Antibacterial Properties and Mechanism of Activity of a Novel Silver-Stabilized Hydrogen Peroxide

Curative effect of hydrogen peroxide combined with silver ion disinfection on pelvic floor dysfunction

BACKGROUND

Pelvic floor dysfunction (PFD) is related to muscle fiber tearing during childbirth, negatively impacting postpartum quality of life of parturient. Appropriate and effective intervention is necessary to promote PFD recovery.

AIM

To analyze the use of hydrogen peroxide and silver ion disinfection for vaginal electrodes in conjunction with comprehensive rehabilitation therapy for postpartum women with PFD.

METHODS

A total of 59 women with PFD who were admitted to the hospital from May 2019 to July 2022 were divided into two groups: Control group (n = 27) received comprehensive rehabilitation therapy and observation group (n = 32) received intervention with pelvic floor biostimulation feedback instrument in addition to comprehensive rehabilitation therapy. The vaginal electrodes were disinfected with hydrogen peroxide and silver ion before treatment. Intervention for both groups was started 6 weeks postpartum, and rehabilitation lasted for 3 months. Pelvic floor muscle voltage, pelvic floor muscle strength, vaginal muscle voltage, vaginal muscle tone, pelvic floor function, quality of life, and incidence of postpartum PFD were compared between the two groups.

RESULTS

Before comprehensive rehabilitation treatment, basic data and pelvic floor function were not significantly different between the two groups. After treatment, the observation group showed significant improvements in the maximum voltage and average voltage of pelvic floor muscles, contraction time of type I and type II fibers, pelvic floor muscle strength, vaginal muscle tone, vaginal muscle voltage, and quality of life (GQOLI-74 reports), compared with the control group. The observation group had lower scores on the pelvic floor distress inventory (PFDI-20) and a lower incidence of postpartum PFD, indicating the effectiveness of the pelvic floor biostimulation feedback instrument in promoting the recovery of maternal pelvic floor function.

CONCLUSION

The combination of the pelvic floor biostimulation feedback instrument and comprehensive rehabilitation nursing can improve pelvic floor muscle strength, promote the recovery of vaginal muscle tone, and improve pelvic floor function and quality of life. The use of hydrogen peroxide and silver ion disinfectant demonstrated favorable antibacterial efficacy and is worthy of clinical application.

Biocontrol of multidrug resistant pathogens isolated from fish farms using silver nanoparticles combined with hydrogen peroxide insight to its modulatory effect

This study was divided into two parts. The first part involved the isolation, and detection of the prevalence and antimicrobial resistance profile of Aeromonas hydrophila, Pseudomonas aeruginosa, and Vibrio species from Nile tilapia fish and marine aquatic water. One hundred freshly dead Nile tilapia fish were collected from freshwater aquaculture fish farms located in Al-Abbassah district, Sharkia Governorate, and 100 samples of marine aquatic water were collected from fish farms in Port Said. The second part of the study focused on determining the in vitro inhibitory effect of dual-combination of AgNPs-H2O2 on bacterial growth and its down regulatory effect on crucial virulence factors using RT-PCR. The highest levels of A. hydrophila and P. aeruginosa were detected in 43%, and 34% of Nile tilapia fish samples, respectively. Meanwhile, the highest level of Vibrio species was found in 37% of marine water samples. Additionally, most of the isolated A. hydrophila, P. aeruginosa and Vibrio species exhibited a multi-drug resistance profile. The MIC and MBC results indicated a bactericidal effect of AgNPs-H2O2. Furthermore, a transcriptional modulation effect of AgNPs-H2O2 on the virulence-associated genes resulted in a significant down-regulation of aerA, exoU, and trh genes in A. hydrophila, P. aeruginosa, and Vibrio spp., respectively. The findings of this study suggest the effectiveness of AgNPs-H2O2 against drug resistant pathogens related to aquaculture.

Validating Methods To Eradicate Plant-Pathogenic Ralstonia Strains Reveals that Growth In Planta Increases Bacterial Stress Tolerance

Plant-pathogenic bacteria in the Ralstonia solanacearum species complex (RSSC) cause highly destructive bacterial wilt disease of diverse crops. Wilt disease prevention and management is difficult because RSSC persists in soil, water, and plant material. Growers need practical methods to kill these pathogens in irrigation water, a common source of disease outbreaks. Additionally, the R. solanacearum race 3 biovar 2 (R3bv2) subgroup is a quarantine pest in many countries and a highly regulated select agent pathogen in the United States. Plant protection officials and researchers need validated protocols to eradicate R3bv2 for regulatory compliance. To meet these needs, we measured the survival of four R3bv2 and three phylotype I RSSC strains following treatment with hydrogen peroxide, stabilized hydrogen peroxide (Huwa-San), active chlorine, heat, UV radiation, and desiccation. No surviving RSSC cells were detected after cultured bacteria were exposed for 10 min to 400 ppm hydrogen peroxide, 50 ppm Huwa-San, 50 ppm active chlorine, or temperatures above 50°C. RSSC cells on agar plates were eradicated by 30 s of UV irradiation and killed by desiccation on most biotic and all abiotic surfaces tested. RSSC bacteria did not survive the cell lysis steps of four nucleic acid extraction protocols. However, bacteria in planta were more difficult to kill. Stems of infected tomato plants contained a subpopulation of bacteria with increased tolerance of heat and UV light, but not oxidative stress. This result has significant management implications. We demonstrate the utility of these protocols for compliance with select agent research regulations and for management of a bacterial wilt outbreak in the field. IMPORTANCE Bacteria in the Ralstonia solanacearum species complex (RSSC) are globally distributed and cause destructive vascular wilt diseases of many high-value crops. These aggressive pathogens spread in diseased plant material and via contaminated soil, tools, and irrigation water. A subgroup of the RSSC, race 3 biovar 2, is a European and Canadian quarantine pathogen and a U.S. select agent subject to stringent and constantly evolving regulations intended to prevent pathogen introduction or release. We validated eradication and inactivation methods that can be used by (i) growers seeking to disinfest water and manage bacterial wilt disease outbreaks, (ii) researchers who must remain in compliance with regulations, and (iii) regulators who are expected to define containment practices. Relevant to all these stakeholders, we show that while cultured RSSC cells are sensitive to relatively low levels of oxidative chemicals, desiccation, and heat, more aggressive treatment, such as autoclaving or incineration, is required to eradicate plant-pathogenic Ralstonia growing inside plant material.

Development of a Polymeric Film Entrapping Rose Bengal and Iodide Anion for the Light-Induced Generation and Release of Bactericidal Hydrogen Peroxide

A series of poly(2-hydroxyethyl methacrylate) (PHEMA) thin films entrapping photosensitizer Rose Bengal (RB) and tetrabutylammonium iodide (TBAI) have been synthetized. The materials have been characterized by means of Thermogravimetric Analysis (TGA), Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy (ATR-FTIR) and UV-vis Absorption spectroscopy. Irradiation of the materials with white light led to the generation of several bactericidal species, including singlet oxygen (¹O₂), triiodide anion (I₃^-) and hydrogen peroxide (H₂O₂). ¹O₂ production was demonstrated spectroscopically by reaction with the chemical trap 2,2'-(anthracene-9,10-diylbis(methylene))dimalonic acid (ABDA). In addition, the reaction of iodide anion with ¹O₂ yielded I₃^- inside the polymeric matrix. This reaction is accompanied by the formation of H₂O₂, which diffuses out the polymeric matrix. Generation of both I₃^- and H₂O₂ was demonstrated spectroscopically (directly in the case of triiodide by the absorption at 360 nm and indirectly for H₂O₂ using the xylenol orange test). A series of photodynamic inactivation assays were conducted with the synthesized polymers against Gram-negative bacteria Escherichia coli and Pseudomonas aeruginosa. Complete eradication (7 log₁₀ CFU/mL) of both bacteria occurred after only 5 min of white light irradiation (400-700 nm; total energy dose 24 J/cm²) of the polymer containing both RB and TBAI. The control polymer without embedded iodide (only RB) showed only marginal reductions of ca. 0.5 log₁₀ CFU/mL. The main novelty of the present investigation is the generation of three bactericidal species (¹O₂, I₃^- and H₂O₂) at the same time using a single polymeric material containing all the elements needed to produce such a bactericidal cocktail, although the most relevant antimicrobial activity is shown by H₂O₂. This experimental approach avoids multistep protocols involving a final step of addition of I^-, as described previously for other assays in solution.

Antimicrobial Effects of Novel H2O2-Ag+ Complex on Membrane Damage to Staphylococcus aureus, Escherichia coli O157:H7, and Salmonella Typhimurium

ABSTRACT

Diseases caused by harmful microorganisms pose a serious threat to human health. Safe and environmentally friendly disinfectants are, therefore, essential in preventing and controlling such pathogens. This study aimed to investigate the antimicrobial activity and mechanism of a novel hydrogen peroxide and silver (H2O2-Ag+) complex (HSC) in combatting Staphylococcus aureus ATCC 29213, Escherichia coli O157:H7 NCTC 12900, and Salmonella Typhimurium SL 1344. The MICs and MBCs against S. aureus were found to be 0.014% H2O2-3.125 mg/L Ag+, and for both E. coli O157:H7 and Salmonella Typhimurium they were 0.028% H2O2-6.25 mg/L Ag+. Results of the time-kill trial suggest that HSC could inhibit the growth of the tested bacteria, because 99.9% of viable cells were killed following treatment at 1 MIC for 3 h. The mechanism of antibacterial action of HSC was found to include the disruption of the bacterial cell membrane, followed by reduction of intracellular ATP concentration and inhibition of the activity of antioxidases, superoxide dismutase, and catalase. The enhanced bactericidal effect of hydrogen peroxide combined with silver indicates a potential for its application in environmental disinfection, particularly in the food industry.

HIGHLIGHTS

Back to Basics: Choosing the Appropriate Surface Disinfectant

From viruses to bacteria, our lives are filled with exposure to germs. In built environments, exposure to infectious microorganisms and their byproducts is clearly linked to human health. In the last year, public health emergency surrounding the COVID-19 pandemic stressed the importance of having good biosafety measures and practices. To prevent infection from spreading and to maintain the barrier, disinfection and hygiene habits are crucial, especially when the microorganism can persist and survive on surfaces. Contaminated surfaces are called fomites and on them, microorganisms can survive even for months. As a consequence, fomites serve as a second reservoir and transfer pathogens between hosts. The knowledge of microorganisms, type of surface, and antimicrobial agent is fundamental to develop the best approach to sanitize fomites and to obtain good disinfection levels. Hence, this review has the purpose to briefly describe the organisms, the kind of risk associated with them, and the main classes of antimicrobials for surfaces, to help choose the right approach to prevent exposure to pathogens.

Assessment of Stabilized Hydrogen Peroxide for Use in Reducing Campylobacter Levels and Prevalence on Broiler Chicken Wings

ABSTRACT

Poultry processing establishments use antimicrobial aids on broiler parts to minimize Campylobacter contamination. A silver-stabilized hydrogen peroxide (SHP) product was assessed for use as an antimicrobial processing aid. In a series of experiments, wing segments with skin were inoculated with 103 to 107 cells of Campylobacter coli, followed by treatment with SHP at 15,000 or 30,000 mg/L, peroxyacetic acid (PAA) at 300 or 3,000 mg/L (parts per million), or water. Each treatment was applied by either dip or spray. Rinsates from each wing segment were analyzed for direct counts and prevalence of Campylobacter. Treatment with SHP or PAA significantly reduced Campylobacter levels compared with water controls by up to 2.22 log CFU/mL. At high inoculum levels (106 to 107), SHP and PAA applied by dip had up to 1.27 log CFU/mL further reductions of Campylobacter levels compared with spray-treated wing segments. Additionally, wing drumettes were observed to retain higher levels and prevalence of Campylobacter recovery compared with wing flats at a low inoculation level (103). The results indicated that there was no carryover effect of SHP (same day versus 24 h) and dip treatment with SHP or PAA decreased Campylobacter recovery on broiler chicken wing segments compared with a water control. Although a 2-log reduction was modest, SHP had similar efficacy as the commonly used processing aid PAA. SHP shows potential for further investigation as an antimicrobial processing aid for use on poultry parts.

HIGHLIGHTS

Management of Microbiological Contamination of the Water Network of a Newly Built Hospital Pavilion

The good installation, as well as commissioning plan, of a water network is a crucial step in reducing the risk of waterborne diseases. The aim of this study was to monitor the microbiological quality of water from a newly built pavilion before it commenced operation. Overall, 91 water samples were tested for coliforms, Escherichia coli, enterococci, Pseudomonas aeruginosa and Legionella at three different times: T0 (without any water treatment), T1 (after treatment with hydrogen peroxide and silver ions at initial concentration of 20 mg/L and after flushing of water for 20 min/day for seven successive days) and T2 (15 days later). Coliforms were detected in 47.3% of samples at T0, 36.3% at T1 and 4.4% at T2. E. coli was isolated in 4.4% of the samples only at T1, while enterococci appeared in 12.1% of the samples at T1 and in 2.2% at T2. P. aeruginosa was isolated in 50.5% of the samples at T0, 29.7% at T1 and 1.1% at T2. Legionella pneumophila serogroup 8 was isolated in 80.2% of the samples at T0, 36.3% at T1 and 2.2% at T2. Our results confirmed the need for a water safety plan in new hospital pavilions to prevent the risk of waterborne diseases.

Influence of delivery system on the efficacy of low concentrations of hydrogen peroxide in the disinfection of common healthcare-associated infection pathogens

INTRODUCTION

The ability of healthcare-associated infection pathogens to survive on environmental surfaces is well known. Disinfection is employed to reduce or remove these pathogens but disinfection failures still occur. One method with the potential to improve disinfection efficacy is whole-room disinfection with hydrogen peroxide (H₂O₂).

AIM

To determine the influence of delivery system on the efficacy of low-concentration H₂O₂ on common healthcare-associated infection pathogens.

METHODS

SanoStatic (electrostatic spray) was compared with SanoFog (fogging) in terms of performance for delivery of 5% H₂O₂ and trace silver ions for disinfection. The bacterial test challenges were vancomycin-resistant Enterobacterales (VRE), extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae (ESBLK), carbapenemase-producing Enterobacterales (CPE), meticillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile spores, Bacillus atropheus and Geobacillus stearothermophilus commercial spore strips.

FINDINGS

SanoFog and SanoStatic were effective when tested under the conditions of experimentation reported here. For VRE, ESBLK, CPE and MRSA, SanoFog and SanoStatic were comparable in performance. For C. difficile we concluded the following: SanoFog was most effective for disinfection of C. difficile spores when compared to SanoStatic.

CONCLUSION

Whereas SanoFog and SanoStatic were effective against bacterial cells, the current practice of using SanoFog and SanoStatic together would be effective for disinfection of C. difficile spores based on investigations under the conditions of experimentation reported here. The spore strips results were not comparable to the results either for the vegetation cells (VRE, ESBLK, CPE, and MRSA) or for C. difficile spores.

Development of a highly effective low-cost vaporized hydrogen peroxide-based method for disinfection of personal protective equipment for their selective reuse during pandemics

BACKGROUND

Personal Protective Equipment (PPE) is required to safely work with biological agents of bacterial (i.e. Mycobacterium tuberculosis) or viral origin (Ebola and SARS). COVID-19 pandemic especially has created unforeseen public health challenges including a global shortage of PPE needed for the safety of health care workers (HCWs). Although sufficient stocks of PPE are currently available, their critical shortage may develop soon due to increase in demand and depletion of existing supply lines. To empower our HCWs and ensure their continued protection, proactive measures are urgently required to develop procedures to safely decontaminate the PPEs to allow their "selective reuse" during contingency situations.

METHODS

Herein, we have successfully developed a decontamination method based on vaporized hydrogen peroxide (VHP). We have used a range of concentration of hydrogen peroxide to disinfect PPE (coveralls, face-shields, and N-95 masks). To ensure a proper disinfection, we have evaluated three biological indicators namely Escherichia coli, Mycobacterium smegmatis and spores of Bacillus stearothermophilus, considered as the gold standard for disinfection processes. We next evaluated the impact of repeated VHP treatment on physical features, permeability, and fabric integrity of coveralls and N-95 masks. Next, we performed Scanning Electron Microscopy (SEM) to evaluate microscopic changes in fiber thickness of N-95 masks, melt blown layer or coverall body suits. Considering the fact that any disinfection procedure should be able to meet local requirements, our study included various regionally procured N-95 masks and coveralls available at our institute All India Institute of Medical Sciences (AIIMS), New Delhi, India. Lastly, the practical utility of VHP method developed herein was ascertained by operationalizing a dedicated research facility disinfecting used PPE during COVID-19.

RESULTS

Our prototype studies show that a single VHP cycle (7-8% Hydrogen peroxide) could disinfect PPE and PPE housing room of about 1200 cubic feet (length10 ft × breadth 10 ft × height 12 ft) in less than 10 min, as noted by a complete loss of B. stearothermophilus spore revival. The results are consistent and reproducible as tested in over 10 cycles in our settings. Further, repeated VHP treatment did not result in any physical tear, deformity or other appreciable change in the coverall and N-95 masks. Our permeation tests evaluating droplet penetration did not reveal any change in permeability post-VHP treatments. Also, SEM analysis indeed revealed no significant change in fiber thickness or damage to fibers of coveralls or melt blown layer of N-95 masks essential for filtration. There was no change in user comfort and experience following VHP treatment of PPE. Based on results of these studies, and parameters developed and optimized, an institutional research facility to disinfect COVID-19 PPE is successfully established and operationalized with more than 80% recovery rate for used PPE post-disinfection.

CONCLUSIONS

Our study, therefore, successfully establishes the utility of VHP to effectively disinfect PPE for a possible reuse as per the requirements. VHP treatment did not damage coveralls, cause physical deformity and also did not alter fabric architecture of melt blown layer. We observed that disinfection process was successful consistently and therefore believe that the VHP-based decontamination model will have a universal applicability and utility. This process can be easily and economically scaled up and can be instrumental in easing global PPE shortages in any biosafety facility or in health care settings during pandemic situation such as COVID-19.

Advances in Legionella Control by a New Formulation of Hydrogen Peroxide and Silver Salts in a Hospital Hot Water Network

Legionella surveillance is an important issue in public health, linked to the severity of disease and the difficulty associated with eradicating this bacterium from the water environment. Different treatments are suggested to reduce Legionella risk, however long-term studies of their efficiency are lacking. This study focused on the activity of a new formulation of hydrogen peroxide and silver salts, WTP828, in the hospital hot water network (HWN) to contain Legionella contamination during two years of treatment. The effectiveness of WTP828 was tested measuring physical-chemical and microbiological parameters such as Legionella, Pseudomonas aeruginosa (P. aeruginosa), and a heterotopic plate count (HPC) at 36 °C. Legionella isolates were identified by serotyping and genotyping. WTP 828 induced a reduction in Legionella–positive sites (60% to 36%) and contamination levels (2.12 to 1.7 log₁₀ CFU/L), with isolates belonging to L. pneumophila SG1 (ST1 and ST104), L. anisa and L. rubrilucens widely distributed in HWN. No relevant contamination was found for other parameters tested. The long-term effect of WTP828 on Legionella containment suggest the easy and safe application of this disinfectant, that combined with knowledge of building characteristics, an adequate environmental monitoring and risk assessment plan, become the key elements in preventing Legionella contamination and exposure.

Synergistic antibacterial activity of silver nanoparticles and hydrogen peroxide

The increasing challenge of antibiotic resistance requires not only the discovery of new antibiotics, but also the development of new alternative approaches. Herein, the synergistic antibacterial activity of silver nanoparticles and hydrogen peroxide combination is reported. Unlike the bacteriostatic or slightly bactericidal activity achieved by using each agent alone, using these two agents in combination, even at relatively low concentrations, resulted in complete eradication of both the Gram negative Escherichia coli and the Gram positive Staphylococcus aureus in short treatment times indicating a clear synergistic effect between them. Modifying the surface chemistry of silver nanoparticles and the accompanied change in their surface charge enabled a further enhancement of such synergistic effect implying the importance of this aspect. Mechanistically, a Fenton-like reaction between silver nanoparticles and hydrogen peroxide is discussed and hypothesized to be the basis of the observed synergy. Achieving such a significant antibacterial activity at low concentrations reduces the potential toxicity of these agents and hence enables their utilization as an alternative antibacterial approach in wider range of applications.

Polymeric Composites with Silver (I) Cyanoximates Inhibit Biofilm Formation of Gram-Positive and Gram-Negative Bacteria

Biofilms are surface-associated microbial communities known for their increased resistance to antimicrobials and host factors. This resistance introduces a critical clinical challenge, particularly in cases associated with implants increasing the predisposition for bacterial infections. Preventing such infections requires the development of novel antimicrobials or compounds that enhance bactericidal effect of currently available antibiotics. We have synthesized and characterized twelve novel silver(I) cyanoximates designated as Ag(ACO), Ag(BCO), Ag(CCO), Ag(ECO), Ag(PiCO), Ag(PICO) (yellow and red polymorphs), Ag(BIHCO), Ag(BIMCO), Ag(BOCO), Ag(BTCO), Ag(MCO) and Ag(PiPCO). The compounds exhibit a remarkable resistance to high intensity visible light, UV radiation and heat and have poor solubility in water. All these compounds can be well incorporated into the light-curable acrylate polymeric composites that are currently used as dental fillers or adhesives of indwelling medical devices. A range of dry weight % from 0.5 to 5.0 of the compounds was tested in this study. To study the potential of these compounds in preventing planktonic and biofilm growth of bacteria, we selected two human pathogens (Gram-negative Pseudomonas aeruginosa and Gram-positive Staphylococcus aureus) and Gram-positive environmental isolate Bacillus aryabhattai. Both planktonic and biofilm growth was abolished completely in the presence of 0.5% to 5% of the compounds. The most efficient inhibition was shown by Ag(PiCO), Ag(BIHCO) and Ag(BTCO). The inhibition of biofilm growth by Ag(PiCO)-yellow was confirmed by scanning electron microscopy (SEM). Application of Ag(BTCO) and Ag(PiCO)-red in combination with tobramycin, the antibiotic commonly used to treat P. aeruginosa infections, showed a significant synergistic effect. Finally, the inhibitory effect lasted for at least 120 h in P. aeruginosa and 36 h in S. aureus and B. aryabhattai. Overall, several silver(I) cyanoximates complexes efficiently prevent biofilm development of both Gram-negative and Gram-positive bacteria and present a particularly significant potential for applications against P. aeruginosa infections.

High-touch surfaces: microbial neighbours at hand

Despite considerable efforts, healthcare-associated infections (HAIs) continue to be globally responsible for serious morbidity, increased costs and prolonged length of stay. Among potentially preventable sources of microbial pathogens causing HAIs, patient care items and environmental surfaces frequently touched play an important role in the chain of transmission. Microorganisms contaminating such high-touch surfaces include Gram-positive and Gram-negative bacteria, viruses, yeasts and parasites, with improved cleaning and disinfection effectively decreasing the rate of HAIs. Manual and automated surface cleaning strategies used in the control of infectious outbreaks are discussed and current trends concerning the prevention of contamination by the use of antimicrobial surfaces are taken into consideration in this manuscript.

Electroactive biomimetic collagen-silver nanowire composite scaffolds

Electroactive biomaterials are widely explored as bioelectrodes and as scaffolds for neural and cardiac regeneration. Most electrodes and conductive scaffolds for tissue regeneration are based on synthetic materials that have limited biocompatibility and often display large discrepancies in mechanical properties with the surrounding tissue causing problems during tissue integration and regeneration. This work shows the development of a biomimetic nanocomposite material prepared from self-assembled collagen fibrils and silver nanowires (AgNW). Despite consisting of mostly type I collagen fibrils, the homogeneously embedded AgNWs provide these materials with a charge storage capacity of about 2.3 mC cm(-2) and a charge injection capacity of 0.3 mC cm(-2), which is on par with bioelectrodes used in the clinic. The mechanical properties of the materials are similar to soft tissues with a dynamic elastic modulus within the lower kPa range. The nanocomposites also support proliferation of embryonic cardiomyocytes while inhibiting the growth of both Gram-negative Escherichia coli and Gram-positive Staphylococcus epidermidis. The developed collagen/AgNW composites thus represent a highly attractive bioelectrode and scaffold material for a wide range of biomedical applications.