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Nye AK, Thieman Mankin KM. Small animal patient preoperative preparation: a review of common antiseptics, comparison studies, and resistance. Front Vet Sci 2024; 11:1374826. [PMID: 38605919 PMCID: PMC11007076 DOI: 10.3389/fvets.2024.1374826] [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: 01/22/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
This review aims to describe commonly used antiseptics in veterinary medicine including their mechanism of action, spectrum of activity, potential adverse effects, and application techniques. Additionally, it provides a review of the veterinary literature comparing antiseptics, a discussion of effectiveness and efficacy studies, and the potential for increased resistance to biocides and antimicrobials. This review concludes that appropriate selection and use is necessary to prevent the occurrence of surgical site infections, adverse effects, and potential for increasing resistance to antimicrobials. Continued research is needed to fill gaps in the current knowledge such as optimal preparation procedures for various surgical sites, standardization of efficacy and effectiveness testing, and the clinical impact of decreased susceptibility to chlorhexidine and other antiseptics.
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Affiliation(s)
| | - Kelley M. Thieman Mankin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
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2
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Padalhin A, Ryu HS, Yoo SH, Abueva C, Seo HH, Park SY, Chung PS, Woo SH. Antiseptic, Hemostatic, and Wound Activity of Poly(vinylpyrrolidone)-Iodine Gel with Trimethyl Chitosan. Int J Mol Sci 2024; 25:2106. [PMID: 38396783 PMCID: PMC10889287 DOI: 10.3390/ijms25042106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/30/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Wound management practices have made significant advancements, yet the search for improved antiseptics persists. In our pursuit of solutions that not only prevent infections but also address broader aspects of wound care, we investigated the impact of integrating trimethyl chitosan (TMC) into a widely used poly(vinylpyrrolidone)-iodine gel (PVP-I gel). Our study assessed the antimicrobial efficacy of the PVP gel with TMC against Escherichia coli, Staphylococcus aureus, multidrug-resistant S. aureus MRSA, and Candida albicans. Additionally, we compared hemostatic effects using a liver puncture bleeding model and evaluated wound healing through histological sections from full-thickness dermal wounds in rats. The results indicate that incorporating TMC into the commercially available PVP-I gel did not compromise its antimicrobial activity. The incorporation of TMC into the PVP-I gel markedly improves its hemostatic activity. The regular application of the PVP-I gel with TMC resulted in an increased blood vessel count in the wound bed and facilitated the development of thicker fibrous tissue with a regenerated epidermal layer. These findings suggest that TMC contributes not only to antimicrobial activity but also to the intricate processes of tissue regeneration. In conclusion, incorporating TMC proves beneficial, making it a valuable additive to commercially available antiseptic agents.
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Affiliation(s)
- Andrew Padalhin
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan 31116, Republic of Korea; (A.P.); (H.S.R.); (C.A.); (S.Y.P.); (P.-S.C.)
| | - Hyun Seok Ryu
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan 31116, Republic of Korea; (A.P.); (H.S.R.); (C.A.); (S.Y.P.); (P.-S.C.)
| | - Seung Hyeon Yoo
- School of Medical Laser, Dankook University, Cheonan 31116, Republic of Korea; (S.H.Y.); (H.H.S.)
| | - Celine Abueva
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan 31116, Republic of Korea; (A.P.); (H.S.R.); (C.A.); (S.Y.P.); (P.-S.C.)
- Medical Laser Research Center, Dankook University, Cheonan 31116, Republic of Korea
| | - Hwee Hyon Seo
- School of Medical Laser, Dankook University, Cheonan 31116, Republic of Korea; (S.H.Y.); (H.H.S.)
| | - So Young Park
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan 31116, Republic of Korea; (A.P.); (H.S.R.); (C.A.); (S.Y.P.); (P.-S.C.)
| | - Phil-Sang Chung
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan 31116, Republic of Korea; (A.P.); (H.S.R.); (C.A.); (S.Y.P.); (P.-S.C.)
- Medical Laser Research Center, Dankook University, Cheonan 31116, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan 31116, Republic of Korea
| | - Seung Hoon Woo
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan 31116, Republic of Korea; (A.P.); (H.S.R.); (C.A.); (S.Y.P.); (P.-S.C.)
- Medical Laser Research Center, Dankook University, Cheonan 31116, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan 31116, Republic of Korea
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3
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Ma Y, Yi J, Ma J, Yu H, Luo L, Wu W, Jin L, Yang Q, Lou T, Sun D, Cao M. Hand Sanitizer Gels: Classification, Challenges, and the Future of Multipurpose Hand Hygiene Products. TOXICS 2023; 11:687. [PMID: 37624192 PMCID: PMC10459210 DOI: 10.3390/toxics11080687] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023]
Abstract
Hand hygiene is a crucial measure in the prevention and control of infections, and there is a growing awareness among individuals who are making a conscious effort to maintain hand cleanliness. With the advent of the SARS-CoV-2 outbreak, the demand for hand hygiene products has also gradually shifted towards those with antimicrobial properties. Among these products, hand sanitizer gels (HSGs) have gained considerable popularity as an efficient method of hand cleaning, due to their rapid drying and sustained antimicrobial efficacy. Concurrently, there has been a growing interest in novel HSGs that offer additional functions such as skin whitening, moisturizing, and anti-inflammatory effects. These novel HSGs effectively address concerns associated with the ingestion of antimicrobial ingredients and demonstrate reduced skin irritation, thereby alleviating hand dermatological issues. This review provides an extensive overview of the application scenarios, classification, and challenges associated with HSGs while emphasizing the emergence of novel components with biological functions, aiming to contribute to the advancement of hand hygiene practices and offer novel insights for the development of novel HSGs with outstanding antimicrobial properties with other multiple biological functions and desirable biosafety profiles.
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Affiliation(s)
- Yilei Ma
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Jia Yi
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Jiahui Ma
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Haiyang Yu
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Li Luo
- Affiliated Dongguan Hospital, Southern Medical University, Dongguan 523059, China
| | - Wei Wu
- Bioengineering College of Chongqing University, Chongqing 400044, China
| | - Libo Jin
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Qinsi Yang
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325000, China
| | - Ting Lou
- Yiwu Center for Disease Control and Prevention, Yiwu 322000, China;
| | - Da Sun
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Min Cao
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou 324000, China
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Pattananandecha T, Sirilun S, Apichai S, Ouirungroj T, Uirungroj P, Ogata F, Kawasaki N, Saenjum C. Pharmaceutical Incompatibility of Lubricating Gel Formulation Reduces Antibacterial Activity of Chlorhexidine Gluconate: In Vitro Study in Northern Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12285. [PMID: 36231587 PMCID: PMC9566729 DOI: 10.3390/ijerph191912285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Chlorhexidine gluconate (CHG) is a cationic disinfectant. The positive charge of CHG molecules binds to phospholipid's negative charge in bacterial cell walls, causing membrane disruption. The in vitro kinetic physical, chemical and biological incompatibilities of nine lubricating gels with 1% w/v CHG were investigated. Five containing anionic thickener, two containing nonionic thickener, and two containing cationic thickener were collected from hospitals in northern Thailand. All the anionic and nonionic lubricating gels significantly reduced (p < 0.05) the CHG amount after 5 min of exposure time from 12.54% to 54.99%, respectively. In contrast, the amount of CHG exposed with cationic lubricating gels was maintained. Antibacterial activity was significantly reduced to a 1.17-4.33 log10 reduction for Staphylococcus aureus ATCC25923 and a 1.07-3.52 log10 reduction for Escherichia coli ATCC25922 after 5 min exposure to all anionic and nonionic lubricating gels. In contrast, the two cationic lubricating gels maintained the antibacterial activity of the CHG solution (5.69 ± 0.14 and 5.45 ± 0.17 log10 reduction). The results suggest that anionic and nonionic thickeners in lubricating gel formulations may neutralize the positive charge and reduce the antibacterial activity of CHG, reducing its effectiveness as a disinfectant.
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Affiliation(s)
- Thanawat Pattananandecha
- Center of Excellence for Innovation in Analytical Science and Technology for Biodiversity-Based Economic and Society (I-ANALY-S-T_B.BES-CMU), Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sasithorn Sirilun
- Center of Excellence for Innovation in Analytical Science and Technology for Biodiversity-Based Economic and Society (I-ANALY-S-T_B.BES-CMU), Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sutasinee Apichai
- Center of Excellence for Innovation in Analytical Science and Technology for Biodiversity-Based Economic and Society (I-ANALY-S-T_B.BES-CMU), Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Teerapat Ouirungroj
- Center of Excellence for Innovation in Analytical Science and Technology for Biodiversity-Based Economic and Society (I-ANALY-S-T_B.BES-CMU), Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
- Pose Health Care Co., Ltd., 1 Soi Ramintra 107, Ramintra Rd., Kannayao, Bangkok 10230, Thailand
| | - Phisit Uirungroj
- Center of Excellence for Innovation in Analytical Science and Technology for Biodiversity-Based Economic and Society (I-ANALY-S-T_B.BES-CMU), Chiang Mai University, Chiang Mai 50200, Thailand
- Pose Health Care Co., Ltd., 1 Soi Ramintra 107, Ramintra Rd., Kannayao, Bangkok 10230, Thailand
| | - Fumihiko Ogata
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan
| | - Naohito Kawasaki
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan
- Antiaging Center, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan
| | - Chalermpong Saenjum
- Center of Excellence for Innovation in Analytical Science and Technology for Biodiversity-Based Economic and Society (I-ANALY-S-T_B.BES-CMU), Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
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Kobayashi R, Murai R, Sato Y, Nakae M, Nirasawa S, Asanuma K, Kuronuma K, Takahashi S. Study of post-opening stability of active ingredients in hand sanitizers. J Infect Chemother 2022; 28:1605-1609. [PMID: 35981652 DOI: 10.1016/j.jiac.2022.08.012] [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: 06/19/2022] [Revised: 07/30/2022] [Accepted: 08/08/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Hand disinfection plays an important role in infection control. Currently, hand sanitizers containing ethanol and chlorhexidine gluconate as active ingredients are widely used. Most of hand sanitizers have a defined expiration date for use. However, there was no rule about the expiration date after opening defined with the evidence. Therefore, we examined the fluctuation of active ingredients and disinfection effect after opening the bottle. METHOD Twelve hand sanitizers from 44 to 921 days after opening set in different places in the hospital were examined and unopened hand sanitizer used as a control. Chlorhexidine gluconate and ethanol of each samples were measured by high performance liquid chromatography and gas chromatography, respectively. The correlation between the concentration of each ingredient obtained and the number of days after opening, bottle weight, storage temperature and humidity was analyzed. A time-kill test based on ASTM E2315-03 was performed to confirm the actual disinfection effect. RESULTS It was observed that active ingredients had not been decreased up to 921 days after opening and were not affected by storage conditions after opening. In addition, a decrease of disinfection effect was not observed in any sample. CONCLUSIONS We found that hand sanitizers do not need to be discard after a number of days have passed because the active ingredients are retained even after opening in it.
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Affiliation(s)
- Ryo Kobayashi
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ryosei Murai
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yuki Sato
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mami Nakae
- Division of Infection Control, Sapporo Medical University Hospital, Sapporo, Japan
| | - Shinya Nirasawa
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan; Division of Infection Control, Sapporo Medical University Hospital, Sapporo, Japan
| | - Koichi Asanuma
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Koji Kuronuma
- Division of Infection Control, Sapporo Medical University Hospital, Sapporo, Japan; Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Takahashi
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan; Division of Infection Control, Sapporo Medical University Hospital, Sapporo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
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6
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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: 18] [Impact Index Per Article: 9.0] [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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Săveanu CI, Porsega A, Anistoroaei D, Iordache C, Bobu L, Săveanu AE. Cross-Sectional Study to Evaluate Knowledge on Hand Hygiene in a Pandemic Context with SARS-CoV-2. Medicina (B Aires) 2022; 58:medicina58020304. [PMID: 35208627 PMCID: PMC8878756 DOI: 10.3390/medicina58020304] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/07/2022] [Accepted: 02/15/2022] [Indexed: 01/24/2023] Open
Abstract
Background and Objectives: The basis of any infection control program is hand hygiene (HH). The aim of this study was to investigate knowledge of HH among medical students. Materials and Methods: Students were randomly selected from two Romanian universities and a cross-sectional, questionnaire-based study was conducted between January and May 2021. The answers regarding demographic data and knowledge concerning the methods, the time and the antiseptics used for HH were collected. The selection of the study group was made according to selection criteria in accordance with ethical issues. A descriptive statistical analysis was performed, and a chi-square test was used for data comparison, with a cut-off point of 0.05 for statistical significance. Results: The results indicated that the attitude of the students towards the practice of HH improved significantly. Most students believe that simple HH can control infections. Significant differences were found by the year of study in terms of the hand surfaces included and recommended duration (p < 0.05). Conclusions: In conclusion, the study shows that most respondents have sufficient knowledge on HH, meaning that a higher compliance is required to control infections. The indicated reasons of non-compliance with HH are emergencies and other priorities.
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Affiliation(s)
- Cătălina Iulia Săveanu
- Department I—Surgicals, Faculty of Dental Medicine, University of Medicine and Pharmacy Grigore T Popa, 700115 Iasi, Romania;
| | - Andreea Porsega
- Faculty of Dental Medicine, University of Medicine and Pharmacy Grigore T Popa, 700115 Iasi, Romania; (A.P.); (A.E.S.)
| | - Daniela Anistoroaei
- Department I—Surgicals, Faculty of Dental Medicine, University of Medicine and Pharmacy Grigore T Popa, 700115 Iasi, Romania;
- Correspondence: or (D.A.); (C.I.); or (L.B.); Tel.: +4-0721-377-269 (D.A.); +4-0745-503-852 (C.I.); +4-0747-896-205 (L.B.)
| | - Cristina Iordache
- Department of Implantology, Removable Prostheses, Dental Technology, Faculty of Dental Medicine, University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence: or (D.A.); (C.I.); or (L.B.); Tel.: +4-0721-377-269 (D.A.); +4-0745-503-852 (C.I.); +4-0747-896-205 (L.B.)
| | - Livia Bobu
- Department I—Surgicals, Faculty of Dental Medicine, University of Medicine and Pharmacy Grigore T Popa, 700115 Iasi, Romania;
- Correspondence: or (D.A.); (C.I.); or (L.B.); Tel.: +4-0721-377-269 (D.A.); +4-0745-503-852 (C.I.); +4-0747-896-205 (L.B.)
| | - Alexandra Ecaterina Săveanu
- Faculty of Dental Medicine, University of Medicine and Pharmacy Grigore T Popa, 700115 Iasi, Romania; (A.P.); (A.E.S.)
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Nishioka H, Shiozaki M, Nii T, Hayashi N, Hagi A. Pharmaceutical properties of a tinted formulation of a biguanide antiseptic agent, olanexidine gluconate. Biol Pharm Bull 2021; 45:220-225. [PMID: 34819410 DOI: 10.1248/bpb.b21-00833] [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: 11/22/2022]
Abstract
Olanexidine gluconate-containing preoperative antiseptic (OLG-C) is colorless, which makes it difficult to determine its area of application. To overcome this drawback, we realized a stable orange-tinted antiseptic (OLG-T) by adding new additives to OLG-C and investigated its pharmaceutical properties compared with OLG-C and povidone iodine (PVP-I). We evaluated the influence of the additives on the antimicrobial activity and adhesiveness of medical adhesives to OLG-T-applied skin by in vitro time-kill/ex vivo micropig skin assays and a peel test using excised micropig skin, respectively. In the in vitro time-kill assay, the bactericidal/fungicidal activity of OLG-T and OLG-C were equivalent. In the ex vivo micropig skin assay, their fast-acting and persistent bactericidal activities against vancomycin-resistant Enterococcus faecalis were higher than that of PVP-I. In the peel test, the adhesion force of the incise drape and the amount of stripped corneocytes on the peeled drape were comparable between OLG-T- and OLG-C-applied skin, but both were less than those of PVP-I-applied skin. The drapes for OLG-T- and OLG-C-applied skin had moderate adhesion force, and the drape-related injuries were expected to be weak. These results suggest that OLG-T performs no worse than OLG-C in terms of its antimicrobial activity and medical adhesive compatibility. Therefore, we expect OLG-T to lead to more convenient preoperative skin preparation and further contribute to lowering SSI rates.
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Affiliation(s)
- Hisae Nishioka
- Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc
| | - Mari Shiozaki
- Pharmaceutical Technology Department, Technical Center, Otsuka Pharmaceutical Factory, Inc
| | - Takuya Nii
- Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc
| | - Nahoki Hayashi
- Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc
| | - Akifumi Hagi
- Naruto Research Institute, Research and Development Center, Otsuka Pharmaceutical Factory, Inc
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Crosse KR. Pre-surgical hand preparation in veterinary practice. N Z Vet J 2021; 70:69-78. [PMID: 34586948 DOI: 10.1080/00480169.2021.1987348] [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: 10/20/2022]
Abstract
The objective of this paper is to review the evidence for different methods of surgical hand preparation applicable to veterinary practice. Surgical hand preparation is an essential step in performing surgery as a veterinarian. Recommended protocols and products for surgical hand preparation have varied since its inception in the late 1800s. Many factors must be considered when assessing the efficacy, safety, and users' compliance with any available product. Traditional scrub methods employing chlorhexidine gluconate or povidone-iodine have been compared to alcohol-based rub protocols with respect to immediate and prolonged efficacy, safety, compliance, requirements for theatre furniture, cost and water usage. Although much of the comparative data has been generated in human medical facilities, extrapolation of the data to veterinary surgery is appropriate. Considerations for veterinary practice are specifically discussed. Overall, the benefits of alcohol-based rubs indicate that this should be the preferred method of pre-surgical hand preparation for veterinarians in all types of practice.
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Affiliation(s)
- K R Crosse
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
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10
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Abuga K, Nyamweya N. Alcohol-Based Hand Sanitizers in COVID-19 Prevention: A Multidimensional Perspective. PHARMACY 2021; 9:64. [PMID: 33808754 PMCID: PMC8006002 DOI: 10.3390/pharmacy9010064] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 12/11/2022] Open
Abstract
The global use of alcohol-based hand sanitizers (ABHS) as an important means of controlling the transmission of infectious disease has increased significantly as governments and public health agencies across the world advocated hand hygiene as a preventative measure during the COVID-19 pandemic. Although the performance of these products is most commonly defined as a function of their alcohol concentration, they are multifaceted products in which an interplay of several factors is important in determining efficacy. This paper discusses the interplay between ABHS input (formulation) factors and output (product performance) factors in the context of a multidimensional perspective using a novel representative paradigm. In the model, represented in the form of a three-dimensional tetrahedron, each of the faces represents inputs in the manufacturing of the ABHS product, which are the type and amount of alcohol, the inactive ingredients, the formulation and the manufacturing practices. The four corners of the tetrahedron represent the product performance factors which include product efficacy, sensory characteristics, usage and compliance and product safety. The multidimensional approach to the formulation and evaluation of ABHS shows that several factors contribute to the effectiveness and utility of these products. The paradigm provides a useful framework for manufacturers of ABHS and related healthcare products.
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Affiliation(s)
- Kennedy Abuga
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Nairobi, Nairobi P.O. Box 19676-00202, Kenya
| | - Nasser Nyamweya
- Pharma Manufacturing Solutions, Nairobi P.O. Box 21297-00505, Kenya;
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11
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Khokhar M, Roy D, Purohit P, Goyal M, Setia P. Viricidal treatments for prevention of coronavirus infection. Pathog Glob Health 2020; 114:349-359. [PMID: 32877308 DOI: 10.1080/20477724.2020.1807177] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), which causes severe acute respiratory syndrome and lung failure, is caused by the novel coronavirus, also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to high transmission rates from individual to individual, it has progressed to a pandemic. However, indirect transmission from inanimate objects or surfaces that have come in contact with a patient poses an even more significant threat as it is difficult to trace the source of infection in these cases. Therefore, these surfaces and objects require disinfection with chemicals having potent viricidal activity. These include alcohols, aldehydes, quaternary ammonium compounds, chlorhexidine, and chlorine-based disinfectants, among others. They vary in their viricidal activity depending on their structure, concentrations, and mechanism of action. Several studies have looked into these agents and the transmission of the virus related to it. Moreover, certain viricides, if used as constituents of commercially available oral disinfectants, can further aid in preventing ventilator-associated pneumonia and maintain oral hygiene. However, these chemicals are not entirely free of potential hazards. In this review, we have compiled and critically appraised some commonly used viricidal agents in healthcare settings and the role they can play in the prevention of SARS-CoV-2 transmission.
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Affiliation(s)
- Manoj Khokhar
- Department of Biochemistry, AIIMS Jodhpur , Jodphur, India
| | - Dipayan Roy
- Department of Biochemistry, AIIMS Jodhpur , Jodphur, India
| | - Purvi Purohit
- Department of Biochemistry, AIIMS Jodhpur , Jodphur, India
| | - Manu Goyal
- Department of Obstetrics & Gynecology, AIIMS Jodhpur
| | - Puneet Setia
- Department of Forensic Medicine & Toxicology, AIIMS Jodhpur
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Comparative Antimicrobial Efficacy of Two Hand Sanitizers in Intensive Care Units Common Areas: A Randomized, Controlled Trial. Infect Control Hosp Epidemiol 2018; 39:267-271. [DOI: 10.1017/ice.2017.293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVEContaminated hands of healthcare workers (HCWs) are an important source of transmission of healthcare-associated infections. Alcohol-based hand sanitizers, while effective, do not provide sustained antimicrobial activity. The objective of this study was to compare the immediate and persistent activity of 2 hand hygiene products (ethanol [61% w/v] plus chlorhexidine gluconate [CHG; 1.0% solution] and ethanol only [70% v/v]) when used in an intensive care unit (ICU).DESIGNProspective, randomized, double-blinded, crossover studySETTINGThree ICUs at a large teaching hospitalPARTICIPANTSIn total, 51 HCWs involved in direct patient care were enrolled in and completed the study.METHODSAll HCWs were randomized 1:1 to either product. Hand prints were obtained immediately after the product was applied and again after spending 4–7 minutes in the ICU common areas prior to entering a patient room or leaving the area. The numbers of aerobic colony-forming units (CFU) were compared for the 2 groups after log transformation. Each participant tested the alternative product after a 3-day washout period.RESULTSOn bare hands, use of ethanol plus CHG was associated with significantly lower recovery of aerobic CFU, both immediately after use (0.27 ± 0.05 and 0.88 ± 0.08 log10 CFU; P = .035) and after spending time in ICU common areas (1.81 ± 0.07 and 2.17 ± 0.05 log10 CFU; P<.0001). Both the antiseptics were well tolerated by HCWs.CONCLUSIONSIn comparison to the ethanol-only product, the ethanol plus CHG sanitizer was associated with significantly lower aerobic bacterial counts on hands of HCWs, both immediately after use and after spending time in ICU common areas.CLINICAL TRIAL IDENTIFIERClinicaltrials.gov identifier NCT02258412Infect Control Hosp Epidemiol 2018;39:267–271
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Ryder M, Duley C. Evaluation of Compatibility of a Gum Mastic Liquid Adhesive and Liquid Adhesive Remover With an Alcoholic Chlorhexidine Gluconate Skin Preparation. JOURNAL OF INFUSION NURSING 2017; 40:245-252. [PMID: 28683004 PMCID: PMC5502121 DOI: 10.1097/nan.0000000000000230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The compatibility of a 2% chlorhexidine gluconate/70% isopropyl alcohol (CHG/IPA) skin preparation with a gum mastic liquid adhesive (GMLA) and liquid adhesive remover (LAR) was assessed in healthy volunteers. Twenty subjects completed test material combination with microbial sampling at 3- and 7-day time points. Mean log10 reductions from baseline for normal flora were assessed. There was no significant difference in reduction of normal flora on skin prepped with CHG/IPA versus skin prepped with CHG/IPA followed by GMLA or LAR. The conclusion of the study was that the use of GMLA or LAR with CHG/IPA does not affect the antiseptic effectiveness of CHG/IPA.
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Affiliation(s)
- Marcia Ryder
- Corresponding Author: Marcia Ryder, PhD, MS, RN, 912 Laurens Way, Brentwood, TN 37027 ()
| | - Collette Duley
- Ryder Science, Inc, Brentwood, Tennessee (Dr Ryder); and BioScience Laboratories, Inc, Bozeman, Montana (Ms Duley)
- Marcia Ryder, PhD, MS, RN, of Ryder Science, is an independent collaborative researcher and consultant in medical biofilm-related infections. Her nursing practice includes critical care and nutrition support. She is a nationally and internationally recognized expert in the use and management of vascular access devices
- Collette Duley, BS, has worked in the clinical laboratory for BioScience Laboratories for 10 years and as a principal investigator for more than 6 years. She has been an author on manuscripts and posters for various studies at numerous conferences
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El-Kased RF, Amer RI, Attia D, Elmazar MM. Honey-based hydrogel: In vitro and comparative In vivo evaluation for burn wound healing. Sci Rep 2017; 7:9692. [PMID: 28851905 PMCID: PMC5575255 DOI: 10.1038/s41598-017-08771-8] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/06/2017] [Indexed: 01/22/2023] Open
Abstract
Honey was used to treat wounds since ancient times till nowadays. The present study aimed at preparing a honey-based hydrogel and assay its antimicrobial properties and wound healing activity; in-vitro and in-vivo. Topical honey hydrogel formulations were prepared using three honey concentrations with gelling agents; chitosan and carbopol 934. The prepared formulae were evaluated for pH, spreadability, swelling index, in-vitro release and antimicrobial activity. The pH and spreadability were in the range of 4.3–6.8 and 5.7–8.6 cm, respectively. Chitosan-based hydrogel showed higher in-vitro honey release with diffusional exponent ‘n ≤ 0.5 indicates Fickian diffusion mechanism. Hydrogel formulae were assessed for in-vitro antimicrobial activity using Disc Diffusion antibiotic sensitivity test against common burn infections bacteria; Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumonia and Streptococcus pyogenes. The 75% honey-chitosan hydrogel showed highest antimicrobial activity. This formula was tested for in-vivo burn healing using burn-induced wounds in mice. The formula was evaluated for burn healing and antibacterial activities compared to commercial product. 75% honey-chitosan hydrogel was found to possess highest healing rate of burns. The present study concludes that 75% honey-chitosan hydrogel possesses greater wound healing activity compared to commercial preparation and could be safely used as an effective natural topical wound healing treatment.
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Affiliation(s)
- Reham F El-Kased
- Department of Microbiology & Immunology, Faculty of Pharmacy, The British University in Egypt, BUE, Cairo, Egypt.
| | - Reham I Amer
- Department of Pharmaceutics and Industrial Pharmacy Faculty of Pharmacy, October, University for Modern Sciences and Arts (MSA), Cairo, Egypt.,Department of Pharmaceutics, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Dalia Attia
- Department of Pharmaceutics, Faculty of Pharmacy, The British University in Egypt, BUE, Cairo, Egypt
| | - M M Elmazar
- Department of Pharmacology, Faculty of Pharmacy, The British University in Egypt, BUE, Cairo, Egypt
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15
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Foddai ACG, Grant IR, Dean M. Efficacy of Instant Hand Sanitizers against Foodborne Pathogens Compared with Hand Washing with Soap and Water in Food Preparation Settings: A Systematic Review. J Food Prot 2016; 79:1040-54. [PMID: 27296611 DOI: 10.4315/0362-028x.jfp-15-492] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hands can be a vector for transmitting pathogenic microorganisms to foodstuffs and drinks, and to the mouths of susceptible hosts. Hand washing is the primary barrier to prevent transmission of enteric pathogens via cross-contamination from infected persons. Conventional hand washing involves the use of water, soap, and friction to remove dirt and microorganisms. The availability of hand sanitizing products for use when water and soap are unavailable has increased in recent years. The aim of this systematic review was to collate scientific information on the efficacy of hand sanitizers compared with washing hands with soap and water for the removal of foodborne pathogens from the hands of food handlers. An extensive literature search was carried out using three electronic databases: Web of Science, Scopus, and PubMed. Twenty-eight scientific publications were ultimately included in the review. Analysis of this literature revealed various limitations in the scientific information owing to the absence of a standardized protocol for evaluating the efficacy of hand products and variation in experimental conditions. However, despite conflicting results, scientific evidence seems to support the historical skepticism about the use of waterless hand sanitizers in food preparation settings. Water and soap appear to be more effective than waterless products for removal of soil and microorganisms from hands. Alcohol-based products achieve rapid and effective inactivation of various bacteria, but their efficacy is generally lower against nonenveloped viruses. The presence of food debris significantly affects the microbial inactivation rate of hand sanitizers.
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Affiliation(s)
- Antonio C G Foddai
- Department of Life Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, Scotland, UK
| | - Irene R Grant
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast BT9 5BN, Northern Ireland, UK
| | - Moira Dean
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast BT9 5BN, Northern Ireland, UK.
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16
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Cole MR, Hobden JA, Warner IM. Recycling antibiotics into GUMBOS: a new combination strategy to combat multi-drug-resistant bacteria. Molecules 2015; 20:6466-87. [PMID: 25867831 PMCID: PMC6272440 DOI: 10.3390/molecules20046466] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/28/2015] [Accepted: 04/02/2015] [Indexed: 11/16/2022] Open
Abstract
The emergence of multi-drug-resistant bacteria, coupled with the lack of new antibiotics in development, is fast evolving into a global crisis. New strategies utilizing existing antibacterial agents are urgently needed. We propose one such strategy in which four outmoded β-lactam antibiotics (ampicillin, carbenicillin, cephalothin and oxacillin) and a well-known antiseptic (chlorhexidine di-acetate) were fashioned into a group of uniform materials based on organic salts (GUMBOS) as an alternative to conventional combination drug dosing strategies. The antibacterial activity of precursor ions (e.g., chlorhexidine diacetate and β-lactam antibiotics), GUMBOS and their unreacted mixtures were studied with 25 clinical isolates with varying antibiotic resistance using a micro-broth dilution method. Acute cytotoxicity and therapeutic indices were determined using fibroblasts, endothelial and cervical cell lines. Intestinal permeability was predicted using a parallel artificial membrane permeability assay. GUMBOS formed from ineffective β-lactam antibiotics and cytotoxic chlorhexidine diacetate exhibited unique pharmacological properties and profound antibacterial activity at lower concentrations than the unreacted mixture of precursor ions at equivalent stoichiometry. Reduced cytotoxicity to invasive cell types commonly found in superficial and chronic wounds was also observed using GUMBOS. GUMBOS show promise as an alternative combination drug strategy for treating wound infections caused by drug-resistant bacteria.
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Affiliation(s)
- Marsha R Cole
- Commodity Utilization, Southern Regional Research Center, Agricultural Research Services, United States Department of Agriculture, New Orleans, LA 70124, USA.
| | - Jeffery A Hobden
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Medical Center, New Orleans, LA 70112, USA.
| | - Isiah M Warner
- Department of Chemistry, Louisiana State University, Baton Rouge, LA 70803, USA.
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17
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Measuring residual activity of topical antimicrobials: is the residual activity of chlorhexidine an artefact of laboratory methods? J Hosp Infect 2014; 88:113-5. [DOI: 10.1016/j.jhin.2014.06.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 06/27/2014] [Indexed: 11/19/2022]
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Chow J, Ng J, Pun A. Effects of food colouring added to 2% chlorhexidine gluconate and 70% alcohol for surgical site antisepsis. J Perioper Pract 2013; 23:255-7. [PMID: 24312996 DOI: 10.1177/175045891302301104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Preoperative cleansing of a patient's skin with chlorhexidine gluconate (CHG) in alcohol is superior to cleansing with povidone-iodine for preventing surgical site infection (SSI) after clean-contaminated surgery (Darouilche et al 2010). However, 2% CHG in 70% alcohol, tinted pink, is colourless when applied to limbs for surgery and complete coverage cannot be assured. The purpose of the study was to evaluate the efficacy of food colouring added to CHG in preoperative skin preparation. Two hundred and eight subjects were randomly selected from a population of healthy young adults and were given a questionnaire. They were excluded if they had a known allergy to CHG or food dye, a current infection at the preparation site, or previous preparation with CHG at the site. CHG with food dye additive was applied on the subject's left foot while CHD without the additive was applied on the right. Skin swabs were then taken of both feet and plated on blood agar plates and incubated for 48 hours. Assessment of growth was compared. Patients treated with tinted CHG had around 3.4 times (95% CI: 1.5, 7.8) the risk of a positive bacterial swab compared with those treated with untinted CHG. The efficacy of CHG significantly decreased with food colouring additive. This is consistent with previous studies conducted on similar incompatible substances. In order to have the full efficacy of CHG as a preparation, much thought and care needs to be taken to prevent contamination of the site and substance.
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Affiliation(s)
- Jason Chow
- Mona Vale Hospital, Coronation Street, Mona Vale, NSW 2103, Australia.
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19
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Hommelstad J, Madsø A, Eide PK. Significant reduction of shunt infection rate in children below 1 year of age after implementation of a perioperative protocol. Acta Neurochir (Wien) 2013; 155:523-31. [PMID: 23224578 DOI: 10.1007/s00701-012-1574-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 11/23/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Shunt infection markedly impairs the clinical result of shunt surgery. The infection rate can be reduced by dedicated protocols. This study was undertaken to determine the efficacy of introducing a perioperative protocol for control of shunt infections. METHOD The shunt infection rate and risk factors for shunt infection were determined for two periods, namely the period 2001-2002 (Patient Material A), and the period 2005-2008 (Patient Material B). The perioperative protocol was introduced in 2005 before the second period. RESULTS The total patient material includes 901 patients, in whom 1,404 shunt procedures were performed during the study periods. While the overall infection rate dropped nonsignificantly from 6.5 % to 4.3 %, infection rate dropped markedly and significantly from 18.4 % to 5.7 % among the children younger than 1 year (p = 0.016). The significant risk factors for shunt infection were in Patient Material A age below 1 year (p < .001), and in Patient Material B premature birth (p = 0.045), postoperative cerebrospinal fluid (CSF) leakage (p < .001) and high American Society of Anaesthesiologists (ASA) score (p = 0.039). Of the protocol steps, only the lack of preoperative wash with 4 % clorhexidine gluconate (Hibiscrub®) showed a tendency of influencing the shunt infection rate (p = 0.051). CONCLUSIONS This study showed that implementation of a perioperative protocol markedly and significantly reduced shunt infection rate in children younger than 1 year, even though no significant overall reduction in shunt infection rate was found.
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Kampf G, Reichel M, Hollingsworth A, Bashir M. Efficacy of surgical hand scrub products based on chlorhexidine is largely overestimated without neutralizing agents in the sampling fluid. Am J Infect Control 2013; 41:e1-5. [PMID: 23287283 DOI: 10.1016/j.ajic.2012.07.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 07/18/2012] [Accepted: 07/19/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Surgical hand antiseptics often contain chlorhexidine gluconate (CHG). There are doubts that the full effect measured for these products might only be achieved after sampling because of a lack of valid neutralizing agents (NAs) in the sampling fluid. METHODS We measured the efficacy of Avagard CHG and Hibiclens for 11 applications over 5 days according to the manufacturers' instructions. NAs were added to the sampling fluid and the dilution fluid (group 1) or to only the dilution fluid (group 2). In a third group, NAs were added to the dilution fluid only, and cream was applied after the final scrub on days 1 to 4. Neutralization was validated according to American Society for Testing and Materials International standard 1054 using Staphylococcus epidermidis. RESULTS When NAs were not added to the sampling fluid, both products were very effective, with a mean log(10) reduction in flora of 3.32 ± 0.53 for Avagard and 3.68 ± 0.52 for Hibiclens on day 5. When NAs were included in the sampling fluid, however, the immediate efficacy was significantly lower, at 2.75 ± 0.55 and 3.14 ± 0.50, respectively. A lack of NAs in the sampling fluid resulted in overestimation of efficacy by a factor of between 0.3 and 1.1 log(10). CONCLUSION Efficacy studies carried out without NAs in the sampling fluid for products with CHG should be critically assessed.
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Miller LG. Where We Are With Community-Associated Staphylococcus aureus Prevention—And in the Meantime, What Do We Tell Our Patients? Clin Infect Dis 2011; 54:752-4. [DOI: 10.1093/cid/cir922] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Loren G. Miller
- Division of Infectious Diseases and Los Angeles Biomedical Research Institute, Harbor–UCLA Medical Center
- David Geffen School of Medicine at the University of California, Los Angeles
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22
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Karpanen TJ, Casey AL, Conway BR, Lambert PA, Elliott TSJ. Antimicrobial activity of a chlorhexidine intravascular catheter site gel dressing. J Antimicrob Chemother 2011; 66:1777-84. [PMID: 21609979 DOI: 10.1093/jac/dkr191] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The antimicrobial efficacy of a chlorhexidine gluconate (CHG) intravascular catheter gel dressing was evaluated against methicillin-resistant Staphylococcus aureus (MRSA) and an extended-spectrum β-lactamase (ESBL)-producing Escherichia coli. Chlorhexidine deposition on the skin surface and release from the gel were determined. METHODS The antimicrobial efficacy was evaluated in in vitro studies following microbial inoculation of the dressing and application of the dressing on the inoculated surface of a silicone membrane and donor skin [with and without a catheter segment and/or 10% (v/v) serum] on diffusion cells. Antimicrobial activity was evaluated for up to 7 days. Chlorhexidine skin surface deposition and release were also determined. RESULTS MRSA and E. coli were not detectable within 5 min following direct inoculation onto the CHG gel dressing. On the silicone membrane, 3 log and 6 log inocula of MRSA were eradicated within 5 min and 1 h, respectively. Time to kill was prolonged in the presence of serum and a catheter segment. Following inoculation of donor skin with 6 log cfu of MRSA, none was detected after 24 h. Chlorhexidine was released from the gel after a lag time of 30 min and increasing amounts were detected on the donor skin surface over the 48 h test period. The CHG gel dressing retained its antimicrobial activity on the artificial skin for 7 days. CONCLUSIONS The CHG intravascular catheter site gel dressing had detectable antimicrobial activity for up to 7 days, which should suppress bacterial growth on the skin at the catheter insertion site, thereby reducing the risk of infection.
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Affiliation(s)
- Tarja J Karpanen
- Department of Clinical Microbiology and Infection Control, University Hospitals Birmingham NHS Foundation Trust, UK
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Osorio R, Yamauti M, Osorio E, Ruiz-Requena ME, Pashley D, Tay F, Toledano M. Effect of dentin etching and chlorhexidine application on metalloproteinase-mediated collagen degradation. Eur J Oral Sci 2011; 119:79-85. [PMID: 21244516 DOI: 10.1111/j.1600-0722.2010.00789.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Dentin matrix metalloproteinases (MMPs) are involved in the degradation of collagen in resin-dentin interfaces. This study evaluated whether collagen degradation can be prevented by chlorhexidine digluconate (CHX) after different dentin demineralization procedures. The demineralization of human dentin was performed with phosphoric acid (PA), EDTA or acidic monomers (Clearfil SE Bond and Xeno V). Specimens were stored (for 24 h, or for 1 or 3 wk) in the presence or absence of CHX. In half of the groups, active MMP-2 was incorporated into the storage solution. At the end of each storage period, the C-terminal telopeptide (ICTP) concentration (which indicates the amount of collagen degradation) was measured in the storage solution. Collagen degradation was higher in PA- and EDTA-demineralized dentin. Chlorhexidine digluconate reduced collagen degradation in these groups only for 24 h. When dentin was demineralized with Clearfil SE Bond or Xeno V, collagen degradation was reduced by up to 30%, but the addition of exogenous MMP-2 significantly increased collagen degradation. In self-etchant-treated dentin, the inhibitory effect of CHX on MMPs lasted for up to 3 wk. Treating dentin with EDTA, PA or self-etching agents produces enough demineralization to permit cleavage of the exposed collagen. Monomer infiltration may exert protection on demineralized collagen, probably through immobilization of MMPs. The partial inhibitory action of CHX on MMP activity produced by self-etching adhesives was prolonged compared with the short-acting PA- or EDTA-treated dentin.
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Affiliation(s)
- Raquel Osorio
- Department of Dental Materials, School of Dentistry, University of Granada, Granada, Spain.
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Response to Kampf. Am J Infect Control 2011. [DOI: 10.1016/j.ajic.2010.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Kampf G, Ostermeyer C. "Persistent activity" of chlorhexidine or alcohol-based hand rubs-what is really necessary to prevent nosocomial infections? Am J Infect Control 2011; 39:255-6; author reply 256-8. [PMID: 21458687 DOI: 10.1016/j.ajic.2009.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Revised: 11/23/2009] [Accepted: 11/30/2009] [Indexed: 11/15/2022]
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