兰州大学机构库 >学院待认领
新型物理抗菌材料预防导尿管伴随性尿路感染的临床效果研究
Alternative TitleClinical application of a physical antimicrobial material for the prevention of catheter associated urinary tract infections
马佩芬
Thesis Advisor王志平
2015-05-06
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword洁悠神 细菌生物膜 导尿管伴随性尿路感染 导尿管 护理
Abstract目的 观察新型物理抗菌材料洁悠神(JUC)在不使用抗生素的前提下,对预防导尿管伴随性尿路感染(CAUTI)和阻止导尿管表面细菌生物膜(BF)形成的效果,为临床预防CAUTI的发生提供新思路。 方法 在临床随机对照试验中,随机招募泌尿外科植入留置导尿管的急性尿潴留患者进行多中心随机对照双盲试验,比较洁悠神组和生理盐水(NS)组留置导尿后第5天和第7天菌尿的发生率,并观察药物不良反应。在细菌生物膜试验中,选取于留置导尿第1、2、5、7、10天分别拔除的导尿管,制成样片后采用扫描电子显微镜(SEM)观察其表面细菌生物膜的生长情况。 结果 临床多中心随机对照试验:留置导尿第5天菌尿发生率,JUC组和NS组分别为3.10%和11.63%;留置导尿第7天,两组分别为23.81%和43.65%,JUC组菌尿发生率显著低于NS组(P<0.01)。细菌生物膜试验:SEM显示NS组留置尿管表面第1天可见细菌定植聚集,第2天初步形成细菌生物膜,第5、7、10天均可见成熟细菌生物膜;JUC组留置尿管表面第1、2天无菌,第5、7、10天可见细菌黏附定植,个别样本初步形成细菌生物膜,大部分样本表面残留了较多崩解变形的细菌。尿管体外段和尿管内壁更容易形成细菌生物膜。洁悠神在尿管表面形成的网状抗菌膜能隔离细菌,推迟细菌生物膜形成时间,并使细菌生物膜崩解。 结论 物理抗微生物方法在不预防性使用抗生素的情况下,能够有效阻止体内尿道的导尿管表面细菌生物膜的形成,有效降低CAUTI的发生率。
Other AbstractObjective: Jieyoushen (JUC) is an antimicrobial material. We performed an clinical study to observe the effect of JUC on the prevention of CAUTI and the formation of biofilm on the catheter surface without the use of antibiotics, to provide new ideas on the clinical prevention of CAUTI. Methods: In the randomized controlled clinical trial, Acute urinary retention patients in Urology Surgical with indwelling catheter were recruited to a multi-center, double-blind randomized controlled trial. Make a comparison of the bacteriuria incidence between JUC treated group and NS treated group after catheterization in 5 and 7 days and observe adverse drug reactions of JUC. In biofilm test, Catheters were treated with JUC or NS respectively before insertion into the urethra and removed on the 1, 2, 5, 7, or 10 days to make samples to observe the growth of biofilm by Scanning electron microscope (SEM) . Results: In the randomized controlled clinical trial, The incidence of bacteriuria in catheterization were 3.10% in JUC treated group and 11.63% in NS treated group in the fifth day, and 23.81% in JUC treated group and 43.65% in NS treated group in the seventh day. The number of bacteria in the JUC treated group was significantly lower than that of the NS treated group (P<0.01). In biofilm test, SEM demonstrated that in the NS treated group, bacterial attachment and aggregation was observed after 1 day. Initial biofilms were seen on the 2nd catheterization day, and matured biofilms were seen on the 5th, 7th and 10th day. In contrast, no bacteria were seen after the 1 or 2nd day in the JUC group. Some bacterial attachment and early biofilm formation was seen on the 5th, 7th and 10th day. We found that both the external and internal surface of catheter were more susceptible to biofilm formation than the intrabladder part of the catheter. JUC application formed a honey-comb like antimicrobial membrane on the surface of the catheter, slowed biofilm formation, and degraded existing biofilms. Conclusion: The formation of biofilm on the urethral catheter surface can be prevented effectively and the incidence of CAUTI can be reduced effectively by the physical anti-microbial method without the use of prophylactic antibiotics.
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222454
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
马佩芬. 新型物理抗菌材料预防导尿管伴随性尿路感染的临床效果研究[D]. 兰州. 兰州大学,2015.
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