Pharmacokinetic and metabolic disposition of p-chloro-m-xylenol (PCMX) in dogs

Human exposure and health risk assessment of an increasingly used antibacterial alternative in personal care products: Chloroxylenol

The ban of some antibacterial ingredients, such as triclosan (TCS) and triclocarban (TCC), in personal care products (PCPs) in some countries (but not in China) has resulted in the increasing use of antibacterial alternatives, such as chloroxylenol (PCMX). However, the underlying human health risks and environmental impacts of PCMX exposure are largely unknown. Thus, the distribution characteristics of PCMX in PCPs and susceptible populations and the major routes and health risks of human exposure to PCMX were investigated. The PCMX, TCS, and TCC concentrations in PCPs, urine, drinking water, and surface water were determined using high-performance liquid chromatograph system equipped with diode array detector or triple quadrupole mass spectrometer. Results showed that PCMX is widely used in antibacterial hand sanitizers and household disinfectants in China. The addition of PCMX as an antibacterial ingredient in PCPs showed an increasing trend. The geomean concentrations of urinary PCMX in children and pregnant women were 21.6 and 31.9 μg·L^-1, respectively, which were much higher than TCS and TCC. A considerable concentration of PCMX ranging from 1.62 to 9.57 μg·L^-1 was observed in the aquatic environment, suggesting a potential massive-use of PCMX by humans. Human PCMX exposure via drinking was negligible because the PCMX concentrations in drinking water were less than 2.00 ng·L^-1. During human simulation experiment, we found that dermal contact was the dominant route of human PCMX exposure, accounting for 92.1% of the urinary PCMX concentration. The estimated daily intake of PCMX in 9.68% of children and 5.66% of pregnant women was higher than the reference dose. However, the urinary 8-hydroxy-2'-deoxyguanosine concentrations remained stable despite the elevated PCMX concentrations, thereby suggesting that daily PCMX exposure may not cause oxidative DNA damage in humans. Nevertheless, the potential ecotoxicity and health risks induced by chronic PCMX exposure cannot be ignored because of its increasing use.

Use of the 'ex vivo' test to study long-term bacterial survival on human skin and their sensitivity to antisepsis

AIMS

To determine bacterial survival on human skin and their sensitivity to antisepsis.

METHODS AND RESULTS

An 'ex vivo' protocol which uses human skin samples placed into diffusion cells, and electron microscopy (EM), were used to study the growth of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa inoculated onto skin samples over a 46-h incubation period at 32 degrees C. Concurrently variation in skin pH was evaluated at different time intervals during this period. In addition the antimicrobial activity of three antiseptics against the incubated micro-organisms was assessed quantitatively with the 'ex vivo' test, while their detrimental effects against bacteria were observed by EM. All three bacteria were still present in high number after 46 h inoculation on skin, although the concentration of E. coli and S. aureus were reduced by 2.74 and 1.58 log(10) reduction, respectively, over this period of time. Electron micrographs showed clear evidence of cell division and some bacteria appeared to be embedded into the skin layers. The antiseptics tested had some antibacterial activity against bacteria incubated on skin for 3 and 10 h, and EM evidence showed some morphological damages including cellular blebbing and the presence of fibrillar material around the cells. All micro-organisms had an acidifying effect on skin samples.

CONCLUSIONS

Here, it was shown that bacterial pathogens can survive and grow when incubated on human skin. In addition, it is possible that they can penetrate the stratum corneum, which can provide some protection against antisepsis.

SIGNIFICANCE AND IMPACT OF THE STUDY

The apparent low bactericidal activity of biocides attributed in part to bacterial protection from skin layers is particularly important to assess in order to ensure antisepsis efficacy.

Chlorhexidine gluconate versus chloroxylenol for preoperative skin preparation in dogs

The efficacy of 3% chloroxylenol (PCMX) or 4% chlorhexidine gluconate (CG) for preoperative skin preparation was assessed in 100 dogs undergoing clean or clean-contaminated surgical procedures. Replication Organism Detection and Counting (RODAC) plates were used to quantify skin bacteria colony forming units (CFU) at the operative site before and after skin preparation and immediately postoperatively. Reduction of CFU after skin preparation and immediately postoperatively was significant for each agent. However, CFU levels were significantly lower in the CG group than in the PCMX group after surgical preparation, regardless of initial CFU numbers. No significant difference in CFU counts was observed between antiseptic groups postoperatively. Within-group comparisons showed PCMX to be significantly less efficacious when the prescrub CFU number was greater than 1,000. Bacterial reduction was similar in the CG group regardless of prescrub CFU levels. The number of negative cultures after skin preparation was significantly greater with CG than with PCMX. Chlorhexidine gluconate also had fewer cultures with heavy bacterial growth (> 5 CFUs) after surgical preparation. There was no significant difference between antiseptics in the number of negative cultures or cultures with more than 5 CFUs immediately after surgery. The number of skin reactions and postoperative wound infections that occurred with each technique were similar. Three percent PCMX, as used in this study, was less effective than 4% CG in its immediate antimicrobial activity, however, this difference was not associated with an increased wound infection rate.