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Soni SK, Marya T, Sharma A, Thakur B, Soni R. A systematic overview of metal nanoparticles as alternative disinfectants for emerging SARS-CoV-2 variants. Arch Microbiol 2024; 206:111. [PMID: 38372809 DOI: 10.1007/s00203-023-03818-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/16/2023] [Accepted: 12/25/2023] [Indexed: 02/20/2024]
Abstract
Coronaviruses are a diverse family of viruses, and new strains can emerge. While the majority of coronavirus strains cause mild respiratory illnesses, a few are responsible for severe diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). SARS-CoV-2, the virus responsible for COVID-19, is an example of a coronavirus that has led to a pandemic. Coronaviruses can mutate over time, potentially leading to the emergence of new variants. Some of these variants may have increased transmissibility or resistance to existing vaccines and treatments. The emergence of the COVID-19 pandemic in the recent past has sparked innovation in curbing virus spread, with sanitizers and disinfectants taking center stage. These essential tools hinder pathogen dissemination, especially for unvaccinated or rapidly mutating viruses. The World Health Organization supports the use of alcohol-based sanitizers and disinfectants globally against pandemics. However, there are ongoing concerns about their widespread usage and their potential impact on human health, animal well-being, and ecological equilibrium. In this ever-changing scenario, metal nanoparticles hold promise in combating a range of pathogens, including SARS-CoV-2, as well as other viruses such as norovirus, influenza, and HIV-1. This review explores their potential as non-alcoholic champions against SARS-CoV-2 and other pandemics of tomorrow. This extends beyond metal nanoparticles and advocates a balanced examination of pandemic control tools, exploring their strengths and weaknesses. The manuscript thus involves the evaluation of metal nanoparticle-based alternative approaches as hand sanitizers and disinfectants, providing a comprehensive perspective on this critical issue.
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Affiliation(s)
- Sanjeev Kumar Soni
- Department of Microbiology, Panjab University, Chandigarh, 160014, India.
| | - Tripta Marya
- Department of Microbiology, Panjab University, Chandigarh, 160014, India
| | - Apurav Sharma
- Department of Microbiology, Panjab University, Chandigarh, 160014, India
| | - Bishakha Thakur
- Department of Microbiology, Panjab University, Chandigarh, 160014, India
| | - Raman Soni
- Department of Biotechnology, DAV College, Chandigarh, 160011, India
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Mahmudiono T, Ramaiah P, Maleki H, Doewes RI, Shalaby MN, Alsaikhan F, Mohammadi MJ. Evaluation of the impact of different disinfectants on new coronavirus and human health. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 38:451-460. [PMID: 35508445 DOI: 10.1515/reveh-2022-0051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/17/2022] [Indexed: 02/07/2023]
Abstract
A new health threat was appeared in 2019 known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19). The new coronavirus distributed all over the world and caused millions of deaths. One way to incomplete the process of COVID-19 transfer from one person to another is using disinfectants. A narrative review study was done on manuscript published documents about the stability of the virus, different types of disinfectants and the effects of disinfectants on SARS-CoV2 and environment from 2005 to 2022 based on Searched databases included Google Scholar, Springer, PubMed, Web of Science and Science Direct (Scopus). All relevant studies published 2005 until 2022 gathered. According to the databases, 670 articles were retrieved. Thirty studies were screened after review and 30 full-text articles entered into the analysis process. Finally, 14 articles were selected in this study. New coronavirus could survive until 9 days in room temperature; the surviving time decreases if temperature increases. The virus can survive in various plastic, glass, and metal surfaces for hours to days. Disinfectants, such as alcohol, isopropanol, formaldehyde, glutaraldehyde, and ethanol, can kill 70-90% viruses in up to 30 s but should be noted that these disinfectants are recognized by Occupational Safety and Health Administration (OSHA) as a potential carcinogen. According to the different reports, increased duration and level of disinfectant exposure can have negative impacts on human and animal health including upper and lower respiratory tract irritation, inflammation, edema, ulceration, and allergic reactions.
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Affiliation(s)
- Trias Mahmudiono
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | | | - Heydar Maleki
- Department of Environmental Health Engineering, School of Public Health, Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Mohammed Nader Shalaby
- Biological Sciences and Sports Health Department, Faculty of Physical Education, Suez Canal University, Ismailia, Egypt
| | - Fahad Alsaikhan
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia
| | - Mohammad Javad Mohammadi
- Department of Environmental Health Engineering, School of Public Health and Environmental Technologies Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Garrido L, Lyra P, Rodrigues J, Viana J, Mendes JJ, Barroso H. Revisiting Oral Antiseptics, Microorganism Targets and Effectiveness. J Pers Med 2023; 13:1332. [PMID: 37763100 PMCID: PMC10532628 DOI: 10.3390/jpm13091332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/24/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
A good oral health status is mostly dependent on good oral hygiene habits, which knowingly impacts systemic health. Although controversial, chemical oral antiseptics can be useful in adjunct use to mechanical dental plaque control techniques in the prevention and management of local and overall health and well-being. This review aims to revisit, gather and update evidence-based clinical indications for the use of the most popular oral antiseptics, considering different types, microorganism targets and effectiveness in order to establish updated clinical recommendations.
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Affiliation(s)
| | | | | | | | | | - Helena Barroso
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, 2829-511 Almada, Portugal (P.L.); (J.V.); (J.J.M.)
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Farooq H, Saleem S, Haq FU. Antibacterial assessment of commercially available hand sanitizers in Pakistan by EN-1500. Infect Dis Health 2023; 28:195-201. [PMID: 37005216 DOI: 10.1016/j.idh.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND The effectiveness of hand sanitizers marketed to the general population is essential for infection prevention and control. Main theme of the study was that whether the commercially available hand sanitizers meet the WHO recommended standards in terms of efficacy? Current study aims to investigate the efficacy of ten commercially available hand sanitizers. METHODS The methodology was based on European Standard EN-1500. Following the artificial contamination of hands, pre and post samples were obtained to determine the log reduction values for each sanitizer. RESULTS The results showed that out of ten only one sanitizer showed highest log reduction which was comparable to the reference product. Product B was most efficient in sanitization of hands with mean log reduction of 6.00 ± 0.15. The lowest sanitization efficacy was recorded for product F with mean log reduction of 2.40 ± 0.51, however the reference product 2-propanol result in mean log reduction of 6.0 ± 0.00. The products used in this study show a statistical significant results (p value: < 0.01). CONCLUSION It is concluded that only one product showed active sanitizer efficacy. This study provides an important insight for manufacturing company and authorizing authorities to assess the efficacy of hand sanitizer. Hand sanitization is one approach to stop the spread of diseases carried on by harmful bacteria inhabiting our hands. Apart from the manufacturing strategies, ensuring proper use and quantity of hand sanitizers is very important.
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Affiliation(s)
- Hajra Farooq
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan.
| | - Sidrah Saleem
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan.
| | - Faiz Ul Haq
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan.
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Hasan F, Chiu HY, Salamanca E, Ridwan ES, Wiratama BS, Budi HS. Effects of Chlorhexidine and Povidone-Iodine on the SARS-CoV-2 Load: A Systematic Review and Meta-analysis. Eur J Dent 2023; 17:587-601. [PMID: 36075270 PMCID: PMC10569867 DOI: 10.1055/s-0042-1753470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
The efficacy of mouthwash for reducing the viral load in patients with the novel coronavirus disease 2019 (COVID-19) remains unclear. This systematic review and meta-analysis comprehensively examined the effects of chlorhexidine (CHX) and povidone-iodine (PVP-I) on the viral load in patients with COVID-19. We performed methodological analysis, systematic review, and meta-analysis of included studies using the Comprehensive Meta-analysis Software. PubMed, EMBASE, Cochrane Library, and ProQuest were searched from December 1, 2019, to December 2, 2021. In total, we included 10 studies of 1,339 patients with COVID-19. Compared with the control group, both CHX and PVP-I significantly reduced the number of negative reverse-transcription polymerase chain reaction (RT-PCR) results (p<0.001) among COVID-19 patients. The CHX and PVP-I were effective on reducing the number of negative RT-PCR results in COVID-19 patients. Additional studies using adequate randomization methods and larger samples are warned.
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Affiliation(s)
- Faizul Hasan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Eisner Salamanca
- School of Dentistry, College of Dentistry, Taipei Medical University, Taipei, Taiwan
| | - Edi S. Ridwan
- School of Nursing, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia
| | - Bayu S. Wiratama
- Department of Epidemiology, Biostatistics and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia
| | - Hendrik S. Budi
- Department of Oral Biology, Dental Pharmacology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
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Prophylaxis of Ocular Infection in the Setting of Intraocular Surgery: Implications for Clinical Practice and Risk Management. Ophthalmol Ther 2023; 12:721-734. [PMID: 36719608 PMCID: PMC10011360 DOI: 10.1007/s40123-023-00661-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/19/2023] [Indexed: 02/01/2023] Open
Abstract
In this review we discuss the role of intraocular surgery preoperative prophylaxis. The correct choice of antimicrobial drug is variable in each surgical setting, according to the available strengths of evidence, the anatomical district involved, and the type of procedure. In the ophthalmic surgical field, there has been a progressive shift from antibiotic formulations, which are known to cause antibiotic resistance, to a new class of antiseptic compounds, which proved to be effective not only against bacteria, but also against fungi, protozoa, and viruses. Among these, povidone-iodine (PVI) is a water-soluble polymer that can form a complex with iodine, and the perioperative application of PVI 5-10% eye drop for 3 min is the gold standard for infection prophylaxis. A new formulation of 0.6% PVI eye drop is a new option for infection prophylaxis in the days before surgery. Chlorhexidine is a biguanide compound, which is a valid alternative with a good safety and efficacy profile and is the antiseptic of choice in patients with iodine allergy. New compounds that are currently being studied include polyhexamethylene biguanide (PHMB), picloxydine, ozone, hypochlorous acid (HOCl), and Biosecur. PHMB is a biguanide polymer that was found to be more effective than PVI in in vitro studies for reducing microorganisms and extending the duration of antisepsis, but to date, there are no formulations available on the market for preoperative ocular surgery in which it is present as main ingredient. Ozone is a molecule with oxidizing effect, which showed interesting preliminary results but is not effective against virus, Staphylococcus aureus and Candida albicans. HOCl has a natural bactericidal propriety but its applicability to prophylaxis of ocular infection in the setting of ocular surgery is not established. Biosecur is a non-toxic organic alcohol-free compound that exhibited bactericidal and fungicidal effect versus all common microorganisms and is currently available as an ocular spray.
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In vivo efficacy of alcohol based hand rubs against noroviruses: A novel standardized European test method simulating practical conditions. J Hosp Infect 2023; 135:186-192. [PMID: 36921629 DOI: 10.1016/j.jhin.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/20/2023] [Accepted: 03/05/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Non-enveloped viruses are particularly resistant to disinfectants, so to prevent and control the spread of virus infections, disinfectants with proven virucidal activity must be used. However, a test such as EN 1500, which uses an internal standard as reference treatment for determining the bactericidal efficacy of hand rubs, is still lacking. We aimed to establish a European standard for testing the in vivo efficacy of hand rubs against non-enveloped viruses. METHOD First, concentration and mode of application of ethanol as reference were determined. Afterwards, the efficacies of two commonly used hand rubs were compared to this reference. Hands of volunteers were contaminated with the murine norovirus strain S99. RESULTS 70% wt/wt ethanol (2 x 3 mL in 2 x 30 seconds) was defined as internal reference treatment. The commercial ethanol based hand rub could significantly reduce the titre of norovirus in 30 seconds whereas a rub based on ethanol and propan-2-ol was significantly less effective compared to the reference. CONCLUSION We have established a possible standard for testing the in vivo efficacy of hand rubs against non-enveloped viruses using murine norovirus, a low contamination volume technique and ethanol as internal reference. Nevertheless our findings have to be confirmed in European ring trials.
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Chadwick PR, Trainor E, Marsden GL, Mills S, Chadwick C, O'Brien SJ, Evans CM, Mullender C, Strazds P, Turner S, Weston V, Toleman MS, de Barros C, Kontkowski G, Bak A. Guidelines for the management of norovirus outbreaks in acute and community health and social care settings. J Hosp Infect 2023:S0195-6701(23)00043-9. [PMID: 36796728 DOI: 10.1016/j.jhin.2023.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/19/2023] [Accepted: 01/22/2023] [Indexed: 02/17/2023]
Affiliation(s)
| | - Eamonn Trainor
- Northern Care Alliance NHS Foundation Trust, Greater Manchester, UK.
| | - Gemma L Marsden
- Healthcare Infection Society, London, UK; Royal College of General Practitioners, London, UK
| | - Samuel Mills
- British Infection Association, Seafield, West Lothian, UK; Oxford University NHS Foundation Trust, Oxford, UK
| | | | | | - Cariad M Evans
- Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | | | - Pixy Strazds
- Infection Prevention Society, London, UK; St Andrew's Healthcare, Northampton, UK
| | - Sarah Turner
- Infection Prevention Society, London, UK; Stockport Council, Stockport, UK
| | - Valya Weston
- Healthcare Infection Society, London, UK; Infection Prevention Society, London, UK; NHS England, London, UK
| | - Michelle S Toleman
- Healthcare Infection Society, London, UK; Cambridge University Hospitals NHS Trust, Cambridge, UK
| | | | | | - Aggie Bak
- Healthcare Infection Society, London, UK
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Maciel PP, de Lima Gouveia C, Marques IL, Maciel PP, Lima JMD, Castellano LRC, Bonan RF, Bonan PRF, Batista AUD. Antimicrobial effect and the mechanical and surface properties of a self-disinfecting and a chlorhexidine-incorporated Type IV dental stone. J Prosthet Dent 2023; 129:365.e1-365.e8. [PMID: 36462969 DOI: 10.1016/j.prosdent.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 12/05/2022]
Abstract
STATEMENT OF PROBLEM Stone casts are subject to contamination, but whether disinfectants incorporated into the stone are effective is unclear. PURPOSE The purpose of this in vitro study was to evaluate the antimicrobial activity and the mechanical and surface properties of self-disinfecting gypsum (SDG) and gypsum mixed with 2% chlorhexidine (GCHX). MATERIAL AND METHODS Antimicrobial action was evaluated using the diffusion-disk technique on Streptococcus aureus and Candida albicans 1 hour and 24 hours after pouring the gypsum. The groups were SDG, GCHX, a positive control (PC) of gypsum mixed with distilled water, and a negative control (NC) of filter paper disk soaked with 2% chlorhexidine; n=8. Inhibition halos were measured using the ImageJ software program and statistically analyzed using the repeated measures mixed ANOVA with time×group interaction. Compressive strength (CS) in MPa and surface roughness (SR) in μm (parameters: Ra - roughness average; and Sa - 3-dimensional (3D) arithmetic mean of the surface profile) tests were performed to characterize the specimens (evaluated groups: SDG, GCHX, and PC; n=10). CS data were analyzed by a 2-way ANOVA with time×group interaction, and SR data by a 1-way ANOVA (α=.05). RESULTS For S aureus, there were differences between GCHX and SDG at 1 hour and 24 hours (P<.05), but no significant differences were found for C albicans (P>.05). GCHX was better than PC, except for C albicans, and showed a reduction in CS when compared with PC and SDG (P<.05) at all time intervals. The SR of GCHX increased (Ra:1.76, Sa:2.08) when compared with PC (Ra:0.89, Sa:1.12) and SDG (Ra:1.03, Sa:1.35) (Ra: P<.004 and Sa: P<.001). CONCLUSIONS The antimicrobial activity of GCHX against S aureus was better than that of SDG, but neither had an effect against C albicans. As for CS and SR, GCHX presented a decrease in properties when compared with PC and SDG but was within the American Dental Association #25 specification values.
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Affiliation(s)
- Panmella Pereira Maciel
- Postgraduate student, Postgraduate Program in Dentistry, Universidade Federal da Paraíba (UFPB), Paraíba, Brazil.
| | - Cíntia de Lima Gouveia
- Researcher, Postgraduate Program in Dentistry, Universidade Federal da Paraíba (UFPB), Paraíba, Brazil
| | - Iasmin Lima Marques
- Graduate student, Department of Restorative Dentistry, Universidade Federal da Paraíba (UFPB), Paraíba, Brazil
| | - Patrícia Pereira Maciel
- Researcher, Postgraduate Program in Dentistry, Universidade Federal da Paraíba (UFPB), Paraíba, Brazil
| | - Jeferson Muniz de Lima
- Researcher, School of Dentistry, Universidade Federal de Pernambuco (UFPE), Pernambuco, Brazil
| | | | - Roberta Ferreti Bonan
- Researcher, School of Dentistry, Universidade Federal de Pernambuco (UFPE), Pernambuco, Brazil
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López A, Burgos T, Vanegas M, Álvarez Z, Mendez Y, Quinteros E. Factors associated with microbiological contamination of chicken meat marketed in El Salvador. Rev Peru Med Exp Salud Publica 2023; 40:25-33. [PMID: 37377232 PMCID: PMC10953630 DOI: 10.17843/rpmesp.2023.401.12100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 03/01/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE. To determine the hygienic-sanitary factors associated with the microbiological contamination of chicken meat sold at the municipal markets of El Salvador. MATERIALS AND METHODS. An analytical cross-sectional study was conducted in 33 municipal markets of the 14 departmental capitals of El Salvador. The sample consisted of 256 out of 456 possible market stalls. A sample of chicken meat was obtained from each market stall. The microbiological analysis was conducted at the National Public Health Laboratory. Frequencies, percentages, measures of central tendency and association were calculated with SPSS version 21. RESULTS. Escherichia coli was found in 74% of the samples, Staphylococcus aureus in 24% and Salmonella spp. in 1%. The presence of Salmonella spp. was associated with not using hand sanitizer and not using towels for drying the hands. S. aureus was associated with the use of personal accessories and improper storage. The presence of S. aureus was associated with the lack of hand washing, not using a towel to dry the hands and not wearing an apron. CONCLUSION. The hygienic-sanitary conditions of the handlers and the market stalls were associated with microbiological contamination of chicken meat marketed in El Salvador.
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Affiliation(s)
- Alejandro López
- National Institute of Health of El Salvador, San Salvador, El Salvador. National Institute of Health of El SalvadorSan SalvadorEl Salvador
| | - Tatiana Burgos
- Faculty of Chemistry and Pharmacy, Universidad de El Salvador, San Salvador, El Salvador.Faculty of Chemistry and PharmacyUniversidad de El SalvadorSan SalvadorEl Salvador
| | - Marcela Vanegas
- National Institute of Health of El Salvador, San Salvador, El Salvador. National Institute of Health of El SalvadorSan SalvadorEl Salvador
| | - Zaida Álvarez
- National Institute of Health of El Salvador, San Salvador, El Salvador. National Institute of Health of El SalvadorSan SalvadorEl Salvador
| | - Yudy Mendez
- National Institute of Health of El Salvador, San Salvador, El Salvador. National Institute of Health of El SalvadorSan SalvadorEl Salvador
| | - Edgar Quinteros
- National Institute of Health of El Salvador, San Salvador, El Salvador. National Institute of Health of El SalvadorSan SalvadorEl Salvador
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Dickinson D, Marsh B, Shao X, Liu E, Sampath L, Yao B, Jiang X, Hsu S. Virucidal activities of novel hand hygiene and surface disinfectant formulations containing EGCG-palmitates (EC16). Am J Infect Control 2022; 50:1212-1219. [PMID: 35671844 PMCID: PMC9912545 DOI: 10.1016/j.ajic.2022.05.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Non-toxic hand hygiene and surface disinfectant products with virucidal activity against alcohol-resistant nonenveloped norovirus are in urgent need. METHOD Alcohol-based formulations were made with epigallocatechin-3-gallate-palmitate (EC16), an FDA accepted food additive. Based on in-house testing of formulations, 3 prototypes, PTV80 hand gel, PST70 surface disinfectant spray and PST70 surface disinfectant wipe, were selected from in-house tests for independent testing at GLP (good laboratory practice) laboratories according to EN 14476:2019 (hand gel), ASTM test method E1053-20 (spray), and ASTM E2362-15, E1053, and ASTM E2896-12 (wipe). RESULTS The PTV80 hand gel prototype demonstrated a >99.999% reduction of murine norovirus S99 infectivity in 60 seconds. Carrier testing of the PST70 surface spray and surface wipe demonstrated reduction of feline calicivirus infectivity by >99.99% in 60 seconds. In addition, testing with human coronavirus and human herpes simplex virus demonstrated >99.99% efficacy in 60 seconds, consistent with broad spectrum virucidal activity. CONCLUSIONS The novel non-toxic prototypes containing EC16 were found to be suitable for use in future hand sanitizer gel, surface disinfectant spray and wipe products against norovirus. Products based on these formulations could be used safely to help prevent and control norovirus and other emerging virus outbreaks, pending future studies.
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Affiliation(s)
| | - Bianca Marsh
- Department of Oral Biology & Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | | | - Emma Liu
- Department of Oral Biology & Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | | | - Bo Yao
- Changxing Sanju Biotech Co., Ltd. Hang Zhou, China
| | | | - Stephen Hsu
- Camellix Research Laboratory, Augusta, GA, USA; Department of Oral Biology & Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, USA.
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Sharma P, Singh A, Singh NP, Takhelchangbam N, Kumar R, Yadav R. Effect of 0.5% povidone-iodine on the nasopharyngeal and oropharyngeal viral loads in patients with COVID-19: A double-blind placebo-controlled randomized clinical trial. J Family Med Prim Care 2022; 11:6320-6326. [PMID: 36618132 PMCID: PMC9810934 DOI: 10.4103/jfmpc.jfmpc_446_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/11/2022] Open
Abstract
Background and Objective The povidone-iodine (PvP-I) nasal antiseptic has been shown to completely inactivate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro at variable concentrations. This study was performed to investigate the effect of 0.5% PvP-I nasal drops and oral gargles on the nasopharyngeal and oropharyngeal viral loads in SARS-CoV-2-positive patients. Methods This was a double-blind, placebo-controlled, randomized clinical trial among patients aged ≥18 years with reverse-transcriptase polymerase chain reaction confirmed in the mild to moderate category of SARS-CoV-2 infection. A total of 32 patients were randomly assigned to receive either freshly prepared 0.5% PvP-I solution or distilled water in the form of supervised self-administered 4-5 nasal drops, followed by 20 ml for gargling for at least 30 seconds. The main outcome measure was the mean change in viral titer and Ct values in the nasopharyngeal and oropharyngeal samples at baseline, 5 minutes, and 3 hours post intervention. Results The mean change in viral titers across the time duration for the test group when compared with the control group was not statistically significant (P = 0.109). However, the mean change in Ct value was found to be borderline statistically significant (P = 0.042). Noticeable differences were noted among the mean viral titers and Ct values in the intervention group when plotted against the time of testing as compared to the control group. PvP-I solution at 0.5% dilution was well tolerated, and no evident side effects were reported. Conclusions This study shows that 0.5% PvP-I has an effect on reducing nasopharyngeal and oropharyngeal viral loads in COVID-19 patients. This can be of substantial aid for the primary care physicians, especially for the practitioners in remote and resource poor areas.
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Affiliation(s)
- Pranav Sharma
- Department of Orthopaedics, Uttar Pradesh University of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Amit Singh
- Department of Microbiology, Uttar Pradesh University of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Naresh Pal Singh
- Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Nilima Takhelchangbam
- Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Lucknow, Uttar Pradesh, India,Address for correspondence: Dr. Nilima Takhelchangbam, Department of Community Medicine, UPUMS, Saifai, Etawah, Uttar Pradesh - 206 130, India. E-mail:
| | - Raj Kumar
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ramakant Yadav
- Department of Neurology, Uttar Pradesh University of Medical Sciences, Lucknow, Uttar Pradesh, India
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Xiao S, Yuan Z, Huang Y. Disinfectants against SARS-CoV-2: A Review. Viruses 2022; 14:v14081721. [PMID: 36016342 PMCID: PMC9413547 DOI: 10.3390/v14081721] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/22/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
The pandemic due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged as a serious global public health issue. Besides the high transmission rate from individual to individual, indirect transmission from inanimate objects or surfaces poses a more significant threat. Since the start of the outbreak, the importance of respiratory protection, social distancing, and chemical disinfection to prevent the spread of the virus has been the prime focus for infection control. Health regulatory organizations have produced guidelines for the formulation and application of chemical disinfectants to manufacturing industries and the public. On the other hand, extensive literature on the virucidal efficacy testing of microbicides for SARS-CoV-2 has been published over the past year and a half. This review summarizes the studies on the most common chemical disinfectants and their virucidal efficacy against SARS-CoV-2, including the type and concentration of the chemical disinfectant, the formulation, the presence of excipients, the exposure time, and other critical factors that determine the effectiveness of chemical disinfectants. In this review, we also critically appraise these disinfectants and conduct a discussion on the role they can play in the COVID-19 pandemic.
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Affiliation(s)
- Shuqi Xiao
- Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430020, China
| | - Zhiming Yuan
- National Biosafety Laboratory, Chinese Academy of Sciences, Wuhan 430020, China
| | - Yi Huang
- National Biosafety Laboratory, Chinese Academy of Sciences, Wuhan 430020, China
- Correspondence:
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14
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Kramer A, Arvand M, Christiansen B, Dancer S, Eggers M, Exner M, Müller D, Mutters NT, Schwebke I, Pittet D. Ethanol is indispensable for virucidal hand antisepsis: memorandum from the alcohol-based hand rub (ABHR) Task Force, WHO Collaborating Centre on Patient Safety, and the Commission for Hospital Hygiene and Infection Prevention (KRINKO), Robert Koch Institute, Berlin, Germany. Antimicrob Resist Infect Control 2022; 11:93. [PMID: 35794648 PMCID: PMC9257567 DOI: 10.1186/s13756-022-01134-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The approval of ethanol by the Biocidal Products Regulation has been under evaluation since 2007. This follows concern over alcohol uptake from ethanol-based hand rubs (EBHR). If ethanol is classified as carcinogenic, mutagenic, or reprotoxic by the European Chemicals Agency (ECHA), then this would affect infection prevention and control practices. AIM A review was performed to prove that ethanol is toxicological uncritical and indispensable for hand antisepsis because of its unique activity against non-enveloped viruses and thus the resulting lack of alternatives. Therefore, the following main points are analyzed: The effectiveness of ethanol in hand hygiene, the evidence of ethanol at blood/tissue levels through hand hygiene in healthcare, and the evidence of toxicity of different blood/tissue ethanol levels and the non-comparability with alcoholic consumption and industrial exposure. RESULTS EBHR are essential for preventing infections caused by non-enveloped viruses, especially in healthcare, nursing homes, food industry and other areas. Propanols are effective against enveloped viruses as opposed to non-enveloped viruses but there are no other alternatives for virucidal hand antisepsis. Long-term ingestion of ethanol in the form of alcoholic beverages can cause tumours. However, lifetime exposure to ethanol from occupational exposure < 500 ppm does not significantly contribute to the cancer risk. Mutagenic effects were observed only at doses within the toxic range in animal studies. While reprotoxicity is linked with abuse of alcoholic beverages, there is no epidemiological evidence for this from EBHR use in healthcare facilities or from products containing ethanol in non-healthcare settings. CONCLUSION The body of evidence shows EBHRs have strong efficacy in killing non-enveloped viruses, whereas 1-propanol and 2-propanol do not kill non-enveloped viruses, that pose significant risk of infection. Ethanol absorbed through the skin during hand hygiene is similar to consumption of beverages with hidden ethanol content (< 0.5% v/v), such as apple juice or kefir. There is no risk of carcinogenicity, mutagenicity or reprotoxicity from repeated use of EBHR. Hence, the WHO Task Force strongly recommend retaining ethanol as an essential constituent in hand rubs for healthcare.
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Affiliation(s)
- Axel Kramer
- German Commission for Hospital Hygiene and Infection Prevention at the Robert-Koch Institute, Berlin, Germany. .,WHO Task Force Alcohol-Based Hand Rub, Zürich, Switzerland. .,Institute of Hygiene and Environmental Medicine University Medicine Greifswald, Walther-Rathenau-Straße 38, 17475, Greifswald, Germany.
| | - Mardjan Arvand
- Division Hospital Hygiene, Infection Prevention and Control, Robert-Koch Institute, Berlin, Germany
| | - Bärbel Christiansen
- German Commission for Hospital Hygiene and Infection Prevention at the Robert-Koch Institute, Berlin, Germany.,Department of Hospital Hygiene, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Stephanie Dancer
- Department of Microbiology, University Hospital Hairmyres, Glasgow, UK.,School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Maren Eggers
- Labor Prof. Dr. G. Enders MVZ GbR, Stuttgart, Germany
| | - Martin Exner
- German Commission for Hospital Hygiene and Infection Prevention at the Robert-Koch Institute, Berlin, Germany.,Institute of Hygiene and Public Health, University Hospital, Bonn, Germany
| | - Dieter Müller
- Department of Occupational Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Nico T Mutters
- German Commission for Hospital Hygiene and Infection Prevention at the Robert-Koch Institute, Berlin, Germany.,Institute of Hygiene and Public Health, University Hospital, Bonn, Germany
| | - Ingeborg Schwebke
- German Association for the Control of Virus Diseases (DVV e. V.), Berlin, Germany
| | - Didier Pittet
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva, Hospitals and Faculty of Medicine, Geneva, Switzerland
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15
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Caruso C, Eletto D, Tosco A, Pannetta M, Scarinci F, Troisi M, Porta A. Comparative Evaluation of Antimicrobial, Antiamoebic, and Antiviral Efficacy of Ophthalmic Formulations. Microorganisms 2022; 10:microorganisms10061156. [PMID: 35744674 PMCID: PMC9229167 DOI: 10.3390/microorganisms10061156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 12/10/2022] Open
Abstract
The extensive use of ophthalmic antibiotics is contributing to the appearance of resistant bacterial strains, which require prolonged and massive treatments with consequent detrimental outcomes and adverse effects. In addition to these issues, antibiotics are not effective against parasites and viruses. In this context, antiseptics could be valuable alternatives. They have nonselective mechanisms of action preventing bacterial resistance and a broad spectrum of action and are also effective against parasites and viruses. Here, we compare the in vitro antibacterial, antiameobic, and antiviral activities of six ophthalmic formulations containing antiseptics such as povidone-iodine, chlorhexidine, and thymol against Gram-positive and Gram-negative bacteria, the amoeba Acanthamoeba castellanii, and two respiratory viruses, HAdV-2 and HCoV-OC43. The results suggest that, among all the tested formulations, Dropsept, consisting of Vitamin E TPGS-based (tocopheryl polyethylene glycol succinate) in combination with the antiseptic chlorhexidine, is the one with the highest range of activities, as it works efficiently against bacteria, amoeba, and viruses. On the other hand, the solution containing PVA (polyvinyl alcohol) and thymol showed a promising inhibitory effect on Pseudomonas aeruginosa, which causes severe keratitis. Given its high efficiency, Dropsept might represent a valuable alternative to the widely used antibiotics for the treatment of ocular infections. In addition to this commercial eye drop solution, thymol-based solutions might be enrolled for their natural antimicrobial and antiamoebic effect.
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Affiliation(s)
- Ciro Caruso
- Corneal Transplant Centre, Pellegrini Hospital, 80134 Naples, Italy;
| | - Daniela Eletto
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy; (A.T.); (M.P.)
- Correspondence: (D.E.); (A.P.); Tel.: +39-089-969-421 (D.E.); +39-089-969-455 (A.P.)
| | - Alessandra Tosco
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy; (A.T.); (M.P.)
| | - Martina Pannetta
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy; (A.T.); (M.P.)
| | - Fabio Scarinci
- Department of Ophthalmology, IRCCS Fondazione, Bietti, Via Livenza, 3, 00198 Roma, Italy;
| | - Mario Troisi
- Department of Neurosciences, Reproductive Sciences and Dentistry, Eye Clinic, University of Naples “Federico II”, 80138 Naples, Italy;
| | - Amalia Porta
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy; (A.T.); (M.P.)
- Correspondence: (D.E.); (A.P.); Tel.: +39-089-969-421 (D.E.); +39-089-969-455 (A.P.)
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16
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Tyski S, Bocian E, Laudy AE. The application of normative documents for determination of biocidal activity of disinfectants and antiseptics dedicated for medical area: a narrative review. J Hosp Infect 2022; 125:75-91. [PMID: 35460800 DOI: 10.1016/j.jhin.2022.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/18/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
Disinfectants and antiseptics are important weapons to reduce the number of microorganisms and thus to limit the number of infections. Different methods of antimicrobial activity testing, often not standardised, without appropriate controls and not validated are applied. To address these issues, several European Standards (EN) have been developed, describing the test methods to determine whether chemical disinfectants or antiseptic products have appropriate bactericidal, sporicidal, mycobactericidal or tuberculocidal activity; fungicidal or yeasticidal activity; or virucidal activity. In this narrative review, the 17 EN concerning evaluation of the above-mentioned antimicrobial activity of preparations dedicated to the medical area are briefly reviewed, together with recent publications on this topic. Suspension and carrier tests have been performed in clean and dirty conditions simulating the medical area. In addition, a wide range of applications of these standards has been presented in the research of biocides for hand antisepsis, surfaces disinfection, including airborne disinfection as well as medical device and medical textile disinfection. The role of normative documents in the investigation of antimicrobial activity of disinfectants and antiseptics to limit infections has been underestimated. This narrative review aims to persuade researchers to conduct antimicrobial activity testing in line with validated EN and highlights an existing gap in ongoing research. It also aims to raise awareness of the wide range of biocidal activity tests with standardised methods in medical area. We also pay attention to the recently developed European Pharmacopoeia monography concerning the testing of bactericidal and fungicidal activity of antiseptics classified as medicinal products.
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Affiliation(s)
- Stefan Tyski
- National Medicines Institute, Department of Antibiotics and Microbiology, Chełmska str. 30/34, 00-725 Warsaw, Poland; Medical University of Warsaw, Department of Pharmaceutical Microbiology, Oczki str. 3, 02-007 Warsaw, Poland.
| | - Ewa Bocian
- National Medicines Institute, Department of Antibiotics and Microbiology, Chełmska str. 30/34, 00-725 Warsaw, Poland
| | - Agnieszka E Laudy
- Medical University of Warsaw, Department of Pharmaceutical Microbiology, Oczki str. 3, 02-007 Warsaw, Poland
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17
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Evidence-based intraoperative infection control measures plus feedback are associated with attenuation of SARS-CoV-2 detection in operating rooms. Br J Anaesth 2022; 129:e29-e32. [PMID: 35643533 PMCID: PMC9050652 DOI: 10.1016/j.bja.2022.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/29/2022] [Accepted: 04/18/2022] [Indexed: 11/20/2022] Open
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18
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Salisbury AM, Mullin M, Foulkes L, Chen R, Percival SL. Controlled-release iodine foam dressings demonstrate broad-spectrum biofilm management in several in vitro models. Int Wound J 2022; 19:1717-1728. [PMID: 35166016 DOI: 10.1111/iwj.13773] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/25/2022] [Accepted: 01/31/2022] [Indexed: 12/12/2022] Open
Abstract
Multiple in vitro models were utilised to evaluate the biofilm management capabilities of seven commercially-available wound dressings, varying in composition and antibacterial ingredients, to reduce common aerobic, anaerobic, and multispecies biofilms. The Center for Disease Control bioreactor was used to evaluate single species Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus) 24 and 48 hours biofilms, as well as a multispecies biofilm consisting of these two organisms in addition to Enterococcus faecalis (E. faecalis). As wound biofilms often exist in hypoxic wound environments, a direct contact anaerobic model system was used to evaluate efficacy on Bacteroides fragilis (B. fragilis). Biofilm control was evaluated against P. aeruginosa in the drip flow bioreactor model, where a constant flow of proteinaceous media is used to create a more challenging and wound-like model. The results demonstrated that biofilm management capabilities varied amongst wound dressings. Two dressings, a controlled-release iodine foam dressing and a silver nanocrystalline dressing, showed potent >4 log reductions in recovered organisms compared with untreated controls in all biofilm models evaluated. The effectiveness of other dressings to manage bioburden varied between dressing, test organism, and model system. A silver foam dressing showed moderate biofilm control in some models. However, biofilm exposure to methylene blue and gentian violet-containing foam dressings showed negligible log reductions in all in vitro biofilm methods examined. The data outlined in this in vitro study support the use of the iodine foam dressing for wounds with infection and biofilm.
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Affiliation(s)
- Anne-Marie Salisbury
- Centre of Excellence for Biofilm Science (CEBS), 5D Health Protection Group Ltd., Liverpool, UK
| | - Marc Mullin
- Centre of Excellence for Biofilm Science (CEBS), 5D Health Protection Group Ltd., Liverpool, UK
| | - Lauren Foulkes
- Centre of Excellence for Biofilm Science (CEBS), 5D Health Protection Group Ltd., Liverpool, UK
| | - Rui Chen
- Centre of Excellence for Biofilm Science (CEBS), 5D Health Protection Group Ltd., Liverpool, UK
| | - Steven L Percival
- Centre of Excellence for Biofilm Science (CEBS), 5D Health Protection Group Ltd., Liverpool, UK
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19
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Phi 6 recovery from inoculated fingerpads based on elution buffer and methodology. J Virol Methods 2022; 299:114307. [PMID: 34606796 PMCID: PMC9757907 DOI: 10.1016/j.jviromet.2021.114307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/24/2021] [Accepted: 09/09/2021] [Indexed: 11/22/2022]
Abstract
Phi 6 (Φ6) bacteriophage is a proposed surrogate to study pathogenic enveloped viruses including SARS-CoV-2-the causative agent of COVID-19-based on structural similarities, BSL-1 status, and ease of use. To determine the role of virus-contaminated hands in disease transmission, an enhanced understanding of buffer and method performance for Φ6 recovery needs to be determined. Four buffer types and three methodologies were investigated for the recovery of Φ6 from human fingerpads over a 30 min duration. Phosphate buffered saline (PBS), PBS + 0.1 % Tween, 0.1 M glycine + 3% beef extract, and viral transport medium were evaluated as buffers for recovery of Φ6 via a dish, modified glove juice, and vigorous swabbing method. Φ6 concentrations on fingerpads were determined at 0-, 5-, 10-, and 30-min post-inoculation. While there were observed differences in virus recovery across buffer and method types depending on the time point, log PFU recovery based on buffer type or methodology was not significantly different at any time point (P > 0.05). The results presented in this study will allow for future work on Φ6 persistence, transfer between hands and surfaces, and efficacy of hand hygiene methods to be performed using a well-characterized and validated recovery method.
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20
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Clinical evaluation of antiseptic mouth rinses to reduce salivary load of SARS-CoV-2. Sci Rep 2021; 11:24392. [PMID: 34937855 PMCID: PMC8695582 DOI: 10.1038/s41598-021-03461-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 12/02/2021] [Indexed: 01/07/2023] Open
Abstract
Most public health measures to contain the COVID-19 pandemic are based on preventing the pathogen spread, and the use of oral antiseptics has been proposed as a strategy to reduce transmission risk. The aim of this manuscript is to test the efficacy of mouthwashes to reduce salivary viral load in vivo. This is a multi-centre, blinded, parallel-group, placebo-controlled randomised clinical trial that tests the effect of four mouthwashes (cetylpyridinium chloride, chlorhexidine, povidone-iodine and hydrogen peroxide) in SARS-CoV-2 salivary load measured by qPCR at baseline and 30, 60 and 120 min after the mouthrinse. A fifth group of patients used distilled water mouthrinse as a control. Eighty-four participants were recruited and divided into 12–15 per group. There were no statistically significant changes in salivary viral load after the use of the different mouthwashes. Although oral antiseptics have shown virucidal effects in vitro, our data show that salivary viral load in COVID-19 patients was not affected by the tested treatments. This could reflect that those mouthwashes are not effective in vivo, or that viral particles are not infective but viral RNA is still detected by PCR. Viral infectivity studies after the use of mouthwashes are therefore required. (https://clinicaltrials.gov/ct2/show/NCT04707742; Identifier: NCT04707742)
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21
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Hirose R, Itoh Y, Ikegaya H, Miyazaki H, Watanabe N, Yoshida T, Bandou R, Daidoji T, Nakaya T. Evaluation of the Residual Disinfection Effects of Commonly Used Skin Disinfectants against Viruses: An Innovative Contact Transmission Control Method. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:16044-16055. [PMID: 34841856 DOI: 10.1021/acs.est.1c05296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Lasting disinfection effects, that is, the residual disinfection effects (RDEs), of skin-coated disinfectants have rarely been considered for infection control owing to the challenges involved in the accurate evaluation of RDEs. In this study, we constructed a new skin evaluation model and determined the RDEs of existing disinfectants against viruses. Our results showed that ethanol and isopropanol had no RDE, whereas povidone-iodine, chlorhexidine gluconate, and benzalkonium chloride (BAC) exhibited RDEs, with 10% povidone-iodine and 0.2% BAC showing particularly strong RDEs. The RDE of 0.2% BAC was strong enough to reduce the median survival times of severe acute respiratory syndrome coronavirus-2, human coronavirus-OC43, and influenza virus from 670 to 5.2, 1300 to 12, and 120 to 4.2 min, respectively. Additionally, this strong RDE was maintained even 4 h after coating the skin. Clinical data also showed that the strong RDE of 0.2% BAC was maintained for more than 2 h. Thus, applying disinfectants with strong RDEs on the skin correlates with a reduction in virus survival time and appears to create a skin surface environment that is not conducive to virus survival. A prolonged reduction in virus survival decreases the contact transmission risk, thereby enabling stronger infection control.
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Affiliation(s)
- Ryohei Hirose
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hiroshi Ikegaya
- Department of Forensic Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hajime Miyazaki
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Naoto Watanabe
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takuma Yoshida
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Risa Bandou
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Forensic Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tomo Daidoji
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takaaki Nakaya
- Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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Verma SK, Dev Kumar B, Chaurasia A, Dubey D. Effectiveness of mouthwash against viruses: 2020 perspective. A systematic review. Minerva Dent Oral Sci 2021; 70:206-213. [PMID: 34842407 DOI: 10.23736/s2724-6329.21.04418-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Antiseptic mouthwash is widely recommended to treat various oral diseases as well as to improve oral health. Most of the dental procedures lead to the generation of aerosols. These aerosols have a high potential to transmit disease. Preprocedural oral rinse with antimicrobial agents in the form of mouthwashes reduces the bacterial and viral load many folds. The purpose of this review was to summarize the effectiveness of mouthwash against viruses affecting human beings. EVIDENCE ACQUISITION Search engines like PubMed, Google Scholar, and others were used to search the electronic database. Articles were identified in which the effectiveness of antiseptic mouth rinse against the virus was tested. A comprehensive search strategy was designed to select the articles and then independently screened for eligibility. EVIDENCE SYNTHESIS A total of 9624 articles out of the 13 titles met the eligibility criteria. The selected papers were included in the present manuscript according to their relevance to the topic. Authors searched the most used chemicals as mouthwashes but records of three types of mouthwash tested against various types of viruses i.e. chlorhexidine gluconate, Povidone-iodine and essential oil containing mouthwash (Listerine) were found. CONCLUSIONS Povidone-iodine mouth rinse is effective in reducing viral load either in-vitro or in-vivo conditions. Chlorhexidine gluconate mouthwash and essential oils have shown its effectiveness in a few studies. Insufficient evidence is available to support the claim that oral antiseptics can reduce the risk of developing viral loads in humans or the rate of progression of diseases caused by viruses.
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Affiliation(s)
- Santosh K Verma
- Department of Periodontology and Oral Implantology, Dental Institute, RIMS, Ranchi, India -
| | - Barun Dev Kumar
- Department of Orthodontics, Dental Institute, RIMS, Ranchi, India
| | - Akhilanand Chaurasia
- Department of Oral Medicine and Radiology, King George Medical University, Lucknow, India
| | - Deepyanti Dubey
- Department of Conservative Dentistry and Endodontics, Hazaribag College of Dental Sciences and Hospital, Hazaribag, India
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23
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Skeith AE, Morgan DM, Schmidt PC. Vaginal preparation with povidone-iodine or chlorhexidine before hysterectomy: a propensity score matched analysis. Am J Obstet Gynecol 2021; 225:560.e1-560.e9. [PMID: 34473965 DOI: 10.1016/j.ajog.2021.08.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Antiseptic vaginal preparation is recommended before gynecologic surgery; however, there is a lack of data regarding the effectiveness of different agents. OBJECTIVE To compare rates of postoperative infectious complications and hospital utilization with preoperative vaginal preparation using povidone-iodine or chlorhexidine before hysterectomy. STUDY DESIGN This was a retrospective analysis of patients who underwent hysterectomy for gynecologic indications at 70 hospitals in a statewide surgical collaborative between January 2017 and December 2019. The primary outcome was postoperative infectious complications (including urinary tract infection, surgical site infections involving superficial, deep, or organ space tissues, or cellulitis) within 30 days of surgery. To adjust for confounding, propensity score matching, 1:1 without replacement and with a caliper of.005 was performed to create cohorts that had vaginal preparation with either povidone-iodine or chlorhexidine and did not differ in observable characteristics. We compared the rates of infectious morbidity and hospital utilization (emergency department visits, readmission, reoperation) in the matched cohorts. RESULTS In the statewide collaborative, there were 18,184 patients who received povidone-iodine and 3018 who received chlorhexidine. After propensity score matching of 2935 pairs, the povidone-iodine and chlorhexidine groups did not differ in demographics, comorbidities, choice of preoperative antibiotics, benign vs malignant surgical indication, and surgical approach. Povidone-iodine was associated with a lower rate of infectious morbidity (3.0% vs 4.3%; P=.01), urinary tract infection (1.1% vs 1.7%; P=.03) and emergency department visits (7.9% vs 9.7%; P=.01) than with chlorhexidine. There were nonsignificant trends of lower rates of surgical site infection (2.0% vs 2.7%; P=.07) and reoperation (1.6% vs 2.1%; P=.18). CONCLUSION This propensity score matched analysis provides evidence that povidone-iodine is preferable to chlorhexidine for vaginal preparation before hysterectomy because of lower rates of infectious morbidity and fewer emergency department visits. However, the absolute differences in infectious morbidity rates were approximately 1%, and in the event of an iodine allergy, chlorhexidine appears to be a reasonable alternative.
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Affiliation(s)
- Ashley E Skeith
- Department of Obstetrics and Gynecology, Michigan Medicine University of Michigan, Ann Arbor, MI.
| | - Daniel M Morgan
- Department of Obstetrics and Gynecology, Michigan Medicine University of Michigan, Ann Arbor, MI
| | - Payton C Schmidt
- Department of Obstetrics and Gynecology, Michigan Medicine University of Michigan, Ann Arbor, MI
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24
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Shet M, Hong R, Igo D, Cataldo M, Bhaskar S. In Vitro Evaluation of the Virucidal Activity of Different Povidone-Iodine Formulations Against Murine and Human Coronaviruses. Infect Dis Ther 2021; 10:2777-2790. [PMID: 34581973 PMCID: PMC8477977 DOI: 10.1007/s40121-021-00536-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/13/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction Polyvinylpyrrolidone–iodine (PVP-I) demonstrates broad-spectrum anti-infective activity and is available in different formulations for oral rinse and topical use in medical and personal care settings. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has underscored the need to supplement available preventive strategies. Methods We assessed virucidal activity of PVP-I formulations, including 0.5% (w/v) solution, 5.0% (w/v) solution, 7.5% (w/v) scrub, and 10.0% (w/v) solution, versus placebos when challenged with coronaviruses in two in vitro studies. Murine coronavirus strain A59 (American Type Culture Collection [ATCC]® VR-764™), human coronavirus strain OC43 (ZeptoMetrix Corp. #0810024CF), human coronavirus strain NL63 (ZeptoMetrix Corp. #0810228CF), and human coronavirus strain 229E (ATCC® VR-740™) were used as surrogates for SARS-CoV-2. Both studies used the American Society for Testing and Materials in vitro time-kill method. Results All active PVP-I formulations in study 1 demonstrated virucidal activity at 15 s, with mean log10 reduction of greater than 4.56 or greater than 99.99% inactivation; a cytotoxic effect against the National Collection of Type Cultures clone 1469 host cells was observed with 5.0% (w/v) solution, 7.5% (w/v) scrub, and 10.0% (w/v) solution. Active PVP-I formulations in study 2 demonstrated effective virucidal activity against coronaviruses in less than 15 s; log10 reduction in viral titer for each coronavirus strain was consistently higher for 10.0% (w/v) solution and 0.5% (w/v) solution versus 7.5% (w/v) scrub. Conclusion Both studies demonstrated in vitro virucidal activity of PVP-I formulations when challenged with SARS-CoV-2 surrogate coronaviruses. Although promising, further investigations are needed to evaluate SARS-CoV-2 inactivation.
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Affiliation(s)
- Manjunath Shet
- Imbrium Therapeutics, 201 Tresser Blvd, Stamford, CT, 06901, USA
| | - Rosa Hong
- Avrio Health L.P., 201 Tresser Blvd, Stamford, CT, 06901, USA
| | - David Igo
- Imbrium Therapeutics, 201 Tresser Blvd, Stamford, CT, 06901, USA
| | - Marc Cataldo
- Purdue Pharma L.P., 201 Tresser Blvd, Stamford, CT, 06901, USA.
| | - Sailaja Bhaskar
- Imbrium Therapeutics, 201 Tresser Blvd, Stamford, CT, 06901, USA
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Malani M, Salunke P, Kulkarni S, Jain GK, Sheikh A, Kesharwani P, Nirmal J. Repurposing pharmaceutical excipients as an antiviral agent against SARS-CoV-2. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2021; 33:110-136. [PMID: 34464232 DOI: 10.1080/09205063.2021.1975020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The limited time indorsed to face the COVID-19 emergency and large number of deaths across the globe, poses an unrelenting challenge to find apt therapeutic approaches. However, lead candidate selection to phase III trials of new chemical entity is a time-consuming procedure, and not feasible in pandemic, such as the one we are facing. Drug repositioning, an exploration of existing drug for new therapeutic use, could be an effective alternative as it allows fast-track estimation in phase II-III trials, or even forthright compassionate use. Although, drugs repurposed for COVID-19 pandemic are commercially available, yet the evaluation of their safety and efficacy is tiresome and painstaking. In absence of any specific treatment the easy alternatives such as over the counter products, phytotherapies and home remedies have been largely adopted for prophylaxis and therapy as well. In recent years, it has been demonstrated that several pharmaceutical excipients possess antiviral properties making them prospective candidates against SARS-CoV-2. This review highlights the mechanism of action of various antiviral excipients and their propensity to act against SARs-CoV2. Though, repurposing of pharmaceutical excipients against COVID-19 has the edge over therapeutic agents in terms of safety, cost and fast-track approval trial burdened, this hypothesis needs to be experimentally verified for COVID-19 patients.
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Affiliation(s)
- Manisha Malani
- Translational Pharmaceutics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS)-Pilani, Hyderabad, India
| | - Prerana Salunke
- Translational Pharmaceutics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS)-Pilani, Hyderabad, India
| | - Shraddha Kulkarni
- Translational Pharmaceutics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS)-Pilani, Hyderabad, India
| | - Gaurav K Jain
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Afsana Sheikh
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, New Delhi, India
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, New Delhi, India
| | - Jayabalan Nirmal
- Translational Pharmaceutics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science (BITS)-Pilani, Hyderabad, India
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Dhama K, Patel SK, Kumar R, Masand R, Rana J, Yatoo MI, Tiwari R, Sharun K, Mohapatra RK, Natesan S, Dhawan M, Ahmad T, Emran TB, Malik YS, Harapan H. The role of disinfectants and sanitizers during COVID-19 pandemic: advantages and deleterious effects on humans and the environment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:34211-34228. [PMID: 33991301 PMCID: PMC8122186 DOI: 10.1007/s11356-021-14429-w] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/11/2021] [Indexed: 04/16/2023]
Abstract
Disinfectants and sanitizers are essential preventive agents against the coronavirus disease 2019 (COVID-19) pandemic; however, the pandemic crisis was marred by undue hype, which led to the indiscriminate use of disinfectants and sanitizers. Despite demonstrating a beneficial role in the control and prevention of COVID-19, there are crucial concerns regarding the large-scale use of disinfectants and sanitizers, including the side effects on human and animal health along with harmful impacts exerted on the environment and ecological balance. This article discusses the roles of disinfectants and sanitizers in the control and prevention of the current pandemic and highlights updated disinfection techniques against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This article provides evidence of the deleterious effects of disinfectants and sanitizers exerted on humans, animals, and the environment as well as suggests mitigation strategies to reduce these effects. Additionally, potential technologies and approaches for the reduction of these effects and the development of safe, affordable, and effective disinfectants are discussed, particularly, eco-friendly technologies using nanotechnology and nanomedicine.
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Affiliation(s)
- Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India.
| | - Shailesh Kumar Patel
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Rakesh Kumar
- Department of Veterinary Pathology, Dr. G.C Negi College of Veterinary and Animal Sciences, CSK Himachal Pradesh Agricultural University, Palampur, Himachal Pradesh, 176062, India
| | - Rupali Masand
- Department of Veterinary Pathology, Dr. G.C Negi College of Veterinary and Animal Sciences, CSK Himachal Pradesh Agricultural University, Palampur, Himachal Pradesh, 176062, India
| | - Jigyasa Rana
- Department of Veterinary Anatomy, Faculty of Veterinary and Animal Sciences, Rajeev Gandhi South Campus, Banaras Hindu University, Barkachha, Mirzapur, Uttar Pradesh, 231001, India
| | - Mohd Iqbal Yatoo
- Division of Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, Shuhama, Alusteng Srinagar, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Srinagar, Jammu and Kashmir, 190006, India
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, Uttar Pradesh Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, 281001, India
| | - Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Ranjan K Mohapatra
- Department of Chemistry, Government College of Engineering, Keonjhar, Odisha, 758002, India
| | - Senthilkumar Natesan
- Indian Institute of Public Health Gandhinagar, Lekawada, Gandhinagar, Gujarat, 382042, India
| | - Manish Dhawan
- Department of Microbiology, Punjab Agricultural University, Ludhiana, 141004, India
- The Trafford Group of Colleges, Manchester, WA14 5PQ, UK
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, 4381, Bangladesh
| | - Yashpal Singh Malik
- Division of Biological Standardization, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia.
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia.
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia.
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Rzycki M, Drabik D, Szostak-Paluch K, Hanus-Lorenz B, Kraszewski S. Unraveling the mechanism of octenidine and chlorhexidine on membranes: Does electrostatics matter? Biophys J 2021; 120:3392-3408. [PMID: 34214528 PMCID: PMC8391085 DOI: 10.1016/j.bpj.2021.06.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/26/2021] [Accepted: 06/22/2021] [Indexed: 11/20/2022] Open
Abstract
The increasing problem of antibiotic resistance in bacteria requires the development of new antimicrobial candidates. There are several well-known substances with commercial use, but their molecular mode of action is not fully understood. In this work, we focus on two commonly used antimicrobial agents from the detergent family—octenidine dichloride (OCT) and chlorhexidine digluconate (CHX). Both of them are reported to be agents selectively attacking the cell membrane through interaction inducing membrane disruption by emulsification. They are believed to present electrostatic selectivity toward charged lipids. In this study, we tested this hypothesis and revised previously proposed molecular mechanisms of action. Employing a variety of techniques such as molecular dynamics, ζ potential with dynamic light scattering, vesicle fluctuation spectroscopy, carboxyfluorescein leakage measurement, and fluorescence trimethylammonium-diphenylhexatriene- and diphenylhexatriene-based studies for determination of OCT and CHX membrane location, we performed experimental studies using two model membrane systems—zwitterionic PC and negatively charged PG (18:1/18:1):PC (16:0/18:1) 3:7, respectively. These studies were extended by molecular dynamics simulations performed on a three-component bacterial membrane model system to further test interactions with another negatively charged lipid, cardiolipin. In summary, our study demonstrated that detergent selectivity is far more complicated than supposed simple electrostatic interactions. Although OCT does disrupt the membrane, our results suggest that its primary selectivity was more linked to mechanical properties of the membrane. On the other hand, CHX did not disrupt membranes as a primary activity, nor did it show any sign of electrostatic selectivity toward negatively charged membranes at any stage of interactions, which suggests membrane disruption by influencing more discrete membrane properties.
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Affiliation(s)
- Mateusz Rzycki
- Department of Experimental Physics, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wroclaw, Poland; Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wroclaw, Poland.
| | - Dominik Drabik
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wroclaw, Poland; Laboratory of Cytobiochemistry, Faculty of Biotechnology, University of Wroclaw, Wroclaw, Poland
| | - Kamila Szostak-Paluch
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wroclaw, Poland; Research and Development Center, Regional Specialized Hospital, Wroclaw, Poland
| | - Beata Hanus-Lorenz
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wroclaw, Poland
| | - Sebastian Kraszewski
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wroclaw, Poland
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Quality of life and therapeutic regimen management in onychomycosis patients and in vitro study of antiseptic solutions. Sci Rep 2021; 11:12789. [PMID: 34140577 PMCID: PMC8211768 DOI: 10.1038/s41598-021-92111-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 06/04/2021] [Indexed: 12/02/2022] Open
Abstract
Onychomycosis or tinea unguium (EE12.1) and Onychomycosis due to non-dermatophyte moulds (1F2D.5) (OM) is a fungal infection of the nail plates with a high prevalence that often affects vulnerable people with co-existing health problems. Gold standard pharmacological treatments for onychomycosis have been associated with low success rates and increasing antifungal resistance, suggesting that treatment outcome is dependent on multiple variables. Here, the prevalence of OM and quality of life were characterized in two vulnerable populations—Hospital patients and Homeless people. Comparing both groups, the most prevalent fungal species were identified in Hospital patients. Then, the in vitro fungicidal properties of the antiseptics povidone-iodine, polyhexamethylene biguanide-betaine, octenidine dihydrochloride, and a super-oxidized solution against two ATCC strains (Candida albicans and Aspergillus niger) and three clinical fungal isolates from Hospital patients (Candida parapsilosis, Trichophyton interdigitale, and Trichophyton rubrum) were tested. OM prevalence was high in both patient groups studied, who also reported a reduction in quality of life and concerns about the state of their feet. In addition, Hospital patients had a non-negligent therapeutic regimen management style. Antiseptics tested in vitro revealed antifungal properties. As antiseptics are low-cost and easy to apply and have few iatrogenic effects, the demonstration of fungicidal properties of these solutions suggests that they may constitute potential supportive therapeutics for OM.
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Bartoletti R, Pilatz A, Ficarra V, Tubaro A, Mogorovich A, Novara G. Digital rectal examination and prostate biopsy at the time of COVID-19 outbreak: are there risks of contamination for the urologist? Minerva Urol Nephrol 2021; 73:268-269. [PMID: 34036767 DOI: 10.23736/s2724-6051.21.04270-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Riccardo Bartoletti
- Department of Translational Research and New Technologies, Cisanello University Hospital, University of Pisa, Pisa, Italy -
| | - Adrian Pilatz
- Department of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Vincenzo Ficarra
- Gaetano Barresi Department of Human and Pediatric Pathology, University of Messina, Messina, Italy
| | - Andrea Tubaro
- Department of Urology, Sapienza University, Rome, Italy
| | | | - Giacomo Novara
- Unit of Urology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
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Feng G, Jun H, Elaine G, Haitao S. Powdered Activated Charcoal Tracing in Hand Hygiene Training and Compliance Assessment During the COVID-19 Pandemic. Risk Manag Healthc Policy 2021; 14:675-683. [PMID: 33623457 PMCID: PMC7896769 DOI: 10.2147/rmhp.s295551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/18/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Because of the COVID-19 pandemic there has been a significant increase in the prevalence of nosocomial infections. As a result, we sought to find an effective, efficient and safe way to train healthcare workers on proper hand washing techniques. We used powdered activated carbon (PAC) as a tracer to visually display hand washing defects after the hand washing process. The real-time visual assessment of the efficacy of the hand washing technique aided in the immediate correction of errors, and this definitively improved hand hygiene techniques of the interns. Methods Clinical interns at the emergency department of Shengjing Hospital were included in this study and received training in relation to the six-step hand-washing technique developed by the World Health Organization (WHO). The subjects’ hand-washing defects or faults were traced using PAC and corrected accordingly. Acceptance of the PAC tracing method by the interns, and its safety, were both assessed using a questionnaire survey. Results The results indicated that the back of the hands, fingers, and the wrists were prone to hand-washing defects. The hand-washing defects were significantly reduced after targeted corrections by the trainers. Subjects reported satisfactory acceptance toward the PAC tracing method and the method was relatively safe for subjects. Conclusion The PAC tracing method can visually display hand-washing defects and significantly improve the effectiveness of hand-washing training.
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Affiliation(s)
- Guo Feng
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Han Jun
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Gitonga Elaine
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Shen Haitao
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
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Masotti F, Cattaneo S, Stuknytė M, Pica V, De Noni I. Transmission routes, preventive measures and control strategies of SARS-CoV-2 in the food factory. Crit Rev Food Sci Nutr 2021; 62:4821-4831. [PMID: 33527848 DOI: 10.1080/10408398.2021.1879728] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
SARS-CoV-2 virus represents a health threat in food factories. This infectious virus is transmitted by direct contact and indirectly via airborne route, whereas contamination through inanimate objects/surfaces/equipment is uncertain. To limit the potential spread of the pathogen in the food industry, close working between individuals should be avoided and both personal and respiratory hygiene activities should be enforced. Despite the high infectivity, SARS-CoV-2, being an enveloped virus with a fragile lipid envelop, is sensitive to biocidal products and sanitizers commonly used in the food factory. In the context of the building design, interventions that promote healthy air quality should be adopted, especially in food areas with high-occupancy rates for prolonged times, to help minimize the potential exposure to airborne SARS-CoV-2. Air ventilation and filtration provided by heating, ventilation and air conditioning systems, are effective and easy-to-organize tools to reduce the risk of transmission through the air. In addition to conventional sanitation protocols, aerosolization of hydrogen peroxide, UV-C irradiation or in-situ ozone generation are complementary techniques for an effective virucidal treatment of the air.
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Affiliation(s)
- Fabio Masotti
- Dipartimento di Scienze per gli Alimenti, la Nutrizione e l'Ambiente, Università degli Studi di Milano, Milan, Italy
| | - Stefano Cattaneo
- Dipartimento di Scienze per gli Alimenti, la Nutrizione e l'Ambiente, Università degli Studi di Milano, Milan, Italy
| | - Milda Stuknytė
- Unitech COSPECT - University Technological Platforms Office, Università degli Studi di Milano, Milan, Italy
| | - Valentina Pica
- Dipartimento di Scienze per gli Alimenti, la Nutrizione e l'Ambiente, Università degli Studi di Milano, Milan, Italy
| | - Ivano De Noni
- Dipartimento di Scienze per gli Alimenti, la Nutrizione e l'Ambiente, Università degli Studi di Milano, Milan, Italy
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Maldonado N, Amo-Ochoa P. The role of coordination compounds in virus research. Different approaches and trends. Dalton Trans 2021; 50:2310-2323. [PMID: 33496298 DOI: 10.1039/d0dt04066e] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This article aims to provide an overview of the studies focused on using coordination compounds as antiviral agents against different types of viruses. We present various strategies so far used to this end. This article is divided into two sections. The first collects the series of designed antiviral drugs based on coordination compounds. This approach has been developed for many years, starting from the 70s with the discovery of cis-platin (cis-DDP). It has been mainly focused on studying the synergistic effect of a wide variety of new compounds obtained by combining metal ions with organic antiviral ligands. Then, we collect various strategies analyzing the coordination compounds interacting with viruses using different processes such as wrapping viruses, rapid detection of RNA or DNA virus, or nanocarriers. These recent and novel insights help to study viruses from other points of view, allowing to measure their physical and chemical properties. We also highlight a section in which the issue of viruses from a disinfection viewpoint is addressed, using coordination compounds as a tool able to control the release of antiviral and biocide agents. This is an emerging and promising field but this approach is actually little developed. We finally provide a section with a general conclusion and perspectives.
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Affiliation(s)
- Noelia Maldonado
- Department of Inorganic Chemistry, Autonomous University of Madrid, E-28049 Madrid, Spain.
| | - Pilar Amo-Ochoa
- Department of Inorganic Chemistry, Autonomous University of Madrid, E-28049 Madrid, Spain. and Institute for Advanced Research in Chemistry (IADCHEM). Universidad Autónoma de Madrid, 28049 Madrid, Spain
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Hassandarvish P, Tiong V, Mohamed NA, Arumugam H, Ananthanarayanan A, Qasuri M, Hadjiat Y, Abubakar S. In vitro virucidal activity of povidone iodine gargle and mouthwash against SARS-CoV-2: implications for dental practice. Br Dent J 2020:10.1038/s41415-020-2402-0. [PMID: 33303923 PMCID: PMC7726738 DOI: 10.1038/s41415-020-2402-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/02/2020] [Indexed: 01/01/2023]
Abstract
Introduction Virus particles in respiratory droplets and aerosols generated during medical/dental procedures are a potential source of SARS-CoV-2 cross infection. In the dental setting, oral decontamination could be an important adjunct to personal protective equipment and is recommended by a number of national COVID-19 guidance documents for dental settings.Aim To assess the in vitrovirucidal activity of an oral povidone iodine (PVP-I) product against SARS-CoV-2.Material and methods BETADINE gargle and mouthwash (1% PVP-I) was tested against SARS-CoV-2 virus under both clean and dirty conditions using a suspension assay based on EN14476 methodology. Virucidal activity of the product, undiluted and at 1:2 dilution, was tested at contact times of 15, 30 and 60 seconds. Viral titres were calculated using the Spearman-Kärber method and reported as median tissue culture infectious dose (TCID50/ml).Results The undiluted product achieved >5 log10 reduction in viral titres compared to the control at 15, 30 and 60 seconds under both clean and dirty conditions. At a twofold dilution (0.5% PVP-I), the test product demonstrated >4 log10 kill at 15 seconds and >5 log10 kill at 30 and 60 seconds in both clean and dirty conditions.Conclusion PVP-I gargle and mouthwash product, undiluted and at 1:2 dilution, demonstrated potent and rapid virucidal activity (≥4 log10 reduction of viral titre) in 15 seconds against SARS-CoV-2 in vitro. The PVP-I gargle and mouthwash product is widely available and could be readily integrated into infection control measures during dental treatment including pre-procedural oral decontamination.
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Affiliation(s)
- Pouya Hassandarvish
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Malaysia.
| | - Vunjia Tiong
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Malaysia
| | - Nurul Azmawati Mohamed
- Basic Medical Sciences 2 Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, 55100 Pandan Indah, Kuala Lumpur, Malaysia
| | | | | | | | | | - Sazaly Abubakar
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Malaysia
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Al-Sayah MH. Chemical disinfectants of COVID-19: an overview. JOURNAL OF WATER AND HEALTH 2020; 18:843-848. [PMID: 33095205 DOI: 10.2166/wh.2020.108] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The outbreak of coronavirus (COVID-19) has led to a broad use of chemical disinfectants in order to sterilize public spaces and prevent contamination. This paper surveys the chemicals that are effective in deactivating the virus and their mode of action. It presents the different chemical classes of disinfectants and identifies the chemical features of these compounds that pertain to their biocidal activity, relevant to surface/water disinfection.
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Affiliation(s)
- Mohammad Hussein Al-Sayah
- Department of Biology, Chemistry, and Environmental Sciences, American University of Sharjah, P.O. Box 26666, Sharjah, United Arab Emirates E-mail:
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Eggers M, Benzinger C, Suchomel M, Hjorth E. Virucidal activity of three ethanol-based hand rubs against murine norovirus in a hand hygiene clinical simulation study. Future Microbiol 2020; 15:1335-1341. [PMID: 32960094 DOI: 10.2217/fmb-2020-0168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: We evaluated the efficacy of three ethanol-based hand rubs against murine norovirus in a proposed clinical simulation test (prEN 17430). Materials & methods: Virucidal activity was determined in 18 volunteers using three hand rubs: ethanol 72.4 and 89.5% v/v solutions, and 86% v/v gel. Subjects underwent testing with each product (3/6 ml for 15/30 s) and a reference solution (6 ml 70% v/v ethanol for 60 s). Results: Against murine norovirus, the reduction factors (RF; RF mean ± standard deviation log10 reduction of postsampling) for ethanol gel 86% v/v (RF 1.96 ± 0.64), ethanol 89.5% v/v (RF 2.49 ± 0.59) and ethanol 72.4% v/v (RF 2.61 ± 0.50), were all significantly superior to that of the reference solution. Conclusion: All three hand rubs passed the criteria set out in prEN 17430 and exhibited excellent virucidal efficacy.
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Affiliation(s)
- Maren Eggers
- Labor Prof. Gisela Enders MVZ GbR, Rosenbergstr. 85, 70193 Stuttgart, Germany
| | - Carolin Benzinger
- Labor Prof. Gisela Enders MVZ GbR, Rosenbergstr. 85, 70193 Stuttgart, Germany
| | - Miranda Suchomel
- Institute of Hygiene & Applied Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Elmar Hjorth
- Dr. Schumacher GmbH, Am Roggenfeld 3, 34323 Malsfeld, Germany
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Both Handwashing and an Alcohol-Based Hand Sanitizer Intervention Reduce Soil and Microbial Contamination on Farmworker Hands during Harvest, but Produce Type Matters. Appl Environ Microbiol 2020; 86:AEM.00780-20. [PMID: 32680869 DOI: 10.1128/aem.00780-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/08/2020] [Indexed: 01/04/2023] Open
Abstract
Hand hygiene interventions are critical for reducing farmworker hand contamination and preventing the spread of produce-associated illness. Hand hygiene effectiveness may be produce-commodity specific, which could influence implementation strategies. This study's goal was to determine if produce commodity influences the ability of handwashing with soap and water or two-step alcohol-based hand sanitizer (ABHS) interventions to reduce soil and bacteria on farmworker hands. Farmworkers (n = 326) harvested produce (cantaloupe, jalapeño, and tomato) for 30 to 90 minutes before engaging in handwashing, two-step ABHS (jalapeño and cantaloupe), or no hand hygiene. Hands were rinsed to measure amounts of soil (absorbance at 600 nm) and indicator bacteria (coliforms, Enterococcus sp., generic Escherichia coli, and Bacteroidales universal [AllBac] and human-specific [BFD] 16S rRNA gene markers). Without hand hygiene, bacterial concentrations (0.88 to 5.1 log10 CFU/hand) on hands significantly differed by the produce commodity harvested. Moderate significant correlations (ρ = -0.41 to 0.56) between soil load and bacterial concentrations were observed. There were significant produce-commodity-specific differences in the ability of handwashing and two-step ABHS interventions to reduce soil (P < 0.0001), coliforms (P = 0.002), and Enterococcus sp. (P = 0.003), but not the Bacteroidales markers AllBac (P = 0.4) or BFD (P = 0.3). Contamination on hands of farmworkers who harvested cantaloupe was more difficult to remove. Overall, we found that a two-step ABHS intervention was similar to handwashing with soap and water at reducing bacteria on farmworker hands. In summary, produce commodity type should be considered when developing hand hygiene interventions on farms.IMPORTANCE This study demonstrated that the type of produce commodity handled influences the ability of handwashing with soap and water or a two-step alcohol-based hand sanitizer (ABHS) intervention to reduce soil and bacterial hand contamination. Handwashing with soap and water, as recommended by the FDA's Produce Safety Rule, when tested in three agricultural environments, does not always reduce bacterial loads. Consistent with past results, we found that the two-step ABHS method performed similarly to handwashing with soap and water but also does not always reduce bacterial loads in these contexts. Given the ease of use of the two-step ABHS method, which may increase compliance, the two-step ABHS method should be further evaluated and possibly considered for implementation in the agricultural environment. Taken together, these results provide important information on hand hygiene effectiveness in three agricultural contexts.
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Anderson DE, Sivalingam V, Kang AEZ, Ananthanarayanan A, Arumugam H, Jenkins TM, Hadjiat Y, Eggers M. Povidone-Iodine Demonstrates Rapid In Vitro Virucidal Activity Against SARS-CoV-2, The Virus Causing COVID-19 Disease. Infect Dis Ther 2020; 9:669-675. [PMID: 32643111 PMCID: PMC7341475 DOI: 10.1007/s40121-020-00316-3] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION As of 22 June 2020, Severe Acute Respiratory Syndrome (SARS)-coronavirus (CoV)-2 has infected more than 8.95 million people worldwide, causing > 468,000 deaths. The virus is transmitted through respiratory droplets and physical contact from contaminated surfaces to the mucosa. Hand hygiene and oral decontamination among other measures are key to preventing the spread of the virus. We report the in vitro virucidal activity of topical and oral povidone-iodine (PVP-I) products against SARS-CoV-2. METHODS Suspension assays were used to assess the virucidal activity of PVP-I against SARS-CoV-2. Products were tested at a contact time of 30 s for virucidal activity. Viral titres were calculated using the Spearman-Kärber method and reported as median tissue culture infectious dose (TCID50)/mL. RESULTS All four products [antiseptic solution (PVP-I 10%), skin cleanser (PVP-I 7.5%), gargle and mouth wash (PVP-I 1%) and throat spray (PVP-I 0.45%)] achieved ≥ 99.99% virucidal activity against SARS-CoV-2, corresponding to ≥ 4 log10 reduction of virus titre, within 30 s of contact. CONCLUSION This study provides evidence of rapid and effective virucidal activity of PVP-I against SARS-CoV-2. PVP-I-based products are widely available for medical and personal use for hand hygiene and oral decontamination, and could be readily integrated into coronavirus disease, COVID-19, infection control measures in hospital and community settings.
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Affiliation(s)
- Danielle E Anderson
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore.
| | - Velraj Sivalingam
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - Adrian Eng Zheng Kang
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | | | - Harsha Arumugam
- Mundipharma Singapore Holding Pte. Limited, Singapore, Singapore
| | | | - Yacine Hadjiat
- Mundipharma Singapore Holding Pte. Limited, Singapore, Singapore
| | - Maren Eggers
- Labor Prof. Dr. G. Enders MVZ GbR, Stuttgart, Germany.
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Edington M, Ramaesh K, Lockington D. Virucidal benefits of povidone-iodine use on the ocular surface: a review. BMJ Open Ophthalmol 2020; 5:e000509. [PMID: 32818151 PMCID: PMC7406023 DOI: 10.1136/bmjophth-2020-000509] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 12/23/2022] Open
Abstract
Povidone-iodine (PVI) preparations are well known for their microbicidal effect. In ophthalmology, PVI is commonly used to sterilise the ocular surface prior to surgical procedures. It is also used uncommonly as treatment for adenoviral conjunctivitis, yet the virucidal benefits of PVI have not been clearly documented in existing clinical management guidelines for ocular surface conditions. The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, has challenged traditional healthcare systems. The morbidity and mortality of this highly contagious disease have resulted in fatalities among healthcare workers, including ophthalmologists. The SARS-CoV-2 virus has been identified on conjunctival testing, a potential source of contagious infection which may be unrecognised in asymptomatic carriers. Concern has been raised that ocular procedures may be ‘aerosol-generating’ and the additional wearing of personal protective equipment has been recommended to protect operating theatre staff. This literature review demonstrates that PVI has a broad virucidal activity, including against coronaviruses. It is already used perioperatively as standard of ophthalmic care and has been shown clinically to be effective against adenoviruses on the ocular surface. The current surgical practice of application of 5%–10% PVI applied periocularly for 3 min seems to provide an adequate effective reduction in the patient’s ocular surface viral load. The virucidal benefits of routine PVI use should be included in ophthalmology guidelines regarding safe ocular surgery protocols.
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Affiliation(s)
| | - Kanna Ramaesh
- Tennent Institute of Ophthalmology, Glasgow, United Kingdom
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Loftus RW, Dexter F, Parra MC. In Response: 'Perioperative COVID-19 Defense: An Evidence-Based Approach for Optimization of Infection Control and Operating Room Management'. Anesth Analg 2020; 131:e27-e28. [PMID: 32250978 PMCID: PMC7173083 DOI: 10.1213/ane.0000000000004854] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Randy W. Loftus
- Department of Anesthesia, University of Iowa, Iowa City, Iowa,
| | - Franklin Dexter
- Department of Anesthesia, University of Iowa, Iowa City, Iowa,
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Dadlani S. SARS-CoV-2 Transmission in a Dental Practice in Spain: After the Outbreak. Int J Dent 2020; 2020:8828616. [PMID: 32676111 PMCID: PMC7341376 DOI: 10.1155/2020/8828616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/06/2020] [Accepted: 06/15/2020] [Indexed: 01/05/2023] Open
Abstract
The World Health Organization declared a pandemic on March 11, 2020, due to a virus named SARS-CoV-2 discovered in Wuhan, China, in December 2019. Many countries have been hit hard including Spain, with the highest number of healthcare workers being infected (>50,000). A lack of personal protective equipment and protocols at the time of the outbreak led to many fatalities. Although few of these healthcare workers are dental professionals, this community required protective measures as well. Fortunately, there are no reported cases of SARS-CoV-2 transmission in dental practices. Dental professionals were advised only to treat dental emergencies, and such cases were screened via telephone to maintain social distancing. Nevertheless, new protocols and measures are needed as dental professionals return to normal practice after weeks of confinement in many countries. Relatively, few articles have discussed the management of dental practice during the SARS-CoV-2 with no known articles on postpandemic outbreak guidelines. Though some protocols and measures are the same, there are also many differences. Here, we describe protocols and measures for dental practice in Spain in accordance with the Spanish Health Ministry.
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Affiliation(s)
- Shashi Dadlani
- Section of Periodontology, Faculty of Medicine and Health Sciences, University Clinic of Odontology University of Oviedo, Oviedo, Spain
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Is the oral cavity relevant in SARS-CoV-2 pandemic? Clin Oral Investig 2020; 24:2925-2930. [PMID: 32577830 PMCID: PMC7309196 DOI: 10.1007/s00784-020-03413-2] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/11/2020] [Indexed: 01/09/2023]
Abstract
Objectives Recent scientific evidences suggest a relevant role of the oral cavity in the transmission and pathogenicity of SARS-CoV-2. Methods A literature search was performed in PubMed, up to April 30, 2020, focusing on SARS-CoV-2, COVID-19, oral cavity, and antimicrobial agents. Results Oral viral load of SARS-CoV-2 has been associated with the severity of COVID-19, and thus, a reduction in the oral viral load could be associated with a decrease in the severity of the condition. Similarly, a decrease in the oral viral load would diminish the amount of virus expelled and reduce the risk of transmission, since (i) during the first 10 days, the virus mainly accumulates at the nasal, oral, and pharyngeal area; (ii) the number of angiotensin-converting enzyme (ACE2) receptor is greater in the salivary glands as compared with the lungs; and (iii) salivary droplets represent the most relevant transmission route. To reduce the oral viral load, antiseptic agents may be used, although the evidence on its efficacy is indirect and weak. Conclusions Antiseptic mouth rinses, such as those containing cetylpyridinium chloride or povidone-iodine, may be able to decrease the severity of COVID-19 by reducing oral viral load in infected subjects and decreasing the risk of transmission by limiting viral load in droplets, generated in normal life, or in aerosols, produced during dental procedures. Well-designed clinical and preclinical research must be conducted to support these hypotheses. Clinical relevance Antiseptic mouth rinses may help in decreasing the severity of COVID-19 and in reducing the risk of transmission.
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Liang B, Yuan X, Wei G, Wang W, Zhang M, Peng H, Javer A, Mendenhall M, Julander J, Huang S, Michail H, Lu Y, Zhu Q, Baldwin J. In-Vivo Toxicity Studies and In-Vitro Inactivation of SARS-CoV-2 by Povidone-iodine In-situ Gel Forming Formulations. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2020:2020.05.18.103184. [PMID: 32511395 PMCID: PMC7263542 DOI: 10.1101/2020.05.18.103184] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
To curb the spread of SARS-CoV-2, the etiologic agent of the COVID-19 pandemic, we characterize the virucidal activity of long-acting Povidone Iodine (PVP-I) compositions developed using an in-situ gel forming technology. The PVP-I gel forming nasal spray (IVIEW-1503) and PVP-I gel forming ophthalmic eye drop (IVIEW-1201) rapidly inactivated SARS-CoV-2, inhibiting the viral infection of VERO76 cells. No toxicity was observed for the PVP-I formulations. Significant inactivation was noted with preincubation of the virus with these PVP-I formulations at the lowest concentrations tested. It has been demonstrated that both PVP-I formulations can inactivate SARS-CoV-2 virus efficiently in both a dose-dependent and a time-dependent manner. These results suggest IVIEW-1503 and IVIEW-1201 could be potential agents to reduce or prevent the transmission of the virus through the nasal cavity and the eye, respectively. Further studies are needed to clinically evaluate these formulations in early-stage COVID-19 patients.
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Izzetti R, Nisi M, Gabriele M, Graziani F. COVID-19 Transmission in Dental Practice: Brief Review of Preventive Measures in Italy. J Dent Res 2020; 99:1030-1038. [PMID: 32302257 DOI: 10.1177/0022034520920580] [Citation(s) in RCA: 214] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The outbreak and diffusion of SARS-CoV-2, responsible for the coronavirus disease (COVID-19), has caused an emergency in the health system worldwide. After a first development in Wuhan, China, the virus spread in other countries, with Italy registering the second highest number of cases in Europe on the 7th of April 2020 (135,586 in total). The World Health Organization declared the pandemic diffusion of COVID-19, and restrictive measures to limit contagion have been taken in several countries. The virus has a predominantly respiratory transmission through aerosol and droplets. The importance of infection control is therefore crucial in limiting the effects of virus diffusion. We aim to discuss the risks related to dental practice and current recommendations for dental practitioners. A literature search was performed to retrieve articles on the management of COVID-19 diffusion in dental practice. The documented clinical experience, the measures of professional prevention, and the actual Italian situation were reported and described. Four articles were retrieved from the literature search. Among the eligible articles, 3 reported measures to contrast COVID-19 diffusion. The infection management protocols suggested were reviewed. Finally, recommendations based on the Italian experience in terms of patient triage, patients' entrance into the practice, dental treatment, and after-treatment management are reported and discussed. COVID-19 is a major emergency worldwide, which should not be underestimated. Due to the rapidly evolving situation, further assessment of the implications of COVID-19 outbreak in dental practice is needed.
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Affiliation(s)
- R Izzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - M Nisi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - M Gabriele
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - F Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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Abstract
With reports of vancomycin-resistant enterococci recently emerging in hospital settings, renewed focus is turning to the importance of multifaceted infection prevention efforts. Careful compliance with established hygiene practices by healthcare workers together with effective antiseptic options is essential for the protection of patients from infectious agents. For over 60 years, povidone iodine (PVP-I) formulations have been shown to limit the impact and spread of infectious diseases with potent antiviral, antibacterial and antifungal effects. In addition to a lack of reported resistance, the benefits of PVP-I include an excellent safety profile and a broad spectrum of effect due to its multimodal action. Studies have shown that hand washing with PVP-I-based antiseptics is effective for the decontamination of skin, while PVP-I mouthwashes and gargles significantly reduce viral load in the oral cavity and the oropharynx. The importance of PVP-I has been emphasised by its inclusion in the World Health Organization's list of essential medicines, and high potency for virucidal activity has been observed against viruses of significant global concern, including hepatitis A and influenza, as well as the Middle-East Respiratory Syndrome and Sudden Acute Respiratory Syndrome coronaviruses. Together with its diverse applications in antimicrobial control, broad accessibility across the globe, and outstanding safety and tolerability profile, PVP-I offers an affordable, potent, and widely available antiseptic option.Funding Mundipharma Singapore Holding Pte Limited.
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Affiliation(s)
- Maren Eggers
- Labor Prof Gisela Enders MVZ GbR, Stuttgart, Germany.
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