İntravenöz anestezik ajanlarda antibakteriyel etkinlik
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2009
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info:eu-repo/semantics/openAccess
Özet
Mikroorganizmalar intravenöz ilaçlar içinde hızla büyüyebilirler. İntravenöz verilen ilaçların dış etkenlerden kaynaklanan kirliliği cerrahi operasyondan sonraki vücut içi enfeksi-yonu ve yara yeri enfeksiyonunun bir kaynağı olarak düşünülür. Bir cins Escherichia coli'nin intravenöz olarak kullanılan anestezik ajanların içindeki gelişimini inceledik. Patojen mikroorganizma 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22 ve 24 saat boyunca (aynı oranlar değişik saatler boyunca) yinelenerek uygulandı ve oda sıcaklığında % 2.5'luk tiyopental'e, % 1'lik propofol'e, etomidat'a 2 mg/ml, ketamin'e 50 µgr/ml, midazolam'a 1 mg/ml, diazepam'a, fentanil'e 50 µgr/ml, remifentanil'e 0,02 mg/ml, morfin'e, meperidin'e 50 mg/ml, haloperidol'e, % 0.9'luk normal saline maruz bırakıldı. Bu süspansiyonlardan alınan örnekler 1/1000 oranında steril izotonik ile inaktive edilerek ekimi yapılıp 37 °C'de 48 saat inkübe edildi. İntravenöz anestezik ajanların ölçülen pH'ları tiyopental 8.5, propofol 5.6, etomidat 5.0, ketamin 5.2, midazolam 4.0, diazepam 6.0, fentanil 4.2, remifentanil < 3.0, morfin 4.4, meperidin 5.6, haloperidol 5.3, % 0.9'luk normal salin 7.01 olarak bulundu. Patojen mikroorganizma E.coli'nin ilaçların pH değerinden etkilenmediği saptandı. Tiyopental, ketamin, diazepam, meperidin, haloperidol'ün steril izotonikle 1/1000 oranında seyreltilmesi ve E.coli ile ekimi sonucunda bu solüsyonlarda E.coli üremesi olmadı. Propofol'e, etomidat'a, fentanil'e maruz bırakma süresi arttıkça koloni sayısı arttı. Midazolam'a maruz bırakma sonucu 14. saate kadar koloni oluşumu düşük olmakla birlikte giderek azaldı ve 16. saatten itibaren üreme olmadı. Remifentanil'de ilk iki saat düşük oranda üreme olurken sonraki saatlarde üreme görülmedi. Morfin maruz bırakıldığında 2, 4, 6 saatten sonra azalarak üreme devam etti. Sonuç olarak; çalışmada kullanılan intravenöz ajanlardan propofol, etomidat, fentanil dışında diğer tüm ilaçların antibakterisid özelliğinin olduğunu saptadık. Bir ilacın antibakteriyel etkinliği inokulumun büyüklüğü, ilacın konsantrasyonu gibi pek çok faktöre bağlı olduğundan sık kullanılan bu anestezik ilaçların antibakteriyel etkinliklerinini daha ileri çalışmalarla araştırılması gerektiği sonucuna vardık. Anahtar kelimeler: anestezik; intravenöz; ketamin; propofol; bakteriyel büyüme
Microorganisms can easily grow up in intravenous drugs. Extrinsic contamination of intravenously infused drugs are thought to be the source of the inner body and wound infection after surgery. We researched the growth of a kind of Escherichia coli in some anesthetic agents that are infused intravenously. The pathogen of the microorganism was exposed to 2.5% thiopental, 1% propofol, 2 mg/ml of etomidate, 50 ?gr/ml of ketamine, 1 mg/ml of midazolam, diazepam, 50 ?gr/ml of fentanyl, 0.02 mg/ml of remifentanil, morphine, meperidine, 50 mg/ml of Haloperidol, 0.9% normal saline at room temperature for 2,4,6,8,10,12,14,16,18,20,22,24 hours repeatedly ( with the same rates for different hours ). The samples taken from these suspensions were inactivated by steril isotonic and incubated for 48 hours at 37°C after having been cultured. The calculated pH values of the intravenous anesthetic agents were found as 8.5 for thiopental, 5.6 for propofol, 5.0 for etomidate, 5.2 for ketamine, 4.0 for midazolam, 6.0 for diazepam, 4.2 for fentanyl, < 3.0 for remifentanil, 4.4 for morphine, 5.6 for meperidine, 5.3 for Haloperidol, 7.01 for the 0.9% normal saline. The pathogen of the Escherichia coli (microorganism) was found not to be affected by the pH values of these drugs. After the dilution of thiopental, ketamine, diazepam, meperidine, and haloperidol with steril isotonic with a ratio of 1/1000 and culturing these with Escherichia coli, there was no growth of Escherichia coli in these solutions. As the time of exposure to propofol, etomidate, fentanyl lengthened the cfu ( or colony count) increased. Nonetheless, after exposure to midazolam until 14th hour the cfu was poor, and was lower after that time, there was no growth after the 16th hour. As the cfu was very low during the first two hours, no other growth was observed in the following hours. When morphine was exposed to the bactery growth continued with a decreasing tendency after 2,4,6 hours. As a result, we found out that all the drugs which are used in our study excluding the intravenous agents etomidate, fentanyl, and propofol were antibactericid. Also we concluded (that) further research and study on the antibacterial activities of these popularly and frequently used drugs has to be done, since their antibacterial activities depend many factors on the size of the inoculum, the consentration of the drug, and etc. Key words: anesthetic; intravenosus; ketamine; propofol; bacterial growth
Microorganisms can easily grow up in intravenous drugs. Extrinsic contamination of intravenously infused drugs are thought to be the source of the inner body and wound infection after surgery. We researched the growth of a kind of Escherichia coli in some anesthetic agents that are infused intravenously. The pathogen of the microorganism was exposed to 2.5% thiopental, 1% propofol, 2 mg/ml of etomidate, 50 ?gr/ml of ketamine, 1 mg/ml of midazolam, diazepam, 50 ?gr/ml of fentanyl, 0.02 mg/ml of remifentanil, morphine, meperidine, 50 mg/ml of Haloperidol, 0.9% normal saline at room temperature for 2,4,6,8,10,12,14,16,18,20,22,24 hours repeatedly ( with the same rates for different hours ). The samples taken from these suspensions were inactivated by steril isotonic and incubated for 48 hours at 37°C after having been cultured. The calculated pH values of the intravenous anesthetic agents were found as 8.5 for thiopental, 5.6 for propofol, 5.0 for etomidate, 5.2 for ketamine, 4.0 for midazolam, 6.0 for diazepam, 4.2 for fentanyl, < 3.0 for remifentanil, 4.4 for morphine, 5.6 for meperidine, 5.3 for Haloperidol, 7.01 for the 0.9% normal saline. The pathogen of the Escherichia coli (microorganism) was found not to be affected by the pH values of these drugs. After the dilution of thiopental, ketamine, diazepam, meperidine, and haloperidol with steril isotonic with a ratio of 1/1000 and culturing these with Escherichia coli, there was no growth of Escherichia coli in these solutions. As the time of exposure to propofol, etomidate, fentanyl lengthened the cfu ( or colony count) increased. Nonetheless, after exposure to midazolam until 14th hour the cfu was poor, and was lower after that time, there was no growth after the 16th hour. As the cfu was very low during the first two hours, no other growth was observed in the following hours. When morphine was exposed to the bactery growth continued with a decreasing tendency after 2,4,6 hours. As a result, we found out that all the drugs which are used in our study excluding the intravenous agents etomidate, fentanyl, and propofol were antibactericid. Also we concluded (that) further research and study on the antibacterial activities of these popularly and frequently used drugs has to be done, since their antibacterial activities depend many factors on the size of the inoculum, the consentration of the drug, and etc. Key words: anesthetic; intravenosus; ketamine; propofol; bacterial growth
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Anestezi ve reanimasyon, Anesthesiology and reanimation, Anestezik, Anesthetic, Intravenöz, Intravenosus, Ketamin, Ketamine, Propofol, Propofol, Bakteriyel büyüme, Bacterial growth
