Kubey W, Straka P, Holmes C J
Renal Division, Baxter Healthcare, McGaw Park, Ill. 60085, USA.
Blood Purif. 1998;16(3):154-61. doi: 10.1159/000014329.
The goal of this study was to quantitatively compare in vitro the ability of four commercially available peritoneal dialysis solution system designs to prevent the infusion of the most common accidental touch and airborne bacterial contaminant, Staphylococcus epidermidis, into the peritoneum using a total system evaluation approach. This approach took into consideration the number of system openings to the environment during an exchange combined with each system's convective flushing characteristics. A Y set and a Twinbag system utilizing either an antimicrobial cap or a snap disconnect design for disconnection at the end of the solution exchange procedure were selected for study. The lowest peritoneal bacterial recovery count was seen with the antimicrobial cap system Twinbag, being significantly lower than any of the other systems tested (p < 0.0001). The highest bacterial recovery count occurred in the snap disconnect Y system, being significantly higher than any of the other products tested (p < 0.0001). Both the antimicrobial cap systems permitted infusion of fewer bacteria than the snap disconnect systems, despite being inoculated with larger numbers of bacteria to account for a potential additional opening of the system, during the disconnect procedure. This evaluation emphasizes the importance of fluid path flow design in the overall safety performance of peritoneal dialysis systems.
本研究的目的是采用全系统评估方法，在体外定量比较四种市售腹膜透析溶液系统设计防止最常见的意外接触和空气传播细菌污染物表皮葡萄球菌注入腹膜的能力。该方法考虑了交换过程中系统与外界环境的开口数量以及每个系统的对流冲洗特性。选择了一个Y型装置和一个双袋系统进行研究，双袋系统在溶液交换程序结束时使用抗菌帽或快插式断开设计进行断开连接。抗菌帽系统双袋的腹膜细菌回收计数最低，显著低于其他任何测试系统（p<0.0001）。最高的细菌回收计数出现在快插式断开连接的Y型系统中，显著高于其他任何测试产品（p<0.0001）。尽管在断开连接过程中接种了更多数量的细菌以考虑系统可能的额外开口，但两个抗菌帽系统允许注入的细菌都比快插式断开连接系统少。该评估强调了流体路径流动设计在腹膜透析系统整体安全性能中的重要性。
