SNS - bakteriella infektioner

Den temporära testperioden av SNS innebär en del risker, främst vad gäller infektioner. Det kan ju vem som helst räkna ut när det handlar om att köra in elektroder som skall stimulera sakralnerverna och låta dessa elektroder ligga utanpå kroppen (med fri syretillgång för bakterietillväxt med andra ord då denna enbart döljs av bandagering).

Studier har gjorts på kolonisationen av bakterier på ett antal elektroder som använts vid just testimplantationen och resultaten av denna studie talar sitt tydliga språk. Det blir en ganska stor kolonisation av bakterier på elektroden! Oavsett om man själv utvecklar en infektion eller inte så kommer man att utsättas för ett stort bakteriellt angrepp och jag förmodar att det är här immunförsvaret får komma upp till bevis.. kollodialt silver med andra ord.. I will drink! O hoppas att det håller skiten i schack. Infektioner har jag haft så det räcker o blir över.

Colorectal Dis. 2010 Feb;12(2):141-3. Epub 2009 Aug 17.

Bacterial colonization of stimulation electrode wires in patients undergoing temporary sacral nerve stimulation.

Dudding T, Vaizey C.

Source

Physiology Unit, St Mark's Hospital, London.

Abstract

OBJECTIVE:

In patients undergoing sacral nerve stimulation (SNS), a temporary percutaneous stimulation wire is often used to assess the clinical response to therapy prior to chronic stimulation. The aim of this study was to evaluate the incidence of bacterial colonization of screening wires and risk of clinical infection in patients undergoing prolonged temporary SNS screening.

METHOD:

Data were collected prospectively on a consecutive series of patients undergoing temporary SNS for bowel dysfunction. Procedures were performed using a standardized percutaneous technique with a single shot of either co-amoxyclav 1.2 g or cefuroxime 1.5 g given intravenously on induction. Adherent polyurethane dressings were applied to secure the wire. At the end of the screening period the wire and dressings were removed, the skin entry site was cleaned using an alcohol wipe and the wire removed via an aseptic technique. The distal tip of the wire was then cut and sent for culture.

RESULTS:

Thirteen wires were removed at a median of 21 (range 16-29) days following insertion. There were no signs of local or systemic infection. Seven of the thirteen wires (54%) were found to have deep bacterial colonization. The commonest organisms isolated were staphylococcus species. There was no correlation between the length of time the lead had been implanted and the incidence of bacterial colonization.

CONCLUSION:

Bacterial colonization of the temporary stimulation wire is common but appears to be associated with a low risk of clinical infection. A single peri-operative dose of antibiotics does not appear to prevent colonization.

Källa: http://www.ncbi.nlm.nih.gov/pubmed/19508525