Residual activity of cetrimide and chlorhexidine on Enterococcus faecalis-infected root canals

Effective final irrigation regimen is an important step in order to achieve better disinfection and ensure residual antimicrobial effects after root canal preparation. The aim of this study was to compare the residual antimicrobial activity of 0.2% cetrimide, and 0.2% and 2% chlorhexidine in root canals infected with Enterococcus faecalis. Biofilms of E. faecalis were grown on uniradicular roots for 4 weeks. After root canal preparation, root canals were irrigated with 17% ethylenediaminetetraacetic acid （EDTA） to remove the smear layer. The roots were randomly divided into three experimental groups （n=26） according to the final irrigating solution： Group I, 5 mL 0.2% cetrimide; Group II, 5 mL 0.2% chlorhexidine; and Group III, 5 mL 2% chlorhexidine. Samples were collected for 50 days to denote the presence of bacterial growth. The proportion of ungrown specimens over 50 days was evaluated using the nonparametric Kaplan-Meier survival analysis. Differences among groups were tested using the log-rank test and the level of statistical significance was set at P〈0.05. The highest survival value was found with 2% chlorhexidine, showing statistically significant differences from the other two groups. At 50 days, E. faecalisgrowth was detected in 69.23% specimens in Groups I and II, and in 34.61% specimens of Group III. There were no significant differences between 0.2% cetrimide and 0.2% chlorhexidine. Final irrigation with 2% chlorhexidine showed greater residual activity than 0.2% chlorhexidine and 0.2% cetrimide in root canals infected with E. faecalis.

Development of a New <i>Pseudomonas</i>Agar Medium Containing Benzalkonium Chloride in Cetrimide Agar

Members of the Pseudomonas family are commonly found in nature, some species are pathogenic for humans, as well as being resistant to multiple disinfectants. Various studies have revealed that benzalkonium chloride (BKC) has an inhibitory effect on many bacteria but it has no significant effect on Pseudomonas aeruginosa. Cetrimide agar medium is recommended for the isolation and enumeration of Ps. aeruginosa in food and environmental samples. However, there are claims that for some food factories and in particular the bottled water industry, the selectivity of this medium is not sufficient. The aim of the current research is the creation of a more selective medium for Ps. aeruginosa with BKC. A total of 28 isolates were isolated with Cetrimide agar from raw water samples and identified using biochemical tests and commercial identification kits. All the bacteria were inoculated in Cetrimide agar plates containing 0 - 625 μg/mL BKC. The Petri dishes were incubated at 37°C and 42°C for 24 h. The results showed that 375 μg/mL BKC was sufficient to suppress Burk. pseudomallei at both incubation temperatures. Ps. fluorescens-35 could not grow at 42°C at any concentration, including the control, and was suppressed at 500 μg/mL BKC. All the Ps. aeruginosa isolates and control strain were grown at both incubation temperatures at 375 μg/mL BKC concentration. In conclusion, the analysis of Ps. aeruginosa showed that the growth of accompanying flora may be suppressed by adding 375-μg/mL BKC into Cetrimide agar and incubating at an elevated temperature of 42°C.

A Modified Selective Medium Containing Benzalkonium Chloride (BKC) for the Isolation of <i>Pseudomonas aeruginosa</i>from Raw Milk

A modified selective medium (modified Cetrimide Agar, mCA) consisting of 200 μg/mL benzalkonium chloride (BKC) was developed for the isolation of Pseudomonas aeruginosa from raw milk. Initially, a total of 55 isolates were obtained from 14 raw milk samples collected from several dairy plants in Ankara, Turkey. Among these isolates, 19 were identified as Pseudomonas aeruginosa, 28 as Pseudomonas fluorescens, 4 as Acinetobacter baumannii, 2 as Enterobacter intermedium, 1 asEnterobacter agglomerans, and 1 as Escherichia coli using Microbact biochemical test kit. BKC was chosen as a selective agent to suppress growth of competitive flora because it is very effective against a wide range of Gram-negative bacteria while P. aeruginosa is resistant. MICs (minimum inhibitory concentration) for BKC were determined by agar dilution method. The concentration of 200 μg/mL BKC inhibited competitive flora, while 90% of P. aeruginosa strains were resistant. When the results of enumeration of P. aeruginosa and other Gram (-) bacteria in Cetrimide Agar (CA) and mCA were compared, it was observed that mCA was more selective than the standard CA in preventing the growth of competitive flora especially of P. fluorescens.