Direct and Residual Microbicidal Efficacy of Various Antiseptics against Multi-Drug Resistant Bacteria

Background: Infections in ICU’s patients are known to often originate from the colonization of wounds by the patient’s endogenous microbiota, and to eventually lead to secondary sepsis. Aim: to compare in vitro the direct and residual effects after different exposure times of 4% chlorhexidine, and of 0.1% and 0.04% polyhexanide (in gel and solution forms), on ATCC-microorganisms, and too, on bacterial strains obtained from ICU patients. Methods: We used wild multi-drug resistant strains recently obtained from the wounds of patients hospitalized at ICU and reference strains from the American Type Culture Collection (ATCC). Chlorhexidine 4% was studied as a reference solution. The direct and residual effects of the 0.1% and 0.04% polyhexanide, in gel and solution forms, were analyzed using cotton germ carriers. To evaluate the direct effect, we exposed the strains to the antiseptic. To assess the residual effect, the germ-carriers were impregnated with antiseptic and were allowed to dry before we contaminated them. We inoculated the germ carriers in a culture medium with an inhibitor of antiseptic effect to count the number of surviving microorganisms. Findings: 0.1% Polyhexanide solution proved a direct and residual efficacy after 24 hours equivalent to 4% chlorhexidine. Is very important to highlight that this great efficacy did not change according to whether they were ATCC or multidrug-resistant strains. Conclusions: 0.1% polyhexanide demonstrated a great direct and residual efficacy (like 4% chlorhexidine), against multi-drug resistant strains isolated from ICU’s patients. Moreover, due to its few cytotoxicity against keratinocytes and fibroblasts can be an optimal antiseptic for burns, wounds or ulcers.

Antiseptic Efficacy of A Soap Made from Biosurfactants Isolated from Bacillus and Lactobacillus against Pathogenic Bacteria

The aim of our study was to use a biosurfactant produced by Bacillus and Lactobacillus isolates as an antiseptic in the formulation of local soap. A total of 60 isolates were characterized by microbiological techniques (30 Bacillus and 30 Lactobacillus) and the ability to produce biosurfactants was demonstrated by a hydrocarbon emulsification index (E24). The emulsification indexes (E24) varied from 9% to 100% for Bacillus and from 33% to 100% for Lactobacillus as well. The antagonistic assay showed that biosurfactants were able to inhibit the formation of biofilms and growth of pathogens such as Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus cereus, Salmonella typhirium, Shigella boydii and Proteus mirabilis. The biosurfactant consortium (BioC) from Bacillus consortium and from Lactobacillus was able to inhibit biofilm formation and the pathogens growth. The BioC was stable to alkaline pH and the temperatures stability of Biosurfactant was ranging from 50°C to 90°C. The soap was made by the cold saponification process using one biosurfactant consortium formulated. This soap has a pH of 10 and showed good cleaning power and good foam stability. Similarly, the soap showed good antiseptic power and disinfection power against all pathogens tested. Handwashing is critical to preventing disease transmission. The persistence of pathogens in waste water was evaluated. The BioS produced showed good disinfection power against all pathogens tested. The valor of reduction on the hands and in the waste water was significantly more than compared to the control soaps used. This soap could be used in the prevention, fighting, and treatment of bacterial and viral infections.

Hand Hygiene by Ward Staff at Dapaong Regional Hospital in Togo

Introduction: Hand hygiene (HH) is an effective way to fight infections in healthcare settings. The general purpose of our study was to explore the knowledge, attitudes and practices of health care providers on HH at Dapaong regional hospital (DRH). Methodology: This was a prospective, descriptive cross-sectional study conducted from March to June 2022 in the DRH wards. Data were collected using a questionnaire and observation grid. Results: 90 care providers were surveyed. Males and non-physician personnel predominated with 57.8%, and 94.4% respectively. The survey on staff’s knowledge reported: 31.1% of practitioners did not wash their hands on arrival and departure in services. 24% did not know the difference between simple hand washing (SHW) and hygienic hand washing (HHW). 23.3% did not know the type of soap to use for HHW. The caregivers did not know the type of hand washing (HW) required after a septic and non-septic procedure in respectively 41.6%, and 37.8%. They did not know that there are two types of hand antiseptics (45.4%), nor the amount of antiseptic for HW (78.9%). The survey on staff’s attitude regarding HW found that: 70% did not remove all jewels prior HW, and 51.1% did not know that wearing gloves cannot replace the HW. For HW Staff Practice: 62.2% did not wash their hands before treatment. 91.1% did not spread the soap on their hands and forearms after wetting them. 65.55% did not rinse hands from nails to elbows. Conclusion: The HH was poorly known, the attitude of the staff was dangerous in relation to the HH and the practice of HH was very inadequate at the RHC-Dapaong. As a result, there is a need to retrain staff to increase their capacity to prevent care-related infections and enhance patient safety in the hospital.

Antiseptic use in the neonatal intensive care unit-a dilemma in clinical practice: An evidence based review

Infants in the neonatal intensive care unit are highly susceptible to healthcare associated infections(HAI), with a substantial impact on mortality, morbidity and healthcare costs. Effective skin disinfection with topical antiseptic agents is an important intervention in the prevention or reduction of HAI. A wide array of antiseptic preparations in varying concentrations and combinations has been used in neonatal units worldwide. In this article we have reviewed the current evidence of a preferred antiseptic of choice over other agents for topical skin disinfection in neonates. Chlorhexidine(CHG) appears to be a promising antiseptic agent; however there exists a significant concern regarding the safety of all agents used including CHG especially in preterm and very low birth weight infants. There is substantial evidence to support the use of CHG for umbilical cord cleansing and some evidence to support the use of topical emollients in reducing the mortality in infants born in developing countries. Well-designed large multicentre randomized clinical trials are urgently needed to guide us on the most appropriate and safe antiseptic to use in neonates undergoing intensive care, especially preterm infants.

Topical Treatment of Infectious Vaginitis:Effects of Antibiotic,Antifungal and Antiseptic Drugs on the Growth of Normal Vaginal Lactobacillus Strains

Objectives: The balance of the vaginal ecosystem depends on lactobacilli whose biofilm protectsagainst microorganisms that are not normally present or are subdominant in vaginal flora. Vaginal?infection treatments should eliminate pathogens while preserving the?Lactobacillus?flora to prevent relapse or recurrence. The objective of this study was to determine the sensitivity of lactobacilli to antiseptics, antibiotics and antifungal agents used, alone or in combination, in the topical treatment of infectious vaginitis. Materials and Methods: The minimum inhibitory concentration (MIC) of 15 active ingredients and the minimum inhibitory dilution (MID) of 17 pharmaceuticals products were determined for three main?Lactobacillus?strains (L. crispatus,?L. gasseri?and?L. jensenii). Results: The MICs of the antibiotics and antifungal agents were above their critical concentrations in the three strains, contrary to the antiseptics. According to their MID, some pharmaceutical products, especially combinations, inhibit the growth of one or more strains at concentrations that can be found in the vaginal mucosa after application at the usual dosage. Conclusions: Certain topical anti-infective drugs may interfere with the growth of lactobacilli, worsening the vaginal flora imbalance. Maintaining vaginal flora balance should be a selection criterion when choosing an anti-infective therapy.

It’s Possible to Predict a Decreased Bactericidal Effect of Biocides, through Antibiotic Resistance in ICU: Study Using a Large Sample of Bacteria and Multivariate Analysis

Objective: To determine whether there was any association between resistance to antibiotics and decreased susceptibility to antiseptics and disinfectants and their importance in clinical practice. Methods: We studied a large number of microorganisms isolated from ICU patients (high percentage of cases of antibiotic resistance). The antibiogram (Kirby-Bauer) was determined and, in parallel, the bactericidal effect was assessed by two methods, according to the product used: 1) Effect on rough material (endodontic files) in 10 min, using five disinfectants;2) Effect on a skin equivalent (sterile cotton cloth) in 30 sec, for two alcohol solutions. A predictive equation of the bactericidal effects versus microorganisms’ antibiogram was obtained by multivariate methods. Results:?Bactericidal efficacy was very similar for all the products with the exception of 1% povidone-iodine. Within each product there were no significant differences between the three groups of microorganisms: “Enterobacteria”, “Non Fermentative Gram Negative Bacteria” and “cocci”. Multivariate study only obtained one significant equation: 1% chlorhexidine resistance was directly correlated with aztreonam resistance (OR = 2.16), while resistance to imipenem and to phosphomycin acted as protection factors (OR < 1). Conclusion: There is no necessary to change the indications for antiseptics or disinfectants in ICUs, except if aztreonam resistance is high. In which caseis better to use greater concentration than 1% of Chlorhexidine.

Wound irrigation for preventing surgical site infections

Wound irrigation(i.e.washing out a wound before wound closure)aims to reduce the microbial burden by removing tissue debris,metabolic waste,and tissue exudate from the surgical field before site closure.Although it is a popular procedure in every day surgical practice,the lack of procedure standardization,leads to studies with high heterogeneity and often controversial results.Thus,there are studies that advocate its use,while others discourage its implementation in clinical practice to reduce the risk of surgical site infection.The present article reviews the current literature on wound irrigation for preventing surgical site infections.Several irrigants are presented.Chlorexidine is generally considered to be less effective than povidone-iodine,while antibiotics are not that common nowadays,as they require prolonged exposure with the target to act.Hydrogen peroxide has several potential complications,which eliminate its use.Any differences in the incidence of surgical site infections between different irrigants,especially between antibacterial and non-bacterial ones,should be viewed sceptically.More randomized controlled studies are needed to provide better quality of evidence regarding the irrigants'effectiveness and safety.

GC-MS监测生活饮用水输配水管材及防护材料中溶出的挥发性有机物

我国的生活饮用水行业中,目前常使用的管材分为金属类管材和非金属类管材两种.由于金属类管材本身的化学特性,行业内必须在此类管材的内壁上进行防腐处理,通常采用一些高分子防腐涂料.……

Promoting wound healing effect of the extract of callicarpa nudiflora and preparation technology of the external ointment

Objective: To study the effect of the extracts from Callicarpa nudiflora on wound healing and the preparation of ointment. Methods: Totally 50 KM mice were randomly divided into five groups, which were negative control group ,positive control group, high, middle and low dose groups of Callicarpa nudiflora ointment. Mice ear swelling test was conducted to investigate the effect of Callicarpa nudiflora induced by xylene, Bacteriostasis experiments were conducted to observe the bacteriostasis effects of Callicarpa nudiflora on five indicator bacteria, i.e. Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Bacillus subtilis, and Staphylococcus aureus in vitro. A total of 30 new zealand white rabbit with half male and half female were randomly divided into five groups, which were negative control group, positive control group, high, middle and low groups of Callicarpa nudiflora ointment. The rabbits were treated with sterilizing blade and treated with external medicine to observe the effect of the extracts from Callicarpa nudiflora on wound healing. Orthogonal test was used to determine the preparation method of Callicarpa nudiflora ointment,Physical properties, centrifugal stratification test, heat and cold resistance test were conducted. Results:Bacteriostasis experiments in vitro showed high dose group of Callicarpa nudiflora extracts got 16.8 cm antimicrobial zone of Pseudomonas aeruginosa. The experimental results showed that the ear swelling degree of mice induced by xylene was significantly reduced in the middle and high dose groups. All the treatment groups could promote skin healing of rabbit significantly compared with negative control group. There were significantly differences between all the treatment groups and negative control group on the wound healing rate. The optimum preparation process was determined by orthogonal screening test. The optimal formula was as follows: Twain-801.2 g, glycerin monostearate 4.7 g, glycerinum 0.9 g, liquid paraffin 10.8 g, Span801.4 g,solid paraffin 1.4 g,vaseline 0.9 g. The emulsification temperature was 65 ℃,and emulsification time was 25 min. Conclusions: The extract of Callicarpa nudiflora can be used as external preparation and the preparation is in compliance with Chinese pharmacopoeia 2015.

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 technology in orthopedic and spinal implants

Infections can hinder orthopedic implant function and retention.Current implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial adhesion.Several emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems,material science,immunology,and polymer chemistry are in development and early clinical use.This review outlines orthopedic implant antimicrobial technology,its current applications and supporting evidence,and clinically promising future directions.

Experimental study on disinfection effect of different dose of rapid hand disinfectant

Purpose:To investigate the appropriate antiseptic handrubbing method.Methods:Seventy-four clinical nurses were randomly divided into two groups based on the number of disinfectant presses used,with group 1 using one-press and group 2 using twopresses.Sterilizing effects as a function of presses were compared and analyzed between the two groups.Results:Prior to hand disinfection,the hand sampling region resulted in 72 colony forming units for the 74 nurses.Following disinfection,only 2 colony forming units(p<0.001)were found.The analysis of drying time effects on the disinfection rate between the two groups showed a significant difference(p?0.049).Conclusion:In an effort to reduce the incidence of nosocomial infection,the medical personnel should sufficiently dry hands following handrubbing with disinfectant in a strict accordance with the six part washing technique for antiseptic handrubbing.

The Effect of Antiseptic Cream Myogenic on Expression Levels of VEGF and bFGFmRNA in the Wounded Tissue

[ Objective] The mechanism of antiseptic cream myogenic was revealed from the angle of cytokines to provide theoretical basis for clini- cal application. [ Method] Experiment with Wistar rats were studied, by detecting indicators such as the expression level of VEGF and bFGFmRNA of skin coloboma model rats wound tissue. [ Result] The results showed that： Antiseptic cream myogenic can improve VEGF and bFGFmRNA levels of the wound tissue,[Conclusion] Antiseptic cream myogenic can promote the proliferation and differentiation of vascular endothelial call and fibro- blast, and thus promote wound healing.

Polyhexamethylene Biguanide in Vaginal Solution Is Effective in the Treatment of Vulvovaginal Candidiasis: A Pilot Study

Vaginitis is one of the most recurrent conditions that afflict women and require medical care. Vulvovaginal candidiasis (VVC) is frequently related to vaginal carriage of Candida albicans, an opportunistic polymorphic fungus, which colonizes the human skin, the mucosa and the reproductive tract. Actually, standard treatments to counteract vaginitis include several topical and oral treatments. The aim of this study was to evaluate the efficacy of a new biguanide compound, polyhexamethylene biguanide (PHMB) in avaginal solution, in women affected by vaginal candidiasis. For this reason, 40 women showing the symptoms previously ascribed to vaginal candidiasis were recruited and treated with a single PHMB dose of vaginal solution. After a single dose of treatment, 80% of them had a complete resolution of the fungal infection;furthermore, all of them reported clinical benefits, statistically significant reduction in both clinical signs and symptoms of candidiasis and a score’s reduction of 50%.

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.

Effectiveness of Dosage Forms with Flurenizide in Preventive Care and Treatment of Dangerous and Controlled Infectious Diseases

Creation of an efficient and safe medication is based on the knowledge of the world＇s best achievements in medicine and pharmacy. Development of new original medications and dosage forms, study of their specific medicinal properties, application and advantages over well-known brands are important for achieving a high quality medical assistance. The innovative product----original Ukrainian substance Flurenizide served as the basis for new dosage forms （solid, semisolid and liquid） intended for preventive care and treatment of dangerous and controlled infectious diseases for human and veterinary medicine.

To Investigate the Effect of Using Ethanol Containing Wipes in Collecting Blood for the Measurement of Alcohol Concentration

This study was aimed to establish whether the skin preparation using ethanol-containing skin antiseptics causes ethanol contamination through blood collection. Venous blood was collected from 40 healthy volunteers according to the national guidelines for blood sampling, with four sequential procedures as follows: 1) collecting blood immediately (within 5 seconds) after cleaning the skin with an individually packaged type of ethanol-containing wipe, 2) collecting blood 1 minute after cleaning the skin with an individually packaged type of ethanol-containing wipe, 3) collecting immediately (within 5 seconds) after cleaning the skin with a traditional cleaning method (thoroughly ethanol-impregnated wipe, and 4) collecting 1 minute after cleaning the skin with a traditional cleaning method. Each sequential procedure was performed with and without the ethanol-containing wipe used for skin cleaning on the puncture site on their right and left arms at the time the needle was withdrawn, respectively. The collected specimens were subjected to the determination of ethanol by using headspace gas chromatography-mass spectrometry. In every 80 blood specimens obtained from 40 participants, ethanol was undetectable (<0.001 mg/mL). This study demonstrates that disinfection using ethanol-containing skin antiseptics is unlikely to cause ethanol contamination through blood collection regardless of skin preparation technique according to the guidelines for blood sampling. This may have implications in forensic science.

Correlation of the antiseptic resistance in Acinetobacter baumannii and the antiseptic resistance gene qacEΔ1 located in classⅠintegron

In the past decade, uses of antiseptics and disinfectants in hospitals and other health care centers are rather common, but the chance to develop resistance to antiseptics and disinfectants is also increased. Acinetobacter baumannii is one of the opportunistic bacteria involving in the nosocomial infection. In the present study, the correlation of the antiseptic resistance in A. baumannii and the antiseptic resistance gene qacEΔ 1 was investigated by means of determination of MICs. Meanwhile, the MICs of glutaraldehyde, chlorhexidine, benzalkonium bromide, iodophor and trichloroisocyanurate to 80 clinical isolates of A. baumannii were detected by tube dilution assay and the resistance genes intll and qacE Δ 1 in these isolates were amplified by PCR and verified by DNA sequencer. It was found that the MIC50 for these 5 antiseptics tested were 32, 8, 8, 4 and 1 μg/ml respectively, and the detection rates of intll and qacEΔ1 gene were 60.0% and 77.6% respectively. In addition, 55% of the 80 isolates simultaneously possessed both intll and qacEΔ1 gene, and the percentage of antiseptic resistance of A. baumannii carring both genes to benzalkonium bromide were higher than that without these two genes, however, there was no significant difference between intll and qacEΔ1 gene. The result in bactericidal efficiency assay indicated that chlorhexidine could still produce rapid and strong bactericidal effect at concentration of 1 MIC after 10 rain exposure. These results suggest that the antiseptic resistance of A. baumannil to various antiseptics is correlated with the presence of the antiseptic resistance genes qacEΔ 1 in bacteria, thus warning that the increase of the antiseptic resistance should not be ignored and the relative high concentration or prolonged application time is required to achieve a sufficient bactericidal effect.