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Groenen H, Bontekoning N, Jalalzadeh H, Buis DR, Dreissen YEM, Goosen JHM, Graveland H, Griekspoor M, IJpma FFA, van der Laan MJ, Schaad RR, Segers P, van der Zwet WC, Orsini RG, Eskes AM, Wolfhagen N, de Jonge SW, Boermeester MA. Incisional Wound Irrigation for the Prevention of Surgical Site Infection: A Systematic Review and Network Meta-Analysis. JAMA Surg 2024; 159:792-800. [PMID: 38656408 PMCID: PMC11044014 DOI: 10.1001/jamasurg.2024.0775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/06/2024] [Indexed: 04/26/2024]
Abstract
Importance Surgical site infections (SSIs) are common postoperative complications and associated with significant morbidity, mortality, and costs. Prophylactic intraoperative incisional wound irrigation is used to reduce the risk of SSIs, and there is great variation in the type of irrigation solutions and their use. Objective To compare the outcomes of different types of incisional prophylactic intraoperative incisional wound irrigation for the prevention of SSIs in all types of surgery. Data Sources PubMed, Embase, CENTRAL, and CINAHL databases were searched up to June 12, 2023. Study Selection Included in this study were randomized clinical trials (RCTs) comparing incisional prophylactic intraoperative incisional wound irrigation with no irrigation or comparing irrigation using different types of solutions, with SSI as a reported outcome. Studies investigating intracavity lavage were excluded. Data Extraction and Synthesis This systematic review and network meta-analysis is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Two reviewers independently extracted the data and assessed the risk of bias within individual RCTs using the Cochrane Risk of Bias 2 tool and the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation framework. A frequentist network meta-analysis was conducted, and relative risks (RRs) with corresponding 95% CIs were reported. Main Outcome and Measure The primary study outcome was SSI. Results A total of 1587 articles were identified, of which 41 RCTs were included in the systematic review, with 17 188 patients reporting 1328 SSIs, resulting in an overall incidence of 7.7%. Compared with no irrigation, antiseptic solutions (RR, 0.60; 95% CI, 0.44-0.81; high level of certainty) and antibiotic solutions (RR, 0.46; 95% CI, 0.29-0.73; low level of certainty) were associated with a beneficial reduction in SSIs. Saline irrigation showed no statistically significant difference compared with no irrigation (RR, 0.83; 95% CI, 0.63-1.09; moderate level of certainty). Conclusions and Relevance This systematic review and network meta-analysis found high-certainty evidence that prophylactic intraoperative incisional wound irrigation with antiseptic solutions was associated with a reduction in SSIs. It is suggested that the use of antibiotic wound irrigation be avoided due to the inferior certainty of evidence for its outcome and global antimicrobial resistance concerns.
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Affiliation(s)
- Hannah Groenen
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, the Netherlands
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
| | - Nathan Bontekoning
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, the Netherlands
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
| | - Hasti Jalalzadeh
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, the Netherlands
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
| | - Dennis R. Buis
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
- Department of Neurosurgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Yasmine E. M. Dreissen
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
- Department of Neurosurgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Jon H. M. Goosen
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
- Department of Orthopedic Surgery, Sint Maartenskliniek, Ubbergen, the Netherlands
| | - Haitske Graveland
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
| | - Mitchel Griekspoor
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
- Dutch Association of Medical Specialists, Utrecht, the Netherlands
| | - Frank F. A. IJpma
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
- Department of Surgery, Division of Trauma Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Maarten J. van der Laan
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Roald R. Schaad
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
- Department of Anaesthesiology, Leiden University Medical Centre, Leiden, the Netherlands
- Dutch Association of Anaesthesiology (NVA), the Netherlands
| | - Patrique Segers
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
- Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Wil C. van der Zwet
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Ricardo G. Orsini
- Department of Surgery, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Anne M. Eskes
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Niels Wolfhagen
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, the Netherlands
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
| | - Stijn W. de Jonge
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, the Netherlands
| | - Marja A. Boermeester
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, the Netherlands
- Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, the Netherlands
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Melkam A, Sionov RV, Shalish M, Steinberg D. Enhanced Anti-Bacterial Activity of Arachidonic Acid against the Cariogenic Bacterium Streptococcus mutans in Combination with Triclosan and Fluoride. Antibiotics (Basel) 2024; 13:540. [PMID: 38927206 PMCID: PMC11200779 DOI: 10.3390/antibiotics13060540] [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: 05/20/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Dental caries is a global health problem that requires better prevention measures. One of the goals is to reduce the prevalence of the cariogenic Gram-positive bacterium Streptococcus mutans. We have recently shown that naturally occurring arachidonic acid (AA) has both anti-bacterial and anti-biofilm activities against this bacterium. An important question is how these activities are affected by other anti-bacterial compounds commonly used in mouthwashes. Here, we studied the combined treatment of AA with chlorhexidine (CHX), cetylpyridinium chloride (CPC), triclosan, and fluoride. Checkerboard microtiter assays were performed to determine the effects on bacterial growth and viability. Biofilms were quantified using the MTT metabolic assay, crystal violet (CV) staining, and live/dead staining with SYTO 9/propidium iodide (PI) visualized by spinning disk confocal microscopy (SDCM). The bacterial morphology and the topography of the biofilms were visualized by high-resolution scanning electron microscopy (HR-SEM). The effect of selected drug combinations on cell viability and membrane potential was investigated by flow cytometry using SYTO 9/PI staining and the potentiometric dye DiOC2(3), respectively. We found that CHX and CPC had an antagonistic effect on AA at certain concentrations, while an additive effect was observed with triclosan and fluoride. This prompted us to investigate the triple treatment of AA, triclosan, and fluoride, which was more effective than either compound alone or the double treatment. We observed an increase in the percentage of PI-positive bacteria, indicating increased bacterial cell death. Only AA caused significant membrane hyperpolarization, which was not significantly enhanced by either triclosan or fluoride. In conclusion, our data suggest that AA can be used together with triclosan and fluoride to improve the efficacy of oral health care.
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Affiliation(s)
- Avraham Melkam
- Faculty of Dental Medicine, Ein Kerem Campus, Institute of Biomedical and Oral Research (IBOR), The Hebrew University of Jerusalem, Jerusalem 9112102, Israel; (A.M.); (R.V.S.)
- Hadassah Medical Center, Department of Orthodontics, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel;
| | - Ronit Vogt Sionov
- Faculty of Dental Medicine, Ein Kerem Campus, Institute of Biomedical and Oral Research (IBOR), The Hebrew University of Jerusalem, Jerusalem 9112102, Israel; (A.M.); (R.V.S.)
| | - Miriam Shalish
- Hadassah Medical Center, Department of Orthodontics, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel;
| | - Doron Steinberg
- Faculty of Dental Medicine, Ein Kerem Campus, Institute of Biomedical and Oral Research (IBOR), The Hebrew University of Jerusalem, Jerusalem 9112102, Israel; (A.M.); (R.V.S.)
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Bontekoning N, Huizing NJ, Timmer AS, Groenen H, de Jonge SW, Boermeester MA. Topical antimicrobial treatment of mesh for the reduction of surgical site infections after hernia repair: a systematic review and meta-analysis. Hernia 2024; 28:691-700. [PMID: 38722398 PMCID: PMC11249405 DOI: 10.1007/s10029-024-02987-0] [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: 12/05/2023] [Accepted: 02/08/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE Use of mesh is essential in hernia repair. A common complication after hernia repair is surgical site infection (SSI), which poses a risk in spreading to the mesh, possibly causing mesh infection. Topical antimicrobial pretreatment of mesh may potentially reduce SSI risk in hernia repair and has shown promising results in in vitro and in vivo studies. Clinical evidence, however, is more important. This systematic review aims to provide an overview of available clinical evidence for antimicrobial pretreated mesh in hernia repair surgery to reduce SSI. METHODS We report in accordance with PRISMA guidelines. CENTRAL, EMBASE, CINAHL and PubMed were searched up to October 2023 for studies that investigated the use of antimicrobial pretreated mesh on SSI incidence in adults undergoing hernia repair. The primary outcome was SSI incidence. We also collected data on pathogen involvement, hernia recurrence, and mesh infection. A meta-analysis on SSI risk and GRADE-assessment was performed of eligible studies. RESULTS We identified 11 eligible studies (n = 2660 patients); 5 randomized trials and 6 cohort studies. Investigated interventions included pre-coated mesh, antibiotic carriers, mesh soaked or irrigated with antibiotic or antiseptic solution. Meta-analysis showed no significant reduction in SSI for antibiotic pretreated polypropylene mesh (RR 0.76 [95% CI 0.27; 2.09]; I2 50%). CONCLUSION Data on topical mesh pretreatment to reduce SSI risk after hernia repair is limited. Very low certainty evidence from randomized trials in hernia repair surgery shows no significant benefit for antibiotic mesh pretreatment for SSI reduction, but data are imprecise due to optimal information size not being met.
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Affiliation(s)
- Nathan Bontekoning
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, The Netherlands
| | - Nathalie J Huizing
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Allard S Timmer
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, The Netherlands
| | - Hannah Groenen
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, The Netherlands
| | - Stijn W de Jonge
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, The Netherlands
| | - Marja A Boermeester
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, The Netherlands.
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Batista CSP, Loscos-Giménez I, Gámez M, Altaba R, de Miniac D, Martí N, Bassaganyas F, Juanes E, Rivera A, Navarro F. Comparing the in vitro efficacy of chlorhexidine and povidone-iodine in the prevention of post-surgical endophthalmitis. J Ophthalmic Inflamm Infect 2024; 14:20. [PMID: 38782819 PMCID: PMC11116284 DOI: 10.1186/s12348-024-00404-2] [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: 12/13/2023] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Intravitreal injections are a common ophthalmologic procedure. While infections following these injections are rare, they can lead to endophthalmitis, with potentially serious consequences. Various methods have been proposed to prevent endophthalmitis, including the use of antisepsis and antibiotics in patient preparation. PURPOSE To evaluate the antiseptic efficacy of aqueous chlorhexidine (CHX) and povidone-iodine (PI) when used alone and in combination with lidocaine gel (LG) in vitro. METHODS Two independent experimental trials were conducted. The first trial determined the minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs) of CHX and PI against six bacterial strains. The second trial evaluated the bactericidal efficacy of the antiseptic agents (CHX 0.1% and PI 5%) and their combination with LG against the same bacterial strains. RESULTS CHX was more effective than PI in reducing the number of colonies forming units (cfus) of the tested bacteria. The order in which the antiseptic and LG were administered affected their effectiveness, with CHX administered before LG resulting in greater reduction of bacterial growth. CONCLUSIONS CHX 0.1% is more effective than PI 5% as an antiseptic agent. Application of CHX and PI prior to the use of lidocaine gel results in a more effective reduction of microorganisms.
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Affiliation(s)
- Celso Soares Pereira Batista
- Microbiology department, Hospital de la Santa Creu i Sant Pau, C/ Sant Quintí, 89. Planta B-2, Barcelona, 08041, Spain
- Department of Genetics and Microbiology, Autonomous University of Barcelona, Barcelona, Spain
| | - Irene Loscos-Giménez
- Ophthalmology department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María Gámez
- Pharmacy department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Raul Altaba
- Microbiology department, Hospital de la Santa Creu i Sant Pau, C/ Sant Quintí, 89. Planta B-2, Barcelona, 08041, Spain
| | - Daniela de Miniac
- Microbiology department, Hospital de la Santa Creu i Sant Pau, C/ Sant Quintí, 89. Planta B-2, Barcelona, 08041, Spain
| | - Neus Martí
- Microbiology department, Hospital de la Santa Creu i Sant Pau, C/ Sant Quintí, 89. Planta B-2, Barcelona, 08041, Spain
| | | | - Elena Juanes
- Pharmacy department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Alba Rivera
- Microbiology department, Hospital de la Santa Creu i Sant Pau, C/ Sant Quintí, 89. Planta B-2, Barcelona, 08041, Spain.
- Department of Genetics and Microbiology, Autonomous University of Barcelona, Barcelona, Spain.
- Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain.
| | - Ferran Navarro
- Microbiology department, Hospital de la Santa Creu i Sant Pau, C/ Sant Quintí, 89. Planta B-2, Barcelona, 08041, Spain
- Department of Genetics and Microbiology, Autonomous University of Barcelona, Barcelona, Spain
- Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
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Pimenta J, Dias C, Cotovio M, Saavedra MJ. In Vitro Effect of Eucalyptus Essential Oils and Antiseptics (Chlorhexidine Gluconate and Povidone-Iodine) against Bacterial Isolates from Equine Wounds. Vet Sci 2023; 11:12. [PMID: 38250918 PMCID: PMC10819342 DOI: 10.3390/vetsci11010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/23/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
Considering the increasing antibiotics resistance, there has been a propensity to replace them with antiseptics when it comes to wound management and treatment. Nevertheless, in recent years, there have been reports regarding resistance to antiseptics by some bacterial strains. There is also concern about the environmental impact of these substances. The aim of this study was to compare the antimicrobial efficacy of antiseptics and eucalyptus essential oils on bacterial strains from horse's wounds. We used twelve Escherichia coli, eight Staphylococcus aureus, two Staphylococcus pseudintermedius, one Staphylococcus vitulinus and one Staphylococcus saprophyticus strains from equine wounds. The effect of Eucalyptus radiata essential oil, Eucalyptus globulus essential oil, povidone-iodine and chlorhexidine gluconate against the isolated strains was evaluated applying the Kirby-Baüer method. Regarding the Escherichia coli strains, E. radiata and the mixture of E. radiata and E. globulus had a better inhibitory effect than antiseptics. E. globulus had a better effect against most Staphylococcus spp. compared to E. radiata. For both Gram-negative and Gram-positive strains tested, chlorhexidine gluconate had a better inhibitory effect than povidone-iodine. The antibacterial efficacy of essential oils highlights their potential to substitute or complement the use of antiseptics and so reduce resistance to antiseptics.
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Affiliation(s)
- José Pimenta
- Department of Veterinary Sciences, Antimicrobials, Biocides & Biofilms Unit (A2BUnit), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (J.P.); (C.D.); (M.C.)
- CECAV—Veterinary and Animal Research Center and Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- CIVG—Vasco da Gama Research Center/EUVG–Vasco da Gama University School, 3020-210 Coimbra, Portugal
| | - Carla Dias
- Department of Veterinary Sciences, Antimicrobials, Biocides & Biofilms Unit (A2BUnit), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (J.P.); (C.D.); (M.C.)
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences and Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Mário Cotovio
- Department of Veterinary Sciences, Antimicrobials, Biocides & Biofilms Unit (A2BUnit), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (J.P.); (C.D.); (M.C.)
- CECAV—Veterinary and Animal Research Center and Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Faculty of Veterinary Medicine, Lusófona University, Campo Grande 376, 1749-024 Lisbon, Portugal
| | - Maria José Saavedra
- Department of Veterinary Sciences, Antimicrobials, Biocides & Biofilms Unit (A2BUnit), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (J.P.); (C.D.); (M.C.)
- CECAV—Veterinary and Animal Research Center and Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences and Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
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Feilcke R, Bär V, Wendt C, Imming P. Antibacterial and Disinfecting Effects of Standardised Tea Extracts on More than 100 Clinical Isolates of Methicillin-Resistant Staphylococcus aureus. PLANTS (BASEL, SWITZERLAND) 2023; 12:3440. [PMID: 37836180 PMCID: PMC10575227 DOI: 10.3390/plants12193440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infections are still a major problem in hospitals. The excellent safety profile, accessibility and anti-infective activity of tea extracts make them promising agents for the treatment of infected wounds. To investigate the possibility of sterilising MRSA-infected surfaces, including skin with tea extracts, we determined the MICs for different extracts from green and black tea (Camellia sinensis), including epigallocatechin gallate (EGCG), on a large number of clinical isolates of MRSA, selected to represent a high genetic diversity. The extracts were prepared to achieve the maximal extraction of EGCG from tea and were used as stable lyophilisate with a defined EGCG content. All extracts showed a complete inhibition of cell growth at a concentration of approx. 80 µg/mL of EGCG after a contact time of 24 h. Time-kill plots were recorded for the extract with the highest amount of EGCG. The reduction factor (RF) was 5 after a contact time of 240 min. EGCG and tea extracts showed an RF of 2 in methicillin-sensitive S. aureus. Extracts from green and black tea showed lower MICs than an aqueous solution with the same concentration of pure EGCG. To the best of our knowledge, we are the first to show a reduction of 99.999% of clinically isolated MRSA by green tea extract within 4 h.
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Affiliation(s)
- Ruth Feilcke
- Institut für Pharmazie, Martin-Luther-Universität Halle-Wittenberg, Kurt-Mothes-Str. 3, 06120 Halle, Germany
| | - Volker Bär
- Institut für Pharmazie, Martin-Luther-Universität Halle-Wittenberg, Kurt-Mothes-Str. 3, 06120 Halle, Germany
| | - Constanze Wendt
- Zentrum für Infektiologie, Universität Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
- Labor Dr. Limbach & Kollegen GbR, Medizinisches Versorgungszentrum, Im Breitspiel 15, 69126 Heidelberg, Germany
| | - Peter Imming
- Institut für Pharmazie, Martin-Luther-Universität Halle-Wittenberg, Kurt-Mothes-Str. 3, 06120 Halle, Germany
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Sodhi P, Jiang Y, Lin S, Downey J, Sorenson C, Shayegh M, Sullivan V, Kingsley K, Howard KM. Administration of Clinical COVID-19 Mouthwashing Protocol and Potential Modulation of Pediatric Oral Bacterial Prevalence of Selenomonas noxia: A Pilot Study. Pediatr Rep 2023; 15:414-425. [PMID: 37489412 PMCID: PMC10366775 DOI: 10.3390/pediatric15030038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023] Open
Abstract
Dental office protocols to combat the SARS-CoV-2 (COVID-19) pandemic include mouth washing for an extended 60 s, thereby reducing detectable oral virus. However, it is unclear whether this protocol has any effects on the newly identified periodontal pathogen and obesity-related bacterium often found among pediatric patients, Selenomonas noxia. To determine if the mouthwash protocol has any measurable effect on S. noxia amongst pediatric patients, clinical pediatric saliva samples were obtained from pediatric patients during routine visits for clinical care and treatment. Using an approved protocol, two saliva samples were collected on the same visit before and after chlorhexidine mouthwash (Sample A, Sample B). The third sample (Sample C) was taken at the recall appointment-usually between two and eight weeks later. A total of n = 97 pre-mouthwash samples, and an equal number of matching post-mouthwash samples (n = 97) were collected, with a small number of matching recall samples (n = 36) that were subsequently collected and identified. The demographic composition of the study sample was analyzed using Chi square statistics. Sample DNA from the matching pre-, post-, and recall collections (Sample A, Sample B, and Sample C) was isolated and screened using qPCR and validated primers, which revealed that 11.1% (n = 4/36) from Sample A tested positive for S. noxia with 0% (n = 0/36) of Sample B testing positive and 13.9% (n = 5/36) of the recall (Sample C) testing positive. In addition, comparative analysis of the qPCR cycle threshold data revealed relatively lower expression (quantity) of S. noxia DNA among the recall samples, as determined by two-tailed t-tests (p=0.004). These data and results provide new evidence for the oral prevalence of S. noxia among pediatric patients, while also demonstrating that the COVID-19 protocol of mouth washing prior to clinical treatment for periods extending up to 60 s may be sufficient to reduce the levels of detectable S. noxia-at least temporarily. More research will be needed to determine whether these effects may be limited to the short- or may exhibit more lasting effects in the long-term.
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Affiliation(s)
- Praneeti Sodhi
- Department of Advanced Education in Pediatric Dentistry, School of Dental Medicine, University of Nevada-Las Vegas, 1700 W. Charleston Boulevard, Las Vegas, NV 89106, USA
| | - Yuxin Jiang
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada-Las Vegas, 1700 W. Charleston Boulevard, Las Vegas, NV 89106, USA
| | - Summer Lin
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada-Las Vegas, 1700 W. Charleston Boulevard, Las Vegas, NV 89106, USA
| | - Jackson Downey
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada-Las Vegas, 1700 W. Charleston Boulevard, Las Vegas, NV 89106, USA
| | - Chase Sorenson
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada-Las Vegas, 1700 W. Charleston Boulevard, Las Vegas, NV 89106, USA
| | - Melika Shayegh
- Department of Advanced Education in Pediatric Dentistry, School of Dental Medicine, University of Nevada-Las Vegas, 1700 W. Charleston Boulevard, Las Vegas, NV 89106, USA
| | - Victoria Sullivan
- Department of Advanced Education in Pediatric Dentistry, School of Dental Medicine, University of Nevada-Las Vegas, 1700 W. Charleston Boulevard, Las Vegas, NV 89106, USA
| | - Karl Kingsley
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada-Las Vegas, 1001 Shadow Lane Boulevard, Las Vegas, NV 89106, USA
| | - Katherine M Howard
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada-Las Vegas, 1001 Shadow Lane Boulevard, Las Vegas, NV 89106, USA
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