Specificity of the neutralizers as the cause of errors in evaluating disinfectant efficacy: an assessment of triclosan

Phage cocktail superimposed disinfection: A ecological strategy for preventing pathogenic bacterial infections in dairy farms

Bovine mastitis (BM) is mainly caused by bacterial infection that has a highly impact on dairy production, affecting both economic viability and animal well-being. A cross-sectional study was conducted in dairy farms to investigate the prevalence and antimicrobial resistance patterns of bacterial pathogens associated with BM. The analysis revealed that Staphylococcus (49%), Escherichia (16%), Pseudomonas (11%), and Klebsiella (6%) were the primary bacterial pathogens associated with mastitis. A significant proportion of Staphylococcus strains displayed multiple drug resistance. The use of disinfectants is an important conventional measure to control the pathogenic bacteria in the environment. Bacteriophages (Phages), possessing antibacterial properties, are natural green and effective disinfectants. Moreover, they mitigate the risk of generating harmful disinfection byproducts, which are commonly associated with traditional disinfection methods. Based on the primary bacterial pathogens associated with mastitis in the investigation area, a phage cocktail, named SPBC-SJ, containing seven phages capable of lysing S. aureus, E. coli, and P. aeruginosa was formulated. SPBC-SJ exhibited superior bactericidal activity and catharsis effect on pollutants (glass surface) compared to chemical disinfectants. Clinical trials confirmed that the SPBC-SJ-based superimposed disinfection group (phage combined with chemical disinfectants) not only cut down the dosage of disinfectants used, but significantly reduced total bacterial counts on the ground and in the feeding trough of dairy farms. Furthermore, SPBC-SJ significantly reduced the abundance of Staphylococcus and Pseudomonas in the environment of the dairy farm. These findings suggest that phage-based superimposed disinfection is a promising alternative method to combat mastitis pathogens in dairy farms due to its highly efficient and environmentally-friendly properties.

Evaluation of new formulations for neutralizing antimicrobial preservatives in pharmaceutical preparations

Background

Neutralization of preservative systems is essential to obtain reliable results when testing samples containing preservatives such as nutritional, cosmetic and pharmaceutical products. Therefore, the aim of this study was to prepare and investigate the neutralization ability of in-house neutralizing systems made of available cost-effective materials in the inactivation of preserved pharmaceutical suspensions. Ibuprofen and Cefpodoxime proxetil preserved suspensions were chosen as the quenching model since subsequent microbiological studies will be conducted on their local pharmaceutical formulations available in the Syrian market.

Methods

We reported toxicity and efficacy ratios of ten neutralizing systems (No.1 to No.10) containing polysorbate 80, cetomacrogol 1000 and polyoxyl 40 hydrogenated castor oil with various concentrations dedicated to the inactivation of Ibuprofen and Cefpodoxime proxetil preserved suspensions, methyl paraben/propyl paraben mixture and sodium benzoate controls against low inoculum ranging between 1 × 10²-1.2 × 10³ CFU of five challenged bacteria and fungi; Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans and another environmental isolate of Aspergillus niger. Neutralizing systems validation was conducted according to USP chapter 1227 criteria to assess the acceptance of recovery comparisons for both "Neutralizing systems toxicity test" and "Neutralizing systems efficacy test" which enabled determining the appropriate neutralizing formula for both neutralization of preservative system of a specified product and being non-toxic towards the challenged microorganism additions.

Results

Most neutralizing formulas used in the study were non-toxic for all tested microorganisms. According to "Neutralizing systems efficacy test", No. 3 (polysorbate 80 (3%)) and No. 10 (polysorbate 80 (1%), cetomacrogol 1000 (1%) and polyoxyl 40 hydrogenated castor oil (1%)) effectively recovered at least three microorganisms when used in the neutralization of samples. Most limitations were observed when neutralizing ibuprofen suspension. However, we found neutralizing system No. 10 against Pseudomonas aeruginosa, No. 3 and No. 5 against Escherichia coli and No. 8 and No. 10 against Candida albicans were effective in the neutralization of ibuprofen suspension. All neutralizing systems effectively inactivated the preservative system of cefpodoxime proxetil suspension using all microorganisms while several neutralizing systems failed in quenching cefpodoxime proxetil suspension against Staphylococcus aureus.

Conclusion

Due to the variation in the neutralization efficacy relative to the product sample and challenged microorganism, neutralization validation procedure must be undertaken before microbiological testing of pharmaceuticals which makes the development and validation of neutralizing systems an essential procedure.

The microbiological load and microbiome of the Dutch dental unit; 'please, hold your breath'

Dental unit water systems are prone to biofilm formation. During use of the dental unit, clumps of biofilm slough off and can subsequently be aerosolized and inhaled by both patient and staff, potentially causing infections. The aim of this study was to determine the microbial load and microbiome of dental unit water, in the Netherlands, and the factors influencing these parameters. In total, 226 dental units were sampled and heterotrophic plate counts (HPC) were determined on the traditional effluent sample. Of all dental units, 61% exceeded the recommended microbiological guidelines of 100 colony forming units per milliliter. In addition, the microbiome, with additional q-PCR analysis for specific species, was determined on an effluent sample taken immediately after an overnight stagnancy period, in which the biofilm is in its relaxed state. These relaxed biofilm samples showed that each dental unit had a unique microbiome. Legionella spp., amoeba and fungi were found in 71%, 43% and 98% of all units, respectively. The presence of amoeba was positively associated with nine bacterial biomarkers and correlated positively with bacterial and fungal DNA and Legionella spp. concentrations, but not with HPC. Only when adhering to disinfection protocols, statistically significant effects on the microbial load and microbiome were seen. The relaxed biofilm sample, in combination with molecular techniques gives better insight in the presence of opportunistic pathogens when compared to the heterotrophic plate counts. Infection control measures should focus on biofilm analysis and control in order to guarantee patient safety.

Healthcare failure mode and effect analysis (HFMEA) for improving the qualification rate of disinfection quality monitoring process

BACKGROUND

This study aimed to assess potential failure mode, implement countermeasures against risks and improve disinfection quality monitoring using healthcare failure mode and effect analysis (HFMEA).

METHODS

Between July 2017 and March 2018, a multidisciplinary team was formed to conduct HFMEA and implement improvement interventions. Fourteen monitoring departments and seven monitoring items were involved. The qualification rate of monitoring process was used to evaluate the influence of HFMEA on the standardization monitoring management of disinfection quality.

RESULTS

After HFMEA, the qualification rate of overall monitoring process of disinfection quality improved from 16.5% to 78.7% (P < 0.001), and the qualification rates of each monitoring step were all significantly improved. The qualification rate implemented by the clinical laboratory improved from 20.1% to 100.0% (P < 0.001). The qualification rate implemented by thirteen monitoring departments improved from 20.1% to 78.7% (P < 0.001), where seven reached 100%. Out of seven monitored items, three had the qualification rate of 100.0%, while the remaining four items showed significant rising in qualification rates (P < 0.001).

CONCLUSION

HFMEA were helpful in improving the qualification rate of disinfection effect monitoring process.

Efficacy of copper and silver as residual disinfectants in drinking water

Contamination events and biofilms can decrease the amount of free chlorine available in drinking water systems. The efficacy of 100 μg/L silver and 400 μg/L copper, individually and combined, were evaluated as secondary, longer-lasting residual disinfectants against Salmonella enterica serovar Typhimurium, Escherichia coli, Listeria monocytogenes, and Mycobacterium fortuitum at 24 °C and 4 °C. A >5.0-log₁₀ reduction was observed in E. coli and L. monocytogenes after three hours and S. Typhimurium following seven hours of exposure to silver. M. fortuitum was the most resistant species to silver (1.11-log₁₀ after seven hours). Copper did not significantly reduce S. Typhimurium and E. coli at 24 °C; ≥2.80-log₁₀ reductions were observed in the Gram-positive L. monocytogenes and M. fortuitum. Longer exposure times were required at 4 °C to achieve significant reductions in all species. A synergistic effect was observed when silver and copper were combined at 24 °C. In addition, silver was not affected by the presence of organic matter at concentrations that completely inhibited 0.2 mg/L chlorine. The results of this study suggest that combinations of silver and copper show promise as secondary residual disinfectants. They may also be used in conjunction with low chlorine levels or other disinfectants to provide additional, long-lasting residuals in distribution systems.

Phenotypic Resistance to Disinfectants and Antibiotics in Methicillin-Resistant Staphylococcus aureus Strains Isolated from Pigs

The aim of this research was to study the phenotypic resistances to disinfectants and antibiotics in strains of methicillin-resistant Staphylococcus aureus (MRSA) obtained from Canary black pigs. Analyses were performed on 54 strains of MRSA, isolated in Canary black pigs from the province of Tenerife (Spain); all of them carried the mecA gene. The strains were isolated by means of nasal swab samples of healthy pigs, collected under veterinarian supervision. Bactericidal activity of antiseptics and disinfectants was tested by means of the dilution-neutralization method. Susceptibility to the disinfectants glutaraldehyde, peracetic acid and silver nitrate was assessed, as well as to the antiseptics chlorhexidine, benzalkonium chloride and povidone iodine. Susceptibility to a wide array of antibiotics representing the main groups was determined by means of the disc diffusion method. All the strains demonstrated susceptibility to the disinfectants tested at the recommended concentration, and even to dilutions equal to or lesser than 1/16. The most effective antiseptic and disinfectant were, respectively, chlorhexidine and silver nitrate. With regard to the antibiotics, the strains proved to be multiresistant. All presented phenotypic resistance to the β-lactam antibiotics ampicillin, penicillin and cefoxitin, as well as to numerous aminoglycosides, tetracycline and trimethoprim-sulfamethoxazole. It was also observed that 61.1% of the strains were carriers of plasmids. Our results underline that in the strains such as MRSA, which show multiple resistances to antibiotics, the antiseptics and disinfectants show great efficacy. Moreover, as other authors also suggest, for the treatment and prevention of infections caused by MRSA, the use of β-lactam and aminoglycoside antibiotics may be less effective.