■灭活或螯合微生物的伤口敷料,比如那些有疏水的,细菌结合二烷基氨基甲酰氯(DACC)表面,可以降低临床感染的风险。这种“被动”生物负载控制,避免细菌细胞壁破坏与细菌内毒素释放相关,加重炎症,在难以愈合的伤口中是有利的。因此,DACC敷料的全部范围,包括较高接种物密度的潜在影响,增加的蛋白质负荷和不同的pH值对抗菌活性,需要评估。
■日本工业标准(JIS)L1902挑战测试用于评估DACC涂层敷料对几种世界卫生组织(WHO)优先考虑的伤口病原体的抗菌活性(例如,耐甲氧西林金黄色葡萄球菌,耐万古霉素肠球菌,具有超广谱β-内酰胺酶和鲍曼不动杆菌的微生物),在不利的伤口环境中反复细菌攻击的影响,和在伤口相关的pH值下的抗菌性能。
■使用JISL1902证实了DACC涂覆的敷料通过其不可逆结合和对结合细菌生长的抑制而对WHO优先考虑的细菌菌株的高抗菌活性。在增加的接种密度下,与标准条件相比,DACC涂层敷料仍然实现了强烈到显著的抗菌作用。培养基蛋白质含量的增加也影响了抗菌性能;添加10%胎牛血清后,观察到抗菌活性降低了0.5-1log。pH值不影响抗菌性能。DACC涂覆的敷料还在随后的再感染步骤中维持抗菌活性。
■可以假设DACC涂层敷料在控制伤口生物负载方面发挥有益作用,减少对抗生素的总体需求,不使用抗菌物质。
UNASSIGNED: Wound dressings that inactivate or sequestrate microorganisms, such as those with a hydrophobic, bacteria-binding dialkylcarbamoyl chloride (
DACC) surface, can reduce the risk of clinical infections. This \'passive\' bioburden control, avoiding bacterial cell wall disruption with associated release of bacterial endotoxins aggravating inflammation, is advantageous in hard-to-heal wounds. Hence, the full scope of
DACC dressings, including the potential impact of higher inoculum densities, increased protein load and different pH on antibacterial activity, needs to be evaluated.
UNASSIGNED: The Japanese Industrial Standard (JIS) L 1902 challenge test was used to evaluate the antimicrobial activity of the DACC-coated dressing against several World Health Organization (WHO)-prioritised wound pathogens (e.g., meticillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, microorganisms with extended-spectrum beta-lactamases and Acinetobacter baumannii), the effect of repeated bacterial challenge in an adverse wound environment, and antimicrobial performance at wound-related pH.
UNASSIGNED: High antibacterial activity of the
DACC-coated dressing against the WHO-prioritised bacteria strains by its irreversible binding and inhibition of growth of bound bacteria was confirmed using JIS L 1902. At increased inoculation densities, compared to standard conditions, the
DACC-coated dressing still achieved strong-to-significant antibacterial effects. Augmenting the media protein content also affected antibacterial performance; a 0.5-1 log reduction in antibacterial activity was observed upon addition of 10% fetal calf serum. The pH did not influence antibacterial performance. The
DACC-coated dressing also sustained antibacterial activity over subsequent reinfection steps.
UNASSIGNED: It can be assumed that the DACC-coated dressing exerts beneficial effects in controlling the wound bioburden, reducing the overall demand placed on antibiotics, without using antimicrobial substances.