Actividad antibacteriana de sevoflurano e isoflurano
2017; Volume: 30; Issue: 2 Linguagem: Espanhol
ISSN
1130-331X
AutoresMaría Martínez Serrano, Manuel Gerónimo‐Pardo, Ángel Martínez Monsalve, María Dolores Crespo Sánchez,
Tópico(s)Intensive Care Unit Cognitive Disorders
ResumoespanolIntroduccion. Las bacterias multirresistentes estan aumentando en todo el mundo y las opciones terapeuticas son limitadas. Algunos anestesicos han mostrado actividad antibacteriana previamente. En este estudio hemos investigado dicha actividad en los anestesicos halogenados sevoflurano e isoflurano frente a un grupo de patogenos resistentes. Metodos. Se llevaron a cabo dos experimentos. En el primero se enfrentaron suspensiones bacterianas de aislados clinicos resistentes y cepas de referencia (ATCC) de Staphylococcus aureus, Escherichia coli y Pseudomonas aeruginosa a sevoflurano e isoflurano en su forma liquida durante 15, 30 y 60 minutos. Una muestra de la suspension obtenida se inoculo en agar solido y se incubo. En el segundo experimento se estudiaron aislados clinicos multirresistentes de E. coli, Klebsiella pneumoniae, Enterobacter cloacae, P. aeruginosa, Acinetobacter baumannii, S. aureus y Enterococcus faecium. Placas de agar inoculadas con una cantidad conocida de las cepas se expusieron a los anestesicos liquidos, hasta su evaporacion completa, antes de su incubacion. En ambos experimentos se determino el numero de unidades formadoras de colonias en las placas obtenidas. Resultados. En el primer experimento isoflurano demostro una actividad mayor y mas rapida que sevoflurano frente a las cepas estudiadas. Los microorganismos gramnegativos resultaron mas sensibles. En el segundo E. faecium se mostro resistente a ambos agentes y solo isoflurano mostro diferencias significativas en su efecto antimicrobiano frente al resto de las cepas. Conclusiones. Ambos anestesicos halogenados, especialmente isoflurano, mostraron actividad antibacteriana in vitro frente a patogenos resistentes a los antibioticos convencionales. Se necesita mayor investigacion para determinar si este efecto se confirma in vivo. En ese caso se podria considerar a estos agentes como una alternativa frente a bacterias multirresistentes, incluyendo por ejemplo su uso topico en heridas infectadas. EnglishIntroduction. Multidrug resistant bacteria are increasing worldwide and therapeutic options are limited. Some anaesthetics have shown antibacterial activity before. In this study, we have investigated the antibacterial effect of the halogenated anaesthetic agents sevoflurane and isoflurane against a range of resistant pathogens. Methods. Two experiments were conducted. In the first, bacterial suspensions of both ATCC and resistant strains of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa were exposed to liquid sevoflurane and isoflurane during 15, 30 and 60 minutes. In the second experiment clinical resistant strains of E. coli, Klebsiella pneumoniae, Enterobacter cloacae, P. aeruginosa, Acinetobacter baumannii, S. aureus, and Enterococcus faecium were studied. Previously inoculated agar plates were irrigated with the halogenated anaesthetic agents and these were left to evaporate before the plates were incubated. In both experiments colony forming units were counted in resultant plates. Results. In the first experiment, isoflurane showed faster and higher antimicrobial effect than sevoflurane against all the strains studied. Gram-negative organisms were more susceptible. In the second experiment, E. faecium was found to be resistant to both halogenated agents; only isoflurane showed statistically significant activity against the rest of the strains studied. Conclusions. Both halogenated agents, but particularly isoflurane, showed in vitro antibacterial activity against pathogens resistant to conventional antibiotics. Further investigation is required to determine whether or not they also exhibit this property in vivo. This might then allow these agents to be considered as rescue treatment against multidrug resistant patho-gens, including a topical use in infected wounds.
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