부산대학교 도서관

Byline: Lorenzo Berra (1), Francesco Curto (2), Gianluigi Li Bassi (2), Patrice Laquerriere (3), Betsey Pitts (4), Andrea Baccarelli (5), Theodor Kolobow (2) Keywords: Endotracheal tube; Mechanical ventilation; Bacterial biofilm; Ventilator-associated pneumonia; Silver sulfadiazine Abstract: Objective Antibiotic-resistant bacterial biofilm may quickly form on endotracheal tubes (ETTs) and can enter the lungs, potentially causing pneumonia. In an attempt to prevent bacterial colonization, we developed and tested in an in-vitro study and animal study several antibacterial-coated ETTs (silver sulfadiazine with and without carbon in polyurethane, silver sulfadiazine and chlorhexidine with and without carbon in polyurethane, silver--platinum with and without carbon in polyurethane, chlorhexidine in polyurethane, and rose bengal for UV light). Design, setting, animals, interventions After preliminary studies, silver sulfadiazine in polyurethane (SSD-ETT) was selected among the coatings to be challenged every 24a-h with 10.sup.4--10.sup.6 Pseudomonas aeruginosa/ml and evaluated at 6a-h, 24a-h, and 72a-h with standard microbiological studies, scanning electron microscopy, and confocal scanning microscopy. Subsequently, eight sheep were randomized to receive either a SSD-ETT or a standard ETT (St-ETT). After 24a-h of mechanical ventilation, standard microbiological studies were performed together with scanning electron microscopy and confocal microscopy. Measurements and results In the in-vitro study SSD-ETT remained bacteria-free for up to 72a-h, whereas St-ETT showed heavy P. aeruginosa growth and biofilm formation (pa- Conclusion This study describes several effective and durable antibacterial coatings for ETTs. Particularly, SSD-ETT showed prevention against P. aeruginosa biofilm formation in a 72-h in-vitro study and lower respiratory tract colonization in sheep mechanically ventilated for 24a-h. Author Affiliation: (1) Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, WHT-4-436, Boston, MA, USA (2) Pulmonary and Critical Care Medicine Branch, NHLBI, National Institutes of Health, 9000 Rockville Pike, 20892, Bethesda, MD, USA (3) Laboratoire de Microscopie Electronique, UFR Sciences, University of Reims Champagne Ardenne, INSERM-ERM 0203, 21 rue Clement Ader, BP 138, 51685, Reims, Cedex 2, France (4) Center for Biofilm Engineering and Department of Chemical Engineering, Montana State University Bozeman, 59717-3980, Bozeman, MT, USA (5) Department of Environmental Health, Harvard School of Public Health, 02215, Boston, MA, USA Article History: Registration Date: 11/03/2008 Received Date: 07/04/2006 Accepted Date: 10/12/2007 Online Date: 17/04/2008 Article note: This article is discussed in the editorial available at: http://dx.doi.org/10.1007/s00134-008-1101-0.