inhibit staphylococcal growth in vitro and to delay the onset of clinical manifestations of catheter-related staphylococcal ventriculitis in rabbit experimental model.
The brain toxicity of the TDMAC-coated catheters was tested in New Zealand White rabbits. The efficacy of the vancomycin-bonded, TDMAC-coated catheters in the inhibition of staphylococcal growth was tested in agar seeded with Staphylococcus aureus and Staphylococcus epidermidis strains. Sections of vancomycin-bonded, TDMAC-coated catheters were placed in saline solution for testing of drug release over time. Stereotactic placement of ventriculostomy catheters was performed in two groups of New Zealand White rabbits. In the experimental group, vancomycin-bonded, TDMAC-coated catheters were used. In the control group, TDMAC-coated catheters were used. Staphylococcal colonies were inoculated at the exit site of the catheters. Culture of the catheter tips was performed at the time of death of the animals.
No toxic reactions were seen at the implantation sites or in surrounding brain. Significant inhibition of growth of both S. aureus and S. epidermidis was noted with the vancomycin-bonded catheters (P = 0.01). Vancomycin continued to be released from catheters for the full 6 days of the study. The median interval to development of clinical manifestations of ventriculitis among the experimental group of rabbits was 53 days; among the control group, the interval was 27 days (P < 0.001).
Vancomycin-bonded, TDMAC-coated ventriculostomy catheters bind and release the drug at levels exceeding the minimum inhibitory concentration for S. aureus and S. epidermidis for at least 6 days and can significantly delay the onset of infectious ventriculitis in a rabbit model.
测试三碘去甲环戊铵氯化物（TDMAC）涂层导管在脑内的生物毒性，以及万古霉素结合的TDMAC涂层导管在体外抑制葡萄球菌生长和在兔实验模型中延迟导管相关葡萄球菌性脑室炎临床表现出现的效果。
在新西兰白兔中测试TDMAC涂层导管的脑毒性。在接种金黄色葡萄球菌和表皮葡萄球菌菌株的琼脂中测试万古霉素结合的TDMAC涂层导管抑制葡萄球菌生长的效果。将万古霉素结合的TDMAC涂层导管切片置于盐溶液中测试药物随时间的释放情况。对两组新西兰白兔进行脑室造瘘导管的立体定向放置。实验组使用万古霉素结合的TDMAC涂层导管。对照组使用TDMAC涂层导管。在导管出口部位接种葡萄球菌菌落。在动物死亡时对导管尖端进行培养。
在植入部位或周围脑组织中未观察到毒性反应。万古霉素结合导管对金黄色葡萄球菌和表皮葡萄球菌的生长均有显著抑制作用（P = 0.01）。在研究的整整6天内，万古霉素持续从导管中释放。实验组兔发生脑室炎临床表现的中位间隔时间为53天；对照组为27天（P < 0.001）。
万古霉素结合的TDMAC涂层脑室造瘘导管能结合并释放药物，其水平超过金黄色葡萄球菌和表皮葡萄球菌的最低抑菌浓度至少6天，并能显著延迟兔模型中感染性脑室炎的发病。
