INFLUENCE OF SELECTIVE DECONTAMINATION OF THE DIGESTIVE-TRACT ON MICROBIAL BIOFILM FORMATION ON ENDOTRACHEAL-TUBES FROM ARTIFICIALLY VENTILATED PATIENTS

被引:26
作者
GORMAN, S
ADAIR, C
ONEILL, F
GOLDSMITH, C
WEBB, H
机构
[1] BELFAST CITY HOSP,DEPT PHARM,BELFAST BT9 7AD,ANTRIM,NORTH IRELAND
[2] ROYAL VICTORIA HOSP,DEPT BACTERIOL,BELFAST BT12 6BA,NORTH IRELAND
关键词
D O I
10.1007/BF01997050
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The effect of selective decontamination of the digestive tract on the nature and incidence of microbial biofilm formation on endotracheal tubes was assessed. Thirty endotracheal tubes were obtained post-extubation froin patients in the intensive care unit who had been ventilated for a 1 to 15 day period and who did or did not receive the antibiotic regimen. Extensive biofilm formation was identified by scanning electron microscopy on 97 % of tubes examined. Endotracheal tube biofilm in tubes obtained froin patients who received selective decontamination of the digestive tract showed a high prevalence of colonization with yeast (4 of 15 tubes) and gram-positive bacteria (streptococci, staphylococci and diphtheroids) (14 of 15 tubes). Staphylococcus aureus was isolated only from this group. Pseudomonas spp. were isolated from 2 of 15 tubes in both patient groups. Enteric gram-negative organisms (coliforms, Klebsiella and Proteus spp.) were isolated only from tubes of patients who did not receive the antibiotic regimen (4 of 15 tubes). Yeasts, however, were not isolated from these tubes. Group D streptococcal isolates were resistant to tobramycin as were half of the Staphylococcus aureus isolates. For gram-negative bacteria, the MIC of tobramycin was in the range 1-64 mug/ml and the MIC of polymyxin in the range 0.5-16 mug/ml. Although a reduction was observed in the incidence of gram-negative microorganisms, this antibiotic regimen does not inhibit biofilm formation on the endotracheal tube by other pathogens associated with pneumonia in ventilated patients. This persistent nidus may be a factor in the pathogenesis of nosocomial pneumonia.
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页码:9 / 17
页数:9
相关论文
共 23 条
[1]  
ADAIR CG, 1991, PHARMACOTHERAPY, V11, P39
[2]   EPIDEMIOLOGY OF PSEUDOMONAS-AERUGINOSA IN AN INTENSIVE-CARE UNIT USING SELECTIVE DECONTAMINATION OF THE DIGESTIVE-TRACT [J].
ARMSTRONG, PJ ;
BARR, JG ;
WEBB, CH ;
BLAIR, PH ;
ROWLANDS, BJ .
JOURNAL OF HOSPITAL INFECTION, 1992, 20 (03) :199-208
[3]  
BLAIR P, 1991, SURGERY, V110, P303
[4]   CEFOTAXIME - A REVIEW OF ITS ANTI-BACTERIAL ACTIVITY, PHARMACOLOGICAL PROPERTIES AND THERAPEUTIC USE [J].
CARMINE, AA ;
BROGDEN, RN ;
HEEL, RC ;
SPEIGHT, TM ;
AVERY, GS .
DRUGS, 1983, 25 (03) :223-289
[5]   EVALUATION OF THE BACTERICIDAL ACTIVITY OF BETA-LACTAM ANTIBIOTICS ON SLOWLY GROWING BACTERIA CULTURED IN THE CHEMOSTAT [J].
COZENS, RM ;
TUOMANEN, E ;
TOSCH, W ;
ZAK, O ;
SUTER, J ;
TOMASZ, A .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1986, 29 (05) :797-802
[7]   ELECTRON-MICROSCOPIC EVALUATION OF BACTERIAL ADHERENCE TO POLYVINYL-CHLORIDE ENDOTRACHEAL-TUBES USED IN NEONATES [J].
DIAZBLANCO, J ;
CLAWSON, RC ;
ROBERSON, SM ;
SANDERS, CB ;
PRAMANIK, AK ;
HERBST, JJ .
CRITICAL CARE MEDICINE, 1989, 17 (12) :1335-1340
[8]   EFFECT OF GROWTH-RATE ON RESISTANCE OF GRAM-NEGATIVE BIOFILMS TO CETRIMIDE [J].
EVANS, DJ ;
ALLISON, DG ;
BROWN, MRW ;
GILBERT, P .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 1990, 26 (04) :473-478
[9]   SUSCEPTIBILITY OF BACTERIAL BIOFILMS TO TOBRAMYCIN - ROLE OF SPECIFIC GROWTH-RATE AND PHASE IN THE DIVISION CYCLE [J].
EVANS, DJ ;
BROWN, MRW ;
ALLISON, DG ;
GILBERT, P .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 1990, 25 (04) :585-591
[10]   INFLUENCE OF GROWTH-RATE ON SUSCEPTIBILITY TO ANTIMICROBIAL AGENTS - BIOFILMS, CELL-CYCLE, DORMANCY, AND STRINGENT RESPONSE [J].
GILBERT, P ;
COLLIER, PJ ;
BROWN, MRW .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1990, 34 (10) :1865-1868