复合溶葡萄球菌酶消毒剂的抗菌作用及其对全层皮肤缺损大鼠移植人工真皮后感染的预防作用  

Antiseptic effect of compound lysostaphin disinfectant and its preventive effect on infection of artificial dermis after graft on full-thickness skin defect wound in rats

作　　者：金剑 周浩 崔真慈 王丽 罗鹏飞 纪世召 胡晓燕 马兵 王光毅 朱世辉 夏照帆 Jin Jian;Zhou Hao;Cui Zhenci;Wang Li;Luo Pengfei;Ji Shizhao;Hu Xiaoyan;Ma Bing;Wang Guangyi;Zhu Shihui;Xia Zhaofan.(Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital, Naval Military Medical University, Shanghai 200433, Chin)

机构地区：[1]海军军医大学第一附属医院烧伤外科、全军烧伤研究所,上海200433

出　　处：《中华烧伤杂志》2018年第4期225-232,共8页Chinese Journal of Burns

基　　金：国家重点基础研究发展计划（973计划）（2012CB518100）;国家自然科学基金国际（地区）合作与交流项目（81120108015）;“十二五”国家科技计划（AWS11J008）;长海医院“1255”学科建设计划（CH125510200）;上海市重中之重临床重点学科建设计划

摘　　要：目的 研究复合溶葡萄球菌酶消毒剂的抗菌作用及其对全层皮肤缺损大鼠移植人工真皮后感染的预防作用。方法 （1）取肺炎克雷伯菌、鲍氏不动杆菌、金黄色葡萄球菌标准菌株各1株，采用随机数字表法选取从笔者单位2014年1月—2016年12月收治烧伤患者创面分泌物中分离出的肺炎克雷伯菌、鲍氏不动杆菌、金黄色葡萄球菌各20株，测定复合溶葡萄球菌酶消毒剂对上述菌株的最低抑菌浓度（MIC）及最低杀菌浓度（MBC），实验重复3次。临床菌株MIC和/或MBC高于对应标准菌株者判定为对该消毒剂敏感性降低，计算3种细菌各自的敏感性降低菌株百分比。（2）将人工真皮于复合溶葡萄球菌酶消毒剂中分别浸泡5 min、1 h、2 h、4 h（每个时间点21块），另分别于静置0（即刻）、12、24、36、48、60、72 h（每个时间点3块）后测量其对金黄色葡萄球菌、肺炎克雷伯菌、鲍氏不动杆菌标准菌株抑菌圈直径，实验重复3次。以浸泡消毒剂的人工真皮可形成有效抑菌圈（直径〉7 mm）的最长静置时间所对应的最短浸泡时间为该消毒剂对人工真皮的充分浸泡时间。（3）取40只SD大鼠，采用随机数字表法分为伤后3、7、14、21 d取材组，每组10只。于每只大鼠背部脊柱两侧各做1个直径20 mm的全层皮肤缺损创面，伤后即刻脊柱左侧创面移植未进行任何处理的人工真皮（下称对照创面），脊柱右侧创面移植充分浸泡复合溶葡萄球菌酶消毒剂的人工真皮（下称消毒剂创面）。伤后3、7、14、21 d，观察所有存活大鼠创面大体情况，计算对照创面和消毒剂创面的新发感染率，随后处死对应时间取材组大鼠，取所有包含人工真皮的全层创面组织行细菌定量，对比未感染对照创面和未感染消毒剂创面的细菌含量。对数据进行χ^2检验和Wilcoxon秩和检验。结果 （1）复合溶葡萄球菌酶消毒Objective To study the antiseptic effect of compound lysostaphin disinfectant and its preventive effect on infection of artificial dermis after graft on full-thickness skin defect wound in rats.Methods （1） Each one standard strain of Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus were selected. Each 20 clinical strains of Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus were collected from those isolated from wound exudates of burn patients hospitalized in our wards from January 2014 to December 2016 according to the random number table. The minimum inhibitory concentration （MIC） and minimum bactericidal concentration （MBC） of compound lysostaphin disinfectant to above-mentioned strains were detected. The experiment was repeated 3 times. Compared with the corresponding standard strain, the clinical strain with higher MIC and/or MBC was considered as having decreased sensitivity to the disinfectant. The percentage of strains of each of the three kinds of bacteria with decreased sensitivity was calculated. （2） Artificial dermis pieces were soaked in compound lysostaphin disinfectant for 5 min, 1 h, 2 h, and 4 h, respectively, with 21 pieces at each time point. After standing for 0 （immediately）, 12, 24, 36, 48, 60, 72 h （with 3 pieces at each time point）, respectively, the diameters of their inhibition zones to standard strains of Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus were measured. The experiment was repeated 3 times. The shortest soaking time corresponding to the longest standing time, after which the disinfectant-soaked artificial dermis could form an effective inhibition zone （with diameter more than 7 mm）, was the sufficient soaking time of the disinfectant to the artificial dermis. （3） Forty Sprague-Dawley rats were divided into post injury day （PID） 3, 7, 14, and 21 sampling groups according to the random number table, with 10 rats in each group. A full-thickness skin defect wound with

关 键 词：皮肤 人工 胞壁质酶 伤口感染 复合溶葡萄球菌酶消毒剂 最低抑菌浓 度 最低杀菌浓度 

分 类 号：R644[医药卫生—外科学]