治疗中心静脉导管感染抗生素锁技术指标的量化研究  

Quantitative research on antibiotic lock technology in treatment of central venous catheter related infections

作　　者：敖薪[1] 王娟[2] 刘莲[3] 光玲[4] AO Xin WANG Juan LIU Lian GUANG ling(Yangtze University Medical School, Jingzhou, Hubei 434023, Chin)

机构地区：[1]长江大学医学院护理系,湖北荆州434023 [2]新疆医科大学第一附属医院重症监护病房,新疆乌鲁木齐8300541 [3]长江大学医学院基础学部,湖北荆州434023 [4]长江大学医学院实验中心,湖北荆州434023

出　　处：《中华医院感染学杂志》2017年第20期4626-4629,共4页Chinese Journal of Nosocomiology

基　　金：湖北省卫生和计划生育委员会基金资助项目(WJ2015HB036)

摘　　要：目的在使用抗生素锁(ALT)的常规药物浓度范围内和常用的锁定时间内,寻找灭菌效果最佳的药物浓度和锁定时间。方法采用置片法将含有细菌生物膜的硅胶薄膜样本随机分成300倍最低抑菌浓度(MIC)组、600倍MIC组、900倍MIC组、空白组等四组,各组5份样本,每组在6、12、18、24h四个时间点取出处理后,通过稀释平板计数法进行细菌计数定量培养,比较ALT最佳使用时间及浓度。结果不同浓度下最佳时间:300倍MIC组各时间点的细菌计数与空白对照组比较差异无统计学意义;600倍MIC组与对照组相比6h开始细菌计数明显下降(P<0.05),12h与6h、18h与24h相比细菌计数无统计学差异,18h与6h、12h相比细菌计数有统计学差异(P均<0.05);900倍MIC组与对照组比较6h时细菌计数显著下降(P<0.05),6h与12h比较细菌计数出现显著性差异(P<0.05),12h与18h、24h比较细菌计数无明显差异;不同时间下最有效浓度:在相同锁定时间内与对照组的细菌计数比较,300倍MIC组细菌计数无显著差异性,600倍MIC组和900倍MIC组细菌计数明显降低,差异性有统计学意义(P<0.05);600倍MIC组和900倍MIC组之间细菌计数比较有显著性差异(P<0.05)。结论 300倍MIC的实验用抗生素作为ALT溶液不能有效清除细菌生物膜,而600倍和900倍MIC的抗生素溶液均具有良好的清除细菌生物膜的作用;且在相同的锁定时间内,浓度越高,其清除生物膜的能力越强,效果越好;600倍MIC实验用抗生素作为ALT溶液,锁定时间18h效果最好;900倍MIC实验用抗生素作为ALT溶液,锁定12h效果最好。OBJECTIVE To find the best drug solution concentration and the most effective lock time in the regular and common lock time and drug concentration of antibiotic lock technology（ALT）.METHODS Silica gel film samples containing bacterial biofilms were randomly divided into four different concentration groups,which were 300×MIC,600×MIC,900×MIC and blank control group,with 5 samples in each group,silica gel films were taken out after intervention at 6 h,12 h,18 hand 24 h,quantitative culture of bacteria was carried out by dilution plate count method,and the most effective lock time and concentrations of ALT were compared.RESULTS The most effective time under different concentrations：silicone film bacteria count under 300×MIC and the control group had no significant difference,bacteria count results appeared significant decline at 6 hunder 600×MIC（P〈0.05）,while no significant difference at 12 hand at 6 h,at 18 hand at 24 h,and bacteria count had significant difference at 18 hand at 6 h,at 12 h（P〈0.05）;bacteria count results appeared significant decline at 6 hunder 900×MIC（P〈0.05）,bacteria count had significant difference at 6 hand at 12 h（P〈0.05）,and had no significant difference at 12 hand at 18 h,at 24 h.The most effective concentration under different time lock：at the same locked time,bacteria count under 300×MIC and the control group had no significant difference,bacteria count was dramatic decline under 600×MIC and 900×MIC,which had significant difference（P〈0.05）,and bacteria count under 600×MIC and 900×MIC had significant difference（P〈0.05）.CONCLUSION The 300×MIC as ALT solution has no ability to remove bacteria biofilm,but 600×MIC and 900 ×MIC as ALT solution have good ability to remove bacteria biofilm.In a certain lock time,the higher the concentration,the stronger its ability to remove biofilm.The lock time of 18 hand 12 hfor 600×MIC and 900 ×MIC can achieve the best removal effect,respectively.

关 键 词：抗生素锁 中心静脉导管 细菌计数 药物浓度 锁定时间 

分 类 号：R472[医药卫生—护理学]