Wollin T A, Tieszer C, Riddell J V, Denstedt J D, Reid G
Division of Urology, The University of Western Ontario, London, Canada.
J Endourol. 1998 Apr;12(2):101-11. doi: 10.1089/end.1998.12.101.
Encrustation and urinary tract infection are problematic complications of ureteral stent usage. The objective of our first study was to use surface science techniques to examine three ureteral stent types for encrustation, biofilm formation, and antibiotic adsorption after use in patients. Black Beauty (N = 16), LSe (N = 16), and SofFlex (N = 32) ureteral stents were recovered from patients who had received trimethoprim or ciprofloxacin while the stent was indwelling. These stents were examined with X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy/energy-dispersive X-ray analysis (SEM/EDX) for the presence and composition of encrustation or biofilm. Conditioning films and encrustations were found on all stents. Encrustation elements (Ca, Mg, P) were identified on 11 of 16 Black Beauty (69%), 7 of 16 LSe (44%), and 12 of 32 SofFlex (38%) stents. The stent type, duration of insertion, and age or sex of the patient did not correlate significantly with the amount of encrustation. Bacterial biofilms were found on 1 of 7 Black Beauty stents (14%) and 7 of 32 SofFlex stents (22%). In a second study, an additional 28 patients with SofFlex stents were treated with ciprofloxacin (N = 16) or ofloxacin (N = 12). Their stents were subjected to high-performance liquid chromatography to determine if oral antibiotic therapy can lead to drug adsorption to the stent. Analysis showed that both ciprofloxacin and ofloxacin adsorbed to the stent surfaces. The mean concentrations of the two antibiotics within the conditioning film of the stents were 0.99 microg/mL and 0.34 microg/mL, respectively. These surface science techniques provide a comprehensive method of evaluating ureteral stents and other prosthetic devices in vivo.
输尿管支架使用过程中，结壳和尿路感染是棘手的并发症。我们第一项研究的目的是运用表面科学技术，检查三种输尿管支架在患者体内使用后结壳、生物膜形成及抗生素吸附的情况。从留置支架期间接受过甲氧苄啶或环丙沙星治疗的患者体内取出了Black Beauty支架（n = 16）、LSe支架（n = 16）和SofFlex支架（n = 32）。运用X射线光电子能谱（XPS）以及扫描电子显微镜/能量色散X射线分析（SEM/EDX）对这些支架进行检查，以确定结壳或生物膜的存在及成分。在所有支架上均发现了调理膜和结壳。在16个Black Beauty支架中的11个（69%）、16个LSe支架中的7个（44%）以及32个SofFlex支架中的12个（38%）上鉴定出了结壳元素（钙、镁、磷）。支架类型、置入持续时间以及患者的年龄或性别与结壳量均无显著相关性。在7个Black Beauty支架中的1个（14%）以及32个SofFlex支架中的7个（22%）上发现了细菌生物膜。在第二项研究中，另外28例使用SofFlex支架的患者接受了环丙沙星（n = 16）或氧氟沙星（n = 12）治疗。对他们的支架进行了高效液相色谱分析，以确定口服抗生素治疗是否会导致药物吸附到支架上。分析表明，环丙沙星和氧氟沙星均吸附到了支架表面。支架调理膜内这两种抗生素的平均浓度分别为0.99μg/mL和0.34μg/mL。这些表面科学技术为体内评估输尿管支架及其他假体装置提供了一种全面的方法。
