The aim of this study was to determine the potential application of N-chlorotaurine (NCT), N,N-dichloro-2,2-dimethyltaurine (NVC-422), and N-monochloro-2,2-dimethyltaurine (NVC-612) as catheter lock solutions for the prevention of catheter blockage and catheter-related bloodstream infections by testing their anticoagulant and broad-spectrum antimicrobial activities in human blood. NCT, NVC-422, NVC-612, and control compounds were serially diluted in fresh human blood to evaluate the effects on prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, and direct thrombin inhibition. Quantitative killing assays against pathogens, including methicillin-resistant Staphylococcus aureus, Escherichia coli, and Candida albicans, were performed in the presence of heparin and human blood. NCT and NVC-612 (1.38 mM each) and 1.02 mM NVC-422 prolonged prothrombin time (Quick value, 17 to 30%), activated partial thromboplastin time 3-to 4-fold to 76 to 125 s, and thrombin time 2-to 4-fold to 34 to 68 s. Fibrinogen decreased from 258 to 283 mg/dl (range of controls) to <40 mg/dl. No direct thrombin inhibition was observed by NVC-422 or NVC-612. Heparin did not influence the bactericidal activity of NCT. The microbicidal activities of NCT, NVC-422, and NVC-612 were maintained in diluted human blood. NCT, NVC-612, and NVC-422 have broad-spectrum antimicrobial activity in blood and anticoagulant activity targeting both intrinsic and extrinsic pathways of the coagulation system. These properties support their application as catheter lock solutions.
Bactérias do complexo Acinetobacter calcoaceticus - Acinetobacter baumannii (ACB) são causa frequente das chamadas Infecções Relacionadas à Assistência à Saúde (IRAS). Durante a pandemia de COVID-19, causada pelo vírus SARS-CoV-2, coinfecções e aumento da resistência bacteriana aos antibióticos têm sido observados. Assim, o presente estudo verificou a ocorrência e perfil de resistência aos carbapenêmicos (no ano de 2020) e a polimixina B (de outubro de 2020 a março de 2021) em bactérias do complexo ACB, durante a pandemia de SARS-CoV-2, no Hospital Escola (HE) da Universidade Federal de Pelotas (UFPel/EBSERH). Duas metodologias foram aplicadas, a de identificação e avaliação da suscetibilidade bacteriana por automação (BD Phoenix™), e avaliação da resistência a polimixina B utilizando painel de microdiluição (CIM POLIMIXINA B, Laborclin). Oitenta e um isolados pertencentes ao complexo ACB foram identificados, sendo 69,1% (56) da espécie A. baumannii e 30,9% (25) de outras espécies do complexo ACB. Foi observado um aumento da resistência aos carbapenêmicos de 75% em 2019, para 94,3% em 2020. Dentre as bactérias do complexo ACB resistentes aos carbapenêmicos, 4 delas foram resistentes também a polimixina B. As bactérias do complexo ACB resistentes aos carbapenêmicos foram mais frequentes na UTI COVID-19, representando 44,9% em relação as outras unidades. Esses isolados resistentes foram obtidos de amostras de aspirado traqueal e sangue. Os dados obtidos revelam um aumento da resistência aos carbapenêmicos, além de uma maior frequência de bactérias do complexo ACB obtidas de aspirado traqueal de pacientes diagnosticados com COVID-19, o que pode estar relacionado a quadros de Pneumonia Associada a Ventilação Mecânica (PAVM).
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