Corneal Blindness Caused by Accidental Ocular Use of Chlorhexidine (Hexz) Gel in Two Newborn Born in the Health District of Kati in Mali

Introduction: Corneal opacities in children are relatively common. In children, it is urgent because of the risk of irreversible amblyopia. The causes of these blindnesses vary considerably according to the regions of the world. Chlorhexidine digluconate is a broad-spectrum antiseptic directed against gram-positive and gram-negative bacteria. It has been used as an antiseptic for more than 50 years, both in humans and in animals. However, despite these benefits, it can cause serious damage if applied to the eyes. Incidents of eye damage with 7.1% chlorhexidine have been reported to WHO across Africa. Observation: We report and write two cases of bilateral corneal blindness caused by accidental ocular use of chlorhexidine (HEXZ) GEL 7.1% in two newborns in the health district of Kati in MALI. The ophthalmological examination had revealed corneal opacity, conjunctival hyperaemia and limbic ischemia greater than 50% in 1 eye out of 4, corresponding to stage IV of the ROPPER HALL classification;2 eyes out of 4 were at stage III and 1 eye out of 4 was at stage I of the same classification. Conclusion: It is essential to ensure correct use of chlorhexidine digluconate gel 7%. It is an antiseptic which should not be used on the ocular and auditory mucous membranes, at the risk of most often permanent burns.

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.

Antimicrobial effect of alexidine and chlorhexidine against Enterococcus faecalis infection

A previous study demonstrated that alexidine has greater affinity for the major virulence factors of bacteria than chlorhexidine.The aim of this study was to compare the antimicrobial activity of 1%alexidine with that of 2%chlorhexidine using Enterococcus faecalis-infected dentin blocks.Sixty bovine dentin blocks were prepared and randomly divided into six groups of 10 each.E.faecalis was inoculated on 60 dentin blocks using the Luppens apparatus for 24 h and then the dentin blocks were soaked in 2%chlorhexidine or 1%alexidine solutions for 5 and 10 min,respectively.Sterile saline was used as a control.The antimicrobial efficacy was assessed by counting the number of bacteria adhering to the dentin surface and observing the degradation of bacterial shape or membrane rupture under a scanning electron microscope.Significantly fewer bacteria were observed in the 2%chlorhexidine-or 1%alexidine-soaked groups than in the control group(P<0.05).However,there was no significant difference in the number of bacteria adhering to the dentinal surface between the two experimental groups or between the two soaking time groups(P>0.05).Ruptured or antiseptic-attached bacteria were more frequently observed in the 10-min-soaked chlorhexidine and alexidine groups than in the 5-min-soaked chlorhexidine and alexidine groups.In conclusion,10-min soaking with 1%alexidine or 2%chlorhexidine can be effective against E.faecalis infection.

Evaluation of intratesticular chlorhexidine gluconate for chemical contraception in dogs

Objective:To investigate the contraceptive effect of intratesticular injection of chlorhexidine gluconate in dogs and compare it with that of zinc gluconate neutralized with arginine.Methods:Twenty-four sexually mature male mongrel dogs were randomly divided by replicate into four groups(n=6 per group).GroupⅡreceived intra-testicular injection of 2 mL zinc gluconate(10 mg/mL)neutralized with arginine.GroupⅡreceived intratesticular injection of 2 mL chlorhexidine gluconate(5%w/v).GroupⅢreceived intratesticular injection of 2 mL chlorhexidine gluconate(4%w/v).GroupⅣdid not receive any treatment and served as the control group.Testicular morphometry was conducted on day 0,7,15 and 30 after treatment.Semen was collected and evaluated on day 0 and 30.Data were analyzed using repeated measures analysis of variance.Results:There was no difference in the mean values of various parameters between dogs treated with zinc gluconate and those treated with chlorhexidine gluconate at any of the time points.In dogs treated with zinc gluconate or chlorhexidine gluconate,there was a significant increase in the testicular morphometric parameters on day 7 followed by a significant reduction thereafter(day 15 and 30).In contrast,there was no change in any of the parameters in the control untreated dogs during the course of the study.Compared to the pre-treatment values,the mean scrotal circumference and the mean paired testicular volume and testicular weight on day 30 were significantly lower in the treated dogs.Semen samples collected on day 30 from treated dogs were found to be azoospermic,whereas no change in semen quality was observed in the control untreated dogs.Conclusions:Intratesticular injection of chlorhexidine gluconate(5%w/v and 4%w/v)is equally as effective as zinc gluconate neutralized with arginine for chemical contraception in dogs.

Cytotoxicity of Modified Nonequilibrium Plasma with Chlorhexidine Digluconate on Primary Cultured Human Gingival Fibroblasts

The aim of this study was to investigate the cytotoxicity of modified nonequilibrium plasma with chlorhexidine digluconate（CHX） on human gingival fibroblasts（HGFs）, and to evaluate the biosecurity of modified nonequilibrium plasma with 2% CHX as a new method of root canal treatment. Tissue samples taken from human gingiva were primarily cultured and passaged. Cells from passages 3–7 were used. HGFs were treated by modified nonequilibrium plasma with 2% CHX for 0 min（control group）, 30 s, 1 min, 1.5 min, 3 min, 5 min, and 10 min, respectively, and then they were incubated for 0, 24, and 48 h. After that, cell counting kit-8（CCK-8） assay was applied to analyze the cytotoxicity of modified nonequilibrium plasma with 2% CHX on HGFs. There was no significant difference between the 0 h group treated with the modified nonequilibrium plasma for 1 min and the control group（P〉0.05）. However, there were significant differences between all the other treated groups and the control group（P〈0.05）. When treated for 1.5 min or shorter, the cell viability was obviously increased; while treated for 3 min or longer, it was obviously reduced. Moreover, when successively cultured for 0, 24, and 48 h, cell viability was decreased at first and then increased in the 3-min-treated and 5-min-treated groups. The modified nonequilibrium plasma with 2% CHX was of no influence on cell viability in 1.5 min treatment, and it could be safely used on root canal treatment.

Representativeness of EN 1040/13727 Assay Conditions for Evaluating <i>In Vitro</i>the Bactericidal Activity of a Chlorhexidine Digluconate and Benzalkonium Chloride Antiseptic Preparation

Aims: The representativeness of the mandatory bacterial strains specified in European standards for in vitro assay of the bactericidal activity of antiseptics was evaluated by testing the activity of an antiseptic combining chlorhexidine digluconate 0.2% and benzalkonium chloride 0.5% against 21 additional bacterial strains, and the positive interaction between these two biocidal agents was assessed. Methods and Results: The bactericidal activity of the antiseptic solution used pure or diluted was assessed according to the European standards EN 1040 and EN 13727. The contact time was 1 min at 20°C. Interfering substances used in the EN 13727 assay were bovine serum albumin and sheep erythrocytes, simulating “dirty” conditions, and hard water. A reduction of colony-forming units by ≥5 log10 was deemed to meet the requirements to conclude bactericidal activity. Under “basic” conditions, the bactericidal activity of the antiseptic was observed against all four mandatory strains specified in the standards as well as against nearly all the additional strains tested, including most of those with acquired antibiotic-resistance. The positive interaction between the two biocidal agents was also confirmed. Under “dirty” conditions, the bactericidal activity of the antiseptic solution was maintained against all the mandatory strains and was reduced against only four of the additional strains tested. Conclusions: With regard to the antiseptic tested and under the experimental conditions described, bactericidal activity evidenced against the mandatory strains appeared to be representative of that manifested against a wide range of the main pathogenic bacteria. Reduced bacterial activity against some of the additional strains tested (e.g. Enterobacteriaceae) was observed under “dirty” conditions. Significance and Impact of the Study: EN 13727 with some experimental adjustments represents an additional appropriate standard that needs to be considered for mucocutaneous antiseptic assessment. However, it may be worth including other specific bacterial strains to those specified in the standard, when evaluating antiseptics intended for use in certain clinical situations.

Antimicrobial activity of calcium hydroxide and chlorhexidine on intratubular Candida albicans

This study investigated the efficacy of calcium hydroxide and chlorhexidine gel for the elimination of intratubular Candida albicans (C.albicans).Human single-rooted teeth contaminated with C.albicans were treated with calcium hydroxide,2%chlorhexidine gel, calcium hydroxide plus 2%chlorhexidine gel,or saline(0.9%sodium chloride) as a positive control.The samples obtained at depths of 0-100 and 100-200μm from the root canal system were analyzed for C.albicans load by counting the number of colony forming units and for the percentage of viable C.albicans using fluorescence microscopy.First,the antimicrobial activity of calcium hydroxide and the 2%chlorhexidine gel was evaluated by counting the number of colony forming units.After 14 days of intracanal medication,there was a significant decrease in the number of C.albicans colony forming units at a depth of 0-100μm with chlorhexidine treatment either with or without calcium hydroxide compared with the calcium hydroxide only treatment.However,there were no differences in the number of colony forming units at the 100-200μm depth for any of the medications investigated.C.albicans viability was also evaluated by vital staining techniques and fluorescence microscopy analysis.Antifungal activity against C.albicans significantly increased at both depths in the chlorhexidine groups with and without calcium hydroxide compared with the groups treated with calcium hydroxide only.Treatments with only chlorhexidine or chlorhexidine in combination with calcium hydroxide were effective for elimination of C.albicans.

Priming the tooth surface with chlorhexidine and antibacterial activity of resin cement

AIM: To evaluate the effect of priming the tooth surface with 2% chlorhexidine gluconate on antibacteria activity of resin cement. METHODS: Ten patients in whom a single missing tooth was present on both the right and left side in the upper or lower arch were selected. Two fixed partia dentures(FPDs) in each patient on the right and left side were planned. Each FPD was assigned either to the control or test group. In the control group, FPD was luted with resin cement and in the test group, the tooth surface was primed with 2% chlorhexidine gluconate before luting with resin cement. Bacteriological samples were collected at base line level, as the patient came to the outpatient department before the start of any treatment, 5 wk prior to cementation of FPD and at 13 wk(8wk after final cementation). Microbiological processing of all samples was done and the results were statistically analyzed. RESULTS: In the test group, a predominance of aerobic/facultative gram positive cocci rod was seen which indicates a healthy periodontal site, whereas in thecontrol group, a predominance of anaerobic gram negative rods was present which indicates an unhealthy periodontal condition. This is evident by the fact that the anaerobic bacteria percentage in the control sample is 57% and 15% in the test sample after 13 wk, whereas the aerobic/facultative bacteria percentage is 43% in the control sample and 85% in the test sample after 13 wk. The percentage of gram negative bacteria in the control sample is 61% and in the test sample is 20% after 13 wk, whereas the percentage of gram positive bacteria in the control sample is 39% and in the test sample is 80% after 13 wk. The shift from anaerobic gram negative bacteria to aerobic gram positive bacteria is clearly seen from the control to test sample after 13 wk. CONCLUSION: The present study demonstrated that priming the tooth surface with 2% chlorhexidine gluconate may enhance antibacterial activity of the resin cement.

Anti-biofilm Effect of Glass Ionomer Cements Incorporated with Chlorhexidine and Bioactive Glass

The effect of glass ionomer cement and resin-modified glass ionomer cement incorporated with chlorhexidine and bioactive glass on antimicrobial activity and physicochemical properties were investigated. The experimental results showed that groups incorporated with 1% chlorhexidine exhibited a significant reduction of optical density values of the bacterial suspension and increased the degradation of Streptococcus mutans biofilm. However, groups incorporated with 10% bioactive glass did not affect the optical density values and the biofilm formation. The mechanical properties of the materials and the polymerization were not influenced by the addition of chlorhexidine. Nevertheless, the compressive strength was lower when the materials were incorporated with bioactive glass. It can be concluded that glass ionomer cements incorporated with chlorhexidine can maintain its mechanical properties as well as reduce early S mutans biofilm formation. Controlled release/sustained release technology may be required to optimize the antibacterial activity of glass ionomer cements incorporated with bioactive glass.

Polyamide Fibers Covered with Chlorhexidine: Thermodynamic Aspects

Results of dynamic and equilibrium of sorption of a reactive dye Remazol Brilliant Blue, and a bactericidal agent, Digluconate of Chlorhexidine over Polyamide fibers are presented with the aim of supplying the fiber with bactericidal properties. However, adsorption of Chlorhexidine onto Polyamide is scarce due to the lack of interactions between the reactive groups of the fiber and the antiseptic molecule. Therefore, in order to provide the fiber surface with anionic groups, fiber has been previously dyed with Remazol Brilliant Blue which increases the negative charge of the fiber surface due to the presence of its sulfonate end groups. Thermodynamic parameters of equilibrium sorption in the two situations, fiber/dye and fiber-dye/Chlorhexidine, have been analyzed, as function of the temperature, pH and concentration of the dye in the pretreatment. Results show that when sorption of Remazol Brilliant Blue reaches the value of about 50 mmol/ kg at the higher temperature and concentration tested, the amount of Chlorhexidine adsorbed exhibits its maximum value which is 6 mmol/kg. Both processes, adsorption of Remazol Brilliant Blue and adsorption of Chlorhexidine, fit well to Langmuir adsorption model, suggesting the existence of some kinds of specific interactions between adsorbent and adsorbate. Thermodynamic functions show that the interaction is endothermic and spontaneous in all the rage of temperature tested. The kinetic studies show that sorption of Remazol Brilliant Blue is better described by pseudo-first order model, while sorption of Chlorhexidine fits better to pseudo-second order model, and seems to be quicker process. According to the obtained results, chemical interaction between the vinyl-sulfone group of Remazol Brilliant Blue and the amine groups of Polyamide fiber, followed by electrostatic interactions between the guanine group of the Chlorhexidine and the sulfonate group of the dye must be considered in order to explain the adsorption process.

Comparison of Two Methods of Chlorhexidine Application of Shear Bond Strength Degradation between Composite Resin and Dentin

Background: Chlorhexidine could have effect on shear bond strength of composite resin-dentin. Objective: The purpose of this study is to compare two methods of chlorhexidine application of shear bond strength degradation between composite resin and dentin. Methods: Thirty samples of dentin were taken from the crown of premolars and then divided into three groups (n = 10). Group 1 were applied bonding without chlorhexidine, group 2 were applied with liquid chlorhexidine and followed by bonding, group 3 were applied bonding which contains chlorhexidine. Each group was divided into two sub-groups (n = 5): the group with and without 10% NaOCl immersion for one hour. Then, 4 samples in each sub-group were used to measure shear bond strength using Universal Testing Machine, and 1 sample was examined with Scanning Electron Microscope (SEM). Data were analyzed using SPSS 17 by Mann-Whitney and Kruskal Wallis test. Results: The highest mean shear bond strength without 10% NaOCl immersion was in group 1, while the highest mean with 10% NaOCl immersion was in group 3. Significant differences occurred between the groups 1 and 2, groups 2 and 3. Conclusion: Method of using bonding contains chlorhexidine can increase and inhibit degradation shear bond strength between composite resin and dentin.

Detection of <i>Para</i>-Chloroaniline Resulting from the Interaction between Sodium Hypochlorite and Chlorhexidine Analyzed by Mass Spectrometry

5.1% of sodium hypochlorite (NaOCl) mixed with 2% of chlorhexidine (CHX) forms a brown precipitate that corresponds to para-chloroaniline (PCA), whether PCA is formed after the combination of NaOCl, CHX, and ethylenediaminetetraacetic acid (EDTA) by means of electron impact (high resolution and interlaced scanning) and ionization by fast atom bombardment (FAB), was analyzed. The brown precipitate, showed signals 127 and 153 Da, corresponding to p-chloroaniline and p-chlorophenyl isocyanate, respectively. These results were analyzed and compared with signals from the interlaced scanning program and confirmed with high resolution mass spectrometry analysis and compared with the NIST database. The mass spectra of this precipitated after different days confirmed the evolution of byproducts with the presence of a peak m/z = 127, due to the decrease of the fragment m/z = 153, which disappeared after 180 days. A blue and a white precipitate were observed by the addition of CHX (2%) with or without polyethylene glycol, respectively, EDTA (17%) and NaOCl (5.1%) precipitates contain chlorhexidine (m/z = 505), but no PCA was detected. We confirmed that PCA is not formed directly as a byproduct of CHX oxidation, but through the formation of the para-chlorophenyl isocyanate intermediate, which degrades slowly to PCA.

Antimicrobial Assay of Chlorhexidine-Wetted Textile Napkins for Surgical Site Disinfection in Ocular Surgery

Background: As a new intraoperative disinfection method, chlorhexidine-wetted textile napkins have been employed in order to cover the upper and lower eyelid edges, eyelid skin, eyelashes, lid margins and palpebral conjunctiva during phacoemulsification cataract extraction. This study was conducted to compare the antimicrobial activity of textile napkins before and after their use. Methods: This study evaluated 80 textile napkins wetted with 0.02% aqueous solution of chlorhexidine. All textile napkins were divided into groups. The study group consisted of 60 used textile napkins which were collected from 29 patients (30 eyes) at the end of phacoemulsification, and the control group included 20 unused sterile textile napkins. Antimicrobial assay was performed by means of measuring the growth inhibition zones of the standard or clinical isolate strains under the textile napkins on the surface of agar media. Results: The number of textile napkins and the diameter of the growth inhibition zones (mm) in the study group and in the control group relating to gram-positive, gram-negative, and fungi were: 24/31 vs. 8/31, 32/30 vs. 8/30, and 4/30 vs. 4/30. The diameter of the growth inhibition zones of gram-positive bacteria was more than other investigated microorganisms. In the growth inhibition zones, exogenous microorganism colonies were not found. Conclusion: Antimicrobial activity of textile napkins wetted with 0.02% aqueous solution of chlorhexidine against gram-positive bacteria is more than gram-negative bacteria and fungi, and is preserved to the end of the phacoemulsification.

Preparation of Eri silk fibroin and gelatin blend film loaded chlorhexidine using as model for hydrophilic drug release

The objective of this research was to prepare Eri silk fibroin solution for preparing silk film loaded chlorhexidine drug as model for hydrophilic drug release. The Eri silk cocoons were boiled in 0.5%NaCO3 solution at 90℃, and then left in air dried at room temperature. The fibroin was dissolved in 9M (Ca(NO3)2) with ethanol (2 by mole) and heated at 70℃. The silk fibroin (SF) solution was then dialyzed to exclude salt in phosphate buffer. The SF and gelatin (G) solutions were mixed for preparation of films in both with and without chlorhexidine. The films were observed their morphology under scanning electron microscope. The results found that all of films were rough of their surfaces, homogeneous texture without phase separation. The native SF film composed of pores throughout the film area but did not observe in native G film. The results also showed that the SF and G can be good interacted to form hydrogen bonds. These were indicated from FTIR spectra and thermal analysis. The chlorhexidine drug has not affect on the changes of film properties. However, the releasing pattern of chlorhexidine from each film was varied. The highest rate of drug releasing was found in the native SF film while the native G film was the lowest. It might be suggested that the drug releasing rate was depended on polarity of each polymer components.

Chlorhexidine Digluconate Formulations Used for Skin Antisepsis

Aims: The representativeness of European standards phase 2, step 1 regarding bactericidal and yeasticidal activities was used for the comparison of two marketed antiseptic solutions, one containing chlorhexidine digluconate (0.5%) and the other combining chlorhexidine digluconate (0.25%), benzalkonium chloride (0.025%) and benzylic alcohol (4%). Methods: The bactericidal activity of the antiseptic solutions used pure or diluted was assessed according to the European standards NF EN 13727 and NF EN 13624 for the bactericidal and yeasticidal activity respectively. The contact time was 1 min at 20°C. Interfering substances used correspond to soiling conditions i.e. bovine serum albumin and sheep erythrocytes. A reduction of colony-forming units by ≥5 log10 was deemed to meet the requirements to conclude bactericidal activity and ≥4 log10 for yeasticidal activity. Results: Regarding all the mandatory strains, both solutions are bactericidal and yeasticidal even after a 40% dilution and even under “dirty” conditions. Conclusions: The present study demonstrated the efficient bactericidal and yeasticidal activity of aqueous solutions containing chlorhexidine digluconate either alone at a concentration of 0.5% (w/v) or at a concentration of 0.25% (w/v) when combined with benzalkonium chloride at 0.025% (w/v) and benzylic alcohol 4%. These results have to be considered regarding the respective formulations and potent allergy risks.

<i>Bacillus cereus</i>Group Exhibits More Resistant to Chlorhexidine Rather Than <i>Bacillus subtilis</i>Group

Chlorhexidine is a widely used antiseptic agent;however, its bactericidal effect against bacterial endospores is limited. The genus Bacillus is spore-forming gram-positive bacteria that are ubiquitously found in the environment and cause opportunistic infection and food poisoning. The susceptibility of bacterial endospores to chlorhexidine was previously evaluated in Bacillus subtilis, but the primary target for disinfection with antiseptic agents, including chlorhexidine, should be harmful strains. We aimed to evaluate the susceptibility of harmful cereus group including Bacillus cereus, and to compare that with harmless Bacillus species, containing B. subtilis. We evaluated the susceptibility of the 15 strains of the cereus group to chlorhexidine in comparison with the 5 other strains, named the subtilis group in this study. Our results indicated that chlorhexidine exerted a bacteriostatic effect against Bacillus species at practical concentrations, especially during long-term exposure. The strains of B. cereus group in this study displayed relatively lower susceptibility to the antiseptic than the B. subtilis group according to the minimum inhibitory and bactericidal concentrations. We concluded that there are intrinsic differences in the susceptibility to chlorhexidine between the groups, but the molecular mechanisms are unknown. The minimum inhibitory or bactericidal concentrations of disinfectants other than chlorhexidine may also need to be clarified in the B. cereus and B. subtilis groups.

Rapid HPLC Method for Determination of Parachloroaniline in Chlorhexidine Antiseptic Agent in Mouthrinses, Ophthalmic and Skin Solution

We described a simple and rapid method to quantify simultaneously chlorhexidine (CHD) and its major metabolite, para Chloroaniline (pCA) by HPLC with UV detection without the additional need of mobile-phase amine modifiers or ion-pairing reagents, with good resolution between pCA and CHD, symmetry peak of the compound and short run time. HPLC-UV analyses were performed using a Dionex? Summit liquid chromatograph (Dionex Corp, Sunnyvale, CA, USA). Chromatographic separations were carried out on a Luna? 150 mm×3 mm i.d. column packed with 3 μm CN (cyano) particles (Phenomenex?), guarded by an on-line filter. Mobile phase consist of methanol:water with sodium chloride with 0.02% of formic acid (55:45). Wavelengths for pCA and for CHD are 238 and 255 nm respectively. Influence of methanol and of sodium chloride content in the eluant has been studied. Linearity of CHD is very good, from 0.5 up to 21.2 μg/l while linearity of pCA is in the range of 0.05 to 10 μg/l with correlation coefficients above 0.999. Resolution between the components is above 4, asymmetry is about 1.3 and 1.7 for pCA and CHD respectively and the run time is less than 5 minutes. This method has been applied to CHD solution of different medical devices. No interference has been reported, and the analysis of direct injection of solution, without any treatment is achieved in less than five minutes.In conclusion, we present a validated method for dosage of CHD and its major impurity pCA, known to be carcinogen, available into medical products or medicinal device for in-vitro diagnostic.

Comparative Analysis in Vitro of the Application of blue m Oral Gel versus Chlorhexidine on Porphyromonas gingivalis:A Pilot Study

Oxygen is an essential nutrient for cellular metabolism, especially energy production. The substance is involved in multiple processes including oxidative killing of bacteria, reepithelialization, angiogenesis, and collagen synthesis. In order to test and compare the effects of the oxygen gel blue?m in vitro on Porphyromonas gingivalis, four groups were evaluated: 100% oxygen gel (B1), 75% oxygen gel (B2), 50% oxygen gel (B3), and 100% 0.12% chlorhexidine digluconate solution (C1). For this purpose, evaluations of the proportion of bacterial growth were performed, using the Agar diffusion test. The results demonstrated that blue?m at a dose of 100% and 75% is similar to chlorhexidine (p > 0.05);however blue?m at a concentration of 50% showed a lower inhibition halo when compared to chlorhexidine (p = 0.024). blue?m at higher concentrations provided inhibitory halo of Porphyromonas gingivalis similar to chlorhexidine digluconate, while blue?m at lower concentration had a lower bacterial inhibition halo compared to chlorhexidine.

Chlorhexidine溶液用於口腔護理在預防呼吸機相關性肺炎中作用的文獻複習

目的改善重症病人口腔護理的方法,提高呼吸機相關性肺炎(VAP)的預防成效,以提高預防院內感染性肺炎的成效。方法通過文獻回顧,探討Chlorhexidine用於重症病人口腔護理對减少口腔內細菌定植及預防VAP的作用,從而找出口腔護理的最佳方法,在科室內實施相關的改革,並對改革成效行總結。結果實施改革後,2011年3月~10月痰培養有菌生長率較2010年下降18.3%。結論Chlorhexidine用於口腔護理具有良好的殺菌效果,而且不容易產生耐藥菌株,是一種成本較低、操作簡便、容易使用的方法,相對於VAP的高昂代價,具有淺而易見的成本效益。

The effect of chlorhexidine on plaque index and mutans streptococci in orthodontic patients:A pilot study

Aim: The purpose of this study was to assess chlorhexidine effects on plaque index and salivary levels of mutans streptococci (MS) when used as the immersion solution for removable orthodontic appliances and added to their acrylic resin composition. Methods: Forty-five patients (6 to 12 years old) were randomly assigned into three groups with 15 patients each. Group I (control)—without orthodontic appliances disinfection;Group II—removable orthodontic appliances which had been immersed in 0.12% chlorhexidine digluconate overnight (8 hours), and Group III—orthodontic appliances in which 0.12% chlorhexidine digluconate solution had been incorporated into their resin composition. Saliva was collected for quantification of MS and evaluation of plaque index was performed before and after installation of orthodontic appliance at 0, 2, 4, 6, 8, and 10 weeks. Data were analyzed by using analysis of variance. Results: Number of MS colonies in saliva and plaque index showed no statistically differences among groups at the different periods (p > 0.05). Conclusions: It could be concluded that chlorhexidine incorporation into the acrylic resin of removable orthodontic appliances at 0.12% concentration and immersion of the appliance into 0.12% chlorhexidine solution were not effective in reducing plaque index and the number of MS in saliva.