CAJ | 학술논문

背景：细菌生物膜是导致假体感染难以治愈的主要原因。体外实验研究证实高渗氯化钠、乙醇能够明显促进葡萄球菌生物膜的形成，而关于体内假体周围乙醇、高渗环境对生物膜形成的影响未见报道。 　　目的：探讨假体周围不同环境因素对关节置换后假体感染表皮葡萄球菌生长和生物膜形成的影响。 　　方法：构建关节假体表皮葡萄球菌感染的大白兔模型，分为高渗氯化钠组、乙醇组和对照组，每组15只。高渗氯化钠组、乙醇组注入细菌的同时分别加入0.1 mL 4%的氯化钠和体积分数4%的乙醇溶液，对照组注入0.1 mL 0.9%的氯化钠溶液。造模成功后于接种细菌后第2，4，6，8和16天分别处死3只大白兔，留取关节液、假体和感染周围组织。分离培养细菌提取总RNA于基因水平检测ica操纵子转录水平，以扫描电镜观察假体表面细菌黏附情况，应用苏木精-伊红染色观察假体周围感染组织。 　　结果与结论：假体周围组织学观察结果显示，高渗氯化钠组注入细菌后第4天所有动物假体周围组织有炎细胞浸润并于第16天时观察到菌落形成。乙醇组和对照组于第6天发现有炎性浸润。扫描电镜观察到第6，8和16天高渗氯化钠组和乙醇组与对照组相比，假体表面黏附细菌逐渐增加，差异有显著性意义(P <0.05)。注入细菌后第6，8和16天icaA mRNA在高渗氯化钠组和乙醇组的表达明显高于对照组，差异有显著性意义(P <0.05)。提示关节置换后假体周围环境因素的改变能够影响表皮葡萄球菌的生长以及生物膜的形成。
배경：세균생물막시도치가체감염난이치유적주요원인。체외실험연구증실고삼록화납、을순능구명현촉진포도구균생물막적형성，이관우체내가체주위을순、고삼배경대생물막형성적영향미견보도。 　　목적：탐토가체주위불동배경인소대관절치환후가체감염표피포도구균생장화생물막형성적영향。 　　방법：구건관절가체표피포도구균감염적대백토모형，분위고삼록화납조、을순조화대조조，매조15지。고삼록화납조、을순조주입세균적동시분별가입0.1 mL 4%적록화납화체적분수4%적을순용액，대조조주입0.1 mL 0.9%적록화납용액。조모성공후우접충세균후제2，4，6，8화16천분별처사3지대백토，류취관절액、가체화감염주위조직。분리배양세균제취총RNA우기인수평검측ica조종자전록수평，이소묘전경관찰가체표면세균점부정황，응용소목정-이홍염색관찰가체주위감염조직。 　　결과여결론：가체주위조직학관찰결과현시，고삼록화납조주입세균후제4천소유동물가체주위조직유염세포침윤병우제16천시관찰도균락형성。을순조화대조조우제6천발현유염성침윤。소묘전경관찰도제6，8화16천고삼록화납조화을순조여대조조상비，가체표면점부세균축점증가，차이유현저성의의(P <0.05)。주입세균후제6，8화16천icaA mRNA재고삼록화납조화을순조적표체명현고우대조조，차이유현저성의의(P <0.05)。제시관절치환후가체주위배경인소적개변능구영향표피포도구균적생장이급생물막적형성。
BACKGROUND:Bacterial biofilm is the main cause of the infection of the prosthesis.In vitro experiments confirmed that hypertonic sodium chloride and ethanol can apparently promote the formation of staphylococcal biofilms. There are no reports on the effects of ethanol and hypertonic environment surrounding the prosthesis on the formation of biofilms. OBJECTIVE: To evaluate the effects of different environment factors surrounding the prosthesis on the growth of Staphylococcus epidermidis and bacterial biofilm formation after replacement. METHODS: White rabbit models infected with Staphylococcus epidermidis on the prosthesis were established, and were randomly divided into hypertonic sodium chloride, ethanol and control groups (n=15). The bacteria were injected with 0.1 mL 4% sodium chloride and 4% ethanol into the knee of rabbits in the hypertonic sodium chloride and ethanol groups. The rabbits were injected with 0.1 mL 0.9% sodium chloride in the control group. Three rabbits were sacrificed at 2, 4, 6, 8 and 16 days after inoculated with bacteria. Synovial fluid, prosthesis and tissue surrounding infection were obtained. Bacterium was cultured to extract total RNA. The ica operon transcription levels were detected in the gene levels. Adhesion of bacteria on the surface of the prosthesis was observed using a scanning electron microscope. Tissues surrounding the prosthesis were observed using hematoxylin-eosin staining. RESULTS AND CONCLUSION:Histological examination revealed that inflammatory cel infiltration was observed in al the rabbits at 4 days after injection. Colony formation was found at 16 days after injection. At 6 days after injection, inflammatory cel infiltration was observed in the ethanol and control groups. Scanning electron microscope showed that compared with the control group, the bacteria adhered to the prosthetic surface became more in the hypertonic sodium chloride and ethanol groups at 6, 8 and 16 days (P < 0.05). At 6, 8 and 16 days, the expression of icaA mRNA was significantly higher in the hypertonic sodium chloride and ethanol groups than in the control group (P < 0.05). These data showed that the environment factors could affect the growth of Staphylococcus epidermidis and bacterial biofilm formation.