Li H, Fairfax M R, Dubocq F, Darouiche R O, Rajpurkar A, Thompson M, Tefilli M V, Dhabuwala C B
Department of Urology, Wayne State University, School of Medicine, Detroit, Michigan 48201, USA.
J Urol. 1998 Nov;160(5):1910-3.
Postoperative infection remains one of the most serious complications of implantation of penile prostheses. Attempts to reduce the rate of infection by spraying the prosthesis with an antibiotic solution prior to implantation, along with perioperative antibiotics, have failed to eradicate infection. No published studies have evaluated the effect of antibiotic coating of penile prostheses. In this study, we evaluate the antibacterial effect of antibiotic-coated silicone strips as a surrogate for the penile prosthesis.
Strips coated with several different antibiotics were dipped in bacterial solutions containing Staphylococcus epidermidis or S. aureus and implanted subcutaneously in adult Sprague-Dawley rats. After a week, the strips were removed, and the number of bacteria on the strips and in the surrounding tissue were determined. The in vitro antibiotic activity of the antibiotic-coated strips against the same organisms was also determined.
In the group of rats that received silicone strips contaminated in vitro with S. epidermidis, six of nine control rats yielded strips and tissues containing heavy bacterial growth. None of six strips coated with rifampin/minocycline yielded bacterial growth, nor did any of the seven strips coated with vancomycin. One of seven rats that received amikacin-coated strips had infection of the strip. The tissue results were similar to the strip results. In the group using S. aureus as the contaminating bacterium, the strips and tissues from eight of nine control rats yielded bacteria. None of the six rifampin/minocycline-coated strips yielded bacteria, while two of seven vancomycin-treated strips and two of six amikacin-coated strips were infected with S. aureus. The difference in bacterial growth between controls and antibiotic-coated strips reached a level of statistical significance for the rifampin/minocycline and vancomycin groups and was highly significant for the rifampin/minocycline groups.
The experimental results presented here suggest that coating silicone graft material with antibiotics, particularly rifampin/minocycline, can reduce the incidence of graft colonization in contaminated wounds in rats, even in the absence of systemic antibiotics. These graft materials may prove useful in preventing the infection of penile prostheses.
术后感染仍然是阴茎假体植入最严重的并发症之一。在植入前用抗生素溶液喷洒假体并联合围手术期使用抗生素来降低感染率的尝试未能根除感染。尚无已发表的研究评估阴茎假体抗生素涂层的效果。在本研究中，我们评估抗生素涂层硅胶条作为阴茎假体替代品的抗菌效果。
将涂有几种不同抗生素的硅胶条浸入含有表皮葡萄球菌或金黄色葡萄球菌的细菌溶液中，然后皮下植入成年Sprague-Dawley大鼠体内。一周后，取出硅胶条，测定硅胶条及周围组织中的细菌数量。还测定了抗生素涂层硅胶条对相同细菌的体外抗生素活性。
在体外被表皮葡萄球菌污染的硅胶条植入大鼠组中，9只对照大鼠中有6只的硅胶条和组织出现大量细菌生长。6只涂有利福平/米诺环素的硅胶条均未出现细菌生长，7只涂有万古霉素的硅胶条也未出现细菌生长。7只接受阿米卡星涂层硅胶条植入的大鼠中有1只出现硅胶条感染。组织结果与硅胶条结果相似。在以金黄色葡萄球菌作为污染菌的组中，9只对照大鼠中有8只的硅胶条和组织出现细菌生长。6只涂有利福平/米诺环素的硅胶条均未出现细菌生长，而7只接受万古霉素处理的硅胶条中有2只、6只接受阿米卡星涂层的硅胶条中有2只被金黄色葡萄球菌感染。对照硅胶条与抗生素涂层硅胶条之间的细菌生长差异在利福平/米诺环素组和万古霉素组达到统计学显著水平，在利福平/米诺环素组高度显著。
此处呈现的实验结果表明，用抗生素，特别是利福平/米诺环素涂覆硅胶移植材料，即使在没有全身使用抗生素的情况下，也能降低大鼠污染伤口中移植材料定植的发生率。这些移植材料可能被证明对预防阴茎假体感染有用。
