摘要:目的：評價圍手術期預防性應用抗菌藥物現狀及合理性。方法：采用回顧性調查的方法，隨機抽查2009年度Ⅰ類切口手術圍手術期病案500份，設計外科圍手術期預防性應用抗生素調查表，對預防用藥的適應證、用藥種類、聯合用藥、給藥時機及持續時間進行統計分析。結果：未使用抗生素5例，預防性使用抗生素495例，其中不合理80例（16.00％）。預防性使用抗生素總品規數為540，其中頭孢菌素類453例（83.89%），青霉素類（包括加酶抑制劑）26例（4.81%），喹諾酮類44例（8.15%）。選用頭孢唑啉鈉178例（32.96%）居第一位，頭孢替唑鈉第二，151例（2796%）。結論：Ⅰ類切口手術患者圍手術期預防性使用抗菌藥物較為合理，但仍存在用藥指征把握不嚴，抗菌藥物的選擇、抗菌藥物使用時間較長等問題，有待進一步規范化管理。Abstract: Objective: To understand the current application of perioperative preventive antibiotics, and their rationality. Methods: Five hundred perioperative records of patients with incision Ⅰ were randomly chosen and surveyed in 2009. A questionnaire for prophylactic use of antimicrobial was designed. The indication of antimicrobial use, the species, combination, timing and drug duration were analyzed. Results: Our of 500, 495 used antimicrobial and 80 were unreasonable; 540 kinds of antimicrobial were used, included cephalosporin 453 cases (83.89%), penicillin class (including plus enzyme inhibitors) in 26 cases (4.81%), quinolone 44 cases (8.15%). Cefazolin sodium (178 patients, 32.96%) ranked first, second was cefazolin sodium (151, 27.96%). Conclusion: Perioperative use of antimicrobial prophylaxis in patients with incision Ⅰ is reasonable, but standardization management should be strengthened in the indication, species, and duration.
Objective To systematically review the efficacy of long-acting antibacterial material in the prevention of secondary urinary infection. Methods PubMed, The Cochrane Library, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of long-acting antibacterial material in the prevention of secondary urinary infection from inception to November, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software. Results A total of 16 RCTs were included. The results of meta-analysis showed that: the long-acting antibacterial material group was superior to the general intervention group in morbidity of secondary urinary infection (Peto OR=0.17, 95%CI 0.13 to 0.23, P<0.000 01), and bacterial positive rate of secondary urinary infection (Peto OR=0.15, 95%CI 0.08 to 0.27,P<0.000 01). Conclusion Current evidence shows that long-acting antibacterial material can effectively reduce the infection rates of secondary urinary infection. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
With the development of photothermal nanomaterials, photothermal therapy based on near-infrared light excitation shows great potential for the bacterial infected wound treatment. At the same time, in order to improve the photothermal antibacterial effect of wound infection and reduce the damage of high temperature and heat to healthy tissue, the targeted bacteria strategy has been gradually applied in wound photothermal therapy. In this paper, several commonly used photothermal nanomaterials as well as their targeted bacterial strategies were introduced, and then their applications in photothermal antibacterial therapy, especially in bacterial infected wounds were described. Besides, the challenges of targeted photothermal antibacterial therapy in the wound healing application were analyzed, and the development of photothermal materials with targeted antibacterial property has prospected in order to provide a new idea for wound photothermal therapy.
摘要:目的: 探討在闌尾切除術中應用抗菌薇喬縫線以減少闌尾切口感染的可能性。 方法 : 將我院2007年4月至2009年3月所有闌尾切除術病例1425例隨機分為抗菌薇喬縫線組和絲線組,比較其切口感染發生率。 結果 : 統計中按闌尾未穿孔、闌尾穿孔以及總計分別計算切口感染率,在抗菌微喬線組感染率分別為017%、072%、028%,絲線組分別為154%、781%、267%,兩組間分別予以X2檢驗,其〖WTBX〗P 值均小于001,具有顯著性差異。 結論 : 縫線是輔助產生切口感染的一個危險因素,在闌尾切除術中使用抗菌薇喬縫線可以顯著降低切口感染率。Abstract: Objective: To investigate the application of Coated VICRYL Plus Antibacterial suture in order to reduce the possibility of infection of appendectomy incision. Methods : Hospital from April 2007 to March 2009 appendectomy patients in all 1425 cases were randomly divided into Coated VICRYL Plus Antibacterial suture group and silk group,compared to the incidence of incision infection. Results : The statistics are not in accordance with perforated appendicitis, perforated appendicitis, as well as calculation of the total, respectively, incision infection, the infection rate in the Coated VICRYL Plus Antibacterial suture group were 017%, 072%, 028%, silk group were 154%, 781%, 267% between the two groups separately X2 test, the P value of less than 001, with a significant difference. Conclusion : The suture is to assist the incision produced a risk factor for infection in appendectomy,Coated VICRYL Plus Antibacterial suture can be used in a significant reduction in incision infection rates.
Objective To develop a drug-loaded composite microsphere that can simultaneously release the berberine (BBR) and naringin (NG) to repair infectious bone defects. MethodsThe NG was loaded on mesoporous microspheres (MBG) to obtain the drug-loaded microspheres (NG-MBG). Then the dual drug-loaded compound microspheres (NG-MBG@PDA-BBR) were obtained by wrapping NG-MBG with polydopamine (PDA) and modifying the coated PDA with BBR. The composite microspheres were characterized by scanning electron microscopy, X-ray diffraction, specific surface area and pore volume analyzer, and Fourier transform infrared spectroscopy; the drug loading rate and release of NG and BBR were measured; the colony number was counted and the bacterial inhibition rate was calculated after co-culture with Staphylococcus aureus and Escherichia coli for 12 hours to observe the antibacterial effect; the biocompatibility was evaluated by live/dead cell fluorescence staining and cell counting kit 8 assay after co-culture with rat’s BMSCs for 24 and 72 hours, respectively, and the osteogenic property was evaluated by alkaline phosphatase (ALP) staining and alizarin red staining after 7 and 14 days, respectively. Results NG-MBG@PDA-BBR and three control microspheres (MBG, MBG@PDA, and NG-MBG@PDA) were successfully constructed. Scanning electron microscopy showed that NG-MBG@PDA-BBR had a rough lamellar structure, while MBG had a smooth surface, and MBG@PDA and NG-MBG@PDA had a wrapped agglomeration structure. Specific surface area analysis showed that MBG had a mesoporous structure and had drug-loading potential. Low angle X-ray diffraction showed that NG was successfully loaded on MBG. The X-ray diffraction pattern contrast showed that all groups of microspheres were amorphous. Fourier transform infrared spectroscopy showed that NG and BBR peaks existed in NG-MBG@PDA-BBR. NG-MBG@PDA-BBR had good sustained drug release ability, and NG and BBR had early burst release and late sustained release. NG-MBG@PDA-BBR could inhibit the growth of Staphylococcus aureus and Escherichia coli, and the antibacterial ability was significantly higher than that of MBG, MBG@PDA, and NG-MBG@PDA (P<0.05). But there was a significant difference in biocompatibility at 72 hours among microspheres (P<0.05). ALP and alizarin red staining showed that the ALP positive area and the number of calcium nodules in NG-MBG@PDA-BBR were significantly higher than those of MBG and NG-MBG (P<0.05), and there was no significant difference between NG-MBG@PDA and NG-MBG@PDA (P>0.05). Conclusion NG-MBG@PDA-BBR have sustained release effects on NG and BBR, indicating that it has ideal dual performance of osteogenesis and antibacterial property.
Objective To investigate the physicochemical properties of pure titanium surface grafted with chlorhexidine (CHX) by phenolamine coating, and to evaluate its antibacterial activity and osteoblast-compatibility in vitro. MethodsControl group was obtained by alkali and thermal treatment, and then immersed in the mixture of epigallocatechin-3-gallate/hexamethylene diamine (coating group). Phenolamine coating was deposited on the surface, and then it was immersed in CHX solution to obtain the grafted surface of CHX (grafting group). The surface morphology was observed by scanning electron microscope, the surface element composition was analyzed by X-ray photoelectron spectroscopy, and the surface hydrophilicity was measured by water contact angle test. Live/dead bacterial staining, nephelometery, and inhibition zone method were executed to evaluate the antibacterial property. Cytotoxicity was evaluated by MTT assay and cell fluorescence staining. Bacteria-MC3T3-E1 cells co‐culture was conducted to evaluate the cell viability on the samples under the circumstance with bacteria. Results Scanning electron microscope observation results showed that deposits of coating group and grafting group increased successively and gradually covered the porous structure. X-ray photoelectron spectroscopy results showed the peak of N1s enhanced and the peak of Cl2p appeared in grafting group. Water contact angle test results showed that the hydrophilic angle of three groups increased in turn, and there was significant difference between groups (P<0.05). Live/dead bacteria staining results showed that the grafting group had the least amount of bacteria adhered to the surface and the proportion of dead bacteria was high. The grafting group had a transparent inhibition zone around it and the absorbance (A) value did not increase, showing significant difference when compared with control group and coating group (P<0.05). MTT assay and cell fluorescence staining results showed that the number of adherent cells on the surface of the grafting group was the least, but the adherent cells had good proliferation activity. Bacteria-cell co-culture results showed that there was no bacteria on the surface of grafting group but live cells adhered well. ConclusionCHX-grafted phenolamine coating has the ability to inhibit bacterial adhesion and proliferation, and effectively protect cell adhesion and proliferation in a bacterial environment.
Objective To review the research progress of new antibacterial hydrogels in the treatment of infected wounds in the field of biomedicine, in order to provide new methods and ideas for clinical treatment of infected wounds. Methods The research literature on antibacterial hydrogels at home and abroad was extensively reviewed in recent years, and the antibacterial hydrogels for the treatment of infected wounds were classified and summarized. Results Antibacterial hydrogels can be divided into three categories: inherent antibacterial hydrogels, antibacterial agent release hydrogels, and environmental response antibacterial hydrogels. The advantages and disadvantages of antibacterial materials, antibacterial mechanism, antibacterial ability, and biocompatibility were discussed respectively. Inherent antibacterial hydrogels have the characteristics of wide source, low cost, and simple preparation, but their antibacterial ability is relatively weak. New antimicrobial substances are added to antibacterial agent release hydrogels, such as antimicrobial peptides, metal ions, graphene materials, etc., providing a new therapeutic strategy for alternative antibiotic therapy. On the basis of the antibacterial material, environmental promoting factors such as photothermal effect, pH value, and magnetic force are added to the environmental response antibacterial hydrogels, which synergically enhances the antibacterial ability of the hydrogel, improves the precise regulation function and bionic effect of the hydrogel. ConclusionThe selection of a variety of materials, the addition of a variety of antibacterial agents, and the effect of various promoting factors make composite hydrogels show multiple characteristics. The development of antibacterial hydrogels that can effectively address practical clinical applications remains a significant challenge. In the future, expanding the application range of antibacterial hydrogels, constructing drug-loaded hydrogels, and developing intelligent hydrogels are still new areas that need to be explored and studied.
Objective To clarify the bacterial spectrum and drug resistance of different biliary diseases through bile culture results. Methods Patients who underwent surgical treatment and retained bile for cultivation at the Chinese PLA General Hospital between January 2015 and December 2016 were retrospectively collected. Clinical data such as bile bacterial culture and antibiotic sensitivity results, surgical reasons, and perioperative complications were recorded. Results A total of 272 patients were included, including 142 males and 130 females, aged (53.4 ± 14.1) years old. Intrahepatic and extrahepatic bile duct stones were the most common surgical cause, accounting for 32.4%. The positive rate of bile culture in benign diseases was 78.7%, which was higher than that in malignant diseases (48.5%). The infection related complications (30.0% vs. 6.7%), bile leakage rate (20.8% vs. 6.7%), and poor wound healing rate (24.0% vs. 0.0%) in the bile culture positive group were higher than those in the bile bacteria culture negative group (P<0.05). Among 183 patients with positive bile bacterial culture, a total of 294 strains of pathogenic bacteria were detected. There were 96 patients with single bacterial infection, 66 patients with two bacterial infections simultaneously, 18 patients with three bacterial infections, and 3 patients with four or more bacterial infections. Escherichia coli was the most common bacterium, accounting for 17.0%. There were differences in the positive rate of bile culture among patients with different etiologies (P<0.05). There were significant differences in the sensitivity rate of Enterococcus faecalis and Enterococcus faecalis for many antibacterial drugs. Conclusions There are differences in the positive rate of bacterial culture in the biliary tract of patients with different etiologies, and there is a possibility of mixed infection. It is necessary to select appropriate antibiotics for empirical treatment based on different etiologies. The use of antibiotics should be changed in a timely manner based on the results of bile culture.
ObjectiveTo review the related studies on the application of nanomaterials in the treatment of osteomyelitis, and to provide new ideas for the research and clinical treatment of osteomyelitis.MethodsThe literature about the treatment of osteomyelitis with nanomaterials at home and abroad in recent years was reviewed and analyzed.ResultsAt present, surgical treatment and antibiotic application are the main treatment options for osteomyelitis. But there are many defects such as antibiotic resistance, residual bone defect, and low effective concentration of local drugs. The application of nanomaterials can make up for the above defects. In recent years, nanomaterials play an important role in the treatment of osteomyelitis by filling bone defects, establishing local drug delivery system, and self-antibacterial properties.ConclusionIt will provide a new idea and an important research direction for the treatment of osteomyelitis to fully study the related characteristics of nanomaterials and select beneficial materials to make drug delivery system or substitute drugs.
5–20 wt% trimethoxysilylpropyl octadecyldimethyl ammonium chloride (QAS) was used to modify Poly (ε-caprolactone) (PCL)-gelatin hybrid to fabricate non-leaching antibacterial nanofiber membranes (PG-Q) by electrospinning. The results from scanning electron microscopy (SEM) and transmission electron microscopy (TEM) indicated that the QAS leaded to phase separation between the QAS and PCL. Hydrophilic test demonstrated that the PG-Q nanofiber membranes had hydrophobic surface, which was help for peeling off the dressing from the wound. Additionally, the physical and chemical cross-linking between the QAS/PCL and QAS/gelatin were confirmed by Fourier transform infrared (FTIR), which were good for long lasting antibacterial effect. The PG-Q membranes also showed excellent cell-biocompatibility. Furthermore, compared with pure PCL nanofiber membrane, the PG-Q nanofiber membranes, especially PG-Q15 (QAS: 15 wt%) and PG-Q20 (QAS: 20 wt%), showed a considerable increase in the bacteriostatic rate of S. aureus and P. aeruginosa (more than 99% after 12 h). Therefore, electrospinning non-leaching antibacterial nanofiber membranes could be an optimal choice for antibacterial wound dressing.