One of the most serious complications of extracorporeal membrane oxygenation (ECMO) therapy is ECMO cannulae infection, which can occur at quadruple the rate of central venous catheter infections, and significantly impact morbidity and paediatric mortality. The objective of this in vitro observational study was to assess antimicrobial properties of two n-butyl-2-octyl cyanoacrylate tissue adhesive (TA) formulations for bacterial inhibition at peripheral ECMO cannulae insertion sites. Antimicrobial properties were assessed using modified agar disk-diffusion (n = 3) and simulated agar cannulation insertion site (n = 20) models. Both assays used Staphylococcus epidermidis which was seeded at the edge of the TA or dressing. Microorganism inhibition was visually inspected and evidenced by the presence or absence of a TA bacterial inhibition zone at 24 and 72 h. Both TAs provided effective barriers to bacterial migration under cannula dressings, to cannula insertion sites and down cannula tunnels. Additionally, both TAs demonstrated distinct zones of inhibition produced when left to polymerise onto agar plates seeded with S. epidermidis. N-Butyl-2-octyl cyanoacrylate TA appears to inhibit bacterial growth and migration of S. epidermidis. Application of TA to cannulae insertion sites may therefore be a potential bedside strategy for infection prevention in ECMO cannulae, but requires further testing before being used clinically for this purpose.

中文翻译：

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用于体外膜氧合插管中细菌抑制的组织粘合剂

体外膜氧合（ECMO）治疗最严重的并发症之一是ECMO套管感染，其发生率可能是中心静脉导管感染的四倍，并且显着影响发病率和儿科死亡率。这项体外观察研究的目的是评估两种正丁基-2-辛基氰基丙烯酸酯组织粘合剂（TA）制剂的抗菌性能，以抑制周围ECMO套管插入部位的细菌。使用改良的琼脂圆盘扩散法（n = 3）和模拟琼脂插管插入位点（n = 20）模型评估抗菌性能。两种测定均使用表皮葡萄球菌，其接种在TA或敷料的边缘。肉眼检查微生物的抑制作用，并通过在24和72 h处是否存在TA细菌抑制区来证明。这两个TA都为细菌在插管敷料下，向插管插入位点和向下插管隧道的迁移提供了有效的屏障。另外，当两个TAs聚合到接种有表皮葡萄球菌的琼脂平板上时，两个TA均表现出明显的抑制区。N-丁基-2-辛基氰基丙烯酸酯TA似乎抑制细菌的生长和表皮葡萄球菌的迁移。因此，将TA应用于套管插入位点可能是预防ECMO套管感染的潜在床旁策略，但在临床上用于此目的之前需要进一步测试。到套管插入部位和套管下部通道。另外，当两个TAs聚合到接种有表皮葡萄球菌的琼脂平板上时，两个TA均表现出明显的抑制区。N-丁基-2-辛基氰基丙烯酸酯TA似乎抑制细菌的生长和表皮葡萄球菌的迁移。因此，将TA应用于套管插入位点可能是预防ECMO套管感染的潜在床旁策略，但在临床上用于此目的之前需要进一步测试。到套管插入部位和套管下部通道。另外，当两个TAs聚合到接种有表皮葡萄球菌的琼脂平板上时，两个TA均表现出明显的抑制区。N-丁基-2-辛基氰基丙烯酸TA似乎抑制细菌的生长和表皮葡萄球菌的迁移。因此，将TA应用于插管插入部位可能是预防ECMO插管感染的潜在床旁策略，但在临床上用于此目的之前需要进行进一步测试。