背景:0.05%葡萄糖酸氯己定(CHG;Irrisept[IrriMax])是一种经食品和药物管理局批准的商业伤口冲洗解决方案,最近已在假体泌尿外科领域采用;但是,没有研究评估0.05%CHG是否与AMS700阴茎假体的米诺环素-利福平浸渍表面(抑制区)相容(波士顿科学公司).
目的:评估0.05%CHG是否能改变米诺环素-利福平浸渍的阴茎假体表面的抗菌效果。
方法:通过穿刺活检(Sklar)从无菌阴茎假体储库(其表面已浸渍利福平和米诺环素)中取出圆盘(8mm)。光盘(n=10)悬浮在0.05%CHG中,万古霉素和庆大霉素,或生理盐水2分钟模拟术中冲洗。然后在生理盐水中冲洗圆盘以除去任何未结合的溶液,并与甲氧西林敏感的金黄色葡萄球菌一起孵育48小时。粘附的表面细菌通过摇动悬浮在0.3%吐温20溶液中,连续稀释,镀在3MPetriFilms上,和计数。进行Kirby-Bauer圆盘扩散测定以概括各种生物体的发现。
结果:结果包括(1)以细菌计数(以每毫升菌落形成单位计)测量的植入物表面的细菌粘附和(2)以抑制区(以毫米计)测量的细菌生长减少。
结果:与生理盐水和万古霉素/庆大霉素相比,在0.05%CHG中孵育植入物表面不会改变恢复的细菌计数。同样,在单个细菌物种中,在Kirby-Bauer椎间盘扩散研究中,0.05%CHG和万古霉素/庆大霉素没有改变抑制区测量值。
结论:这项研究表明,在体外,0.05%CHG可以直接用于米诺环素-利福平浸渍的表面,而不会改变涂层的抗生素功效。
■优势包括,这是第一个评估0.05%CHG是否影响米诺环素-利福平浸渍表面的研究。局限性包括使用体外研究,作为体内实践的代理,在临床环境中可能不完全准确或可翻译。
结论:与万古霉素/庆大霉素和生理盐水相比,0.05%CHG不会改变米诺环素-利福平浸渍表面的抗菌活性;但是,其在临床实践中的疗效尚待评估。
BACKGROUND: 0.05% Chlorhexidine gluconate (CHG; Irrisept [IrriMax]) is a commercial wound irrigation solution approved by the Food and Drug Administration that has seen recent adoption in the field of prosthetic urology; however, no study has evaluated whether 0.05% CHG is compatible with the minocycline-rifampin-impregnated surface (InhibiZone) of the AMS 700 penile prosthesis (Boston Scientific).
OBJECTIVE: To evaluate whether 0.05% CHG alters the antibiotic efficacy of the minocycline-rifampin-impregnated penile prosthesis surface.
METHODS: Discs (8 mm) were taken by a punch biopsy (Sklar) from sterile penile prosthesis reservoirs whose surfaces had been impregnated with rifampin and minocycline. Discs (n = 10) were suspended in 0.05% CHG, vancomycin and gentamicin, or normal saline for 2 minutes to simulate intraoperative irrigation. Discs were then rinsed in normal saline to remove any unbound solution and incubated with methicillin-sensitive Staphylococcus aureus for 48 hours. Adherent surface bacteria were suspended by shaking in a 0.3% Tween 20 solution, serially diluted, plated onto 3M PetriFilms, and counted. Kirby-Bauer disc diffusion assays were conducted to generalize findings across various organisms.
RESULTS: Outcomes included (1) bacterial adherence to the implant surface measured as bacterial counts (in colony-forming units per milliliter) and (2) bacterial growth reduction measured as zones of inhibitions (in millimeters).
RESULTS: Incubation of implant surfaces in 0.05% CHG did not alter recovered bacterial counts as compared with normal saline and vancomycin/gentamycin. Similarly, within a single bacterial species, 0.05% CHG and vancomycin/gentamycin did not alter zone-of-inhibition measurements in Kirby-Bauer disc diffusion studies.
CONCLUSIONS: This study demonstrates in vitro that 0.05% CHG may be used directly on the minocycline-rifampin-impregnated surface without altering the antibiotic efficacy of the coating.
UNASSIGNED: Strengths include that this is the first study to evaluate if 0.05% CHG affected the minocycline-rifampin-impregnated surface. Limitations include the use of in vitro studies, which serve as a proxy for in vivo practices and may not be entirely accurate or translatable in a clinical setting.
CONCLUSIONS: 0.05% CHG does not alter the antimicrobial activity of the minocycline-rifampin-impregnated surface as compared with vancomycin/gentamycin and normal saline in vitro; however, its efficacy in clinical practice remains to be evaluated.