Efficacy and Safety Evaluation of a Chlorine Dioxide Solution

Sodium carboxymethyl cellulose hydrogels containing montmorillonite-NaClO2 for postharvest preservation of Chinese bayberries

Owing to their lack of outer skin, Chinese bayberries are highly susceptible to mechanical damage during picking, which accelerates bacterial invasion and rotting, shortening their shelf life. In this study, montmorillonite (MMT) was used to absorb an aqueous sodium chlorite solution embedded in a carboxymethyl cellulose sodium hydrogel after freeze drying, and the hydrogel was crosslinked by Al3+ ions. Al3+ hydrolyzed to produce H+, creating an acidic environment within the hydrogel and reacting with NaClO2 to slowly release ClO2. We prepared a ClO2 slow-release hydrogel gasket with 0.5 wt% MMT-NaClO2 and investigated its storage effect on postharvest Chinese bayberries. Its inhibition rates against Escherichia coli and Listeria monocytogenes were 98.84% and 98.96%, respectively. The results showed that the gasket preserved the appearance and nutritional properties of the berries. The antibacterial hydrogel reduced hardness loss by 26.57% and ascorbic acid loss by 46.36%. This new storage method could also be applicable to other fruits and vegetables.

Virucidal activity of chlorine dioxide in combination with acetic acid or citric acid and a surfactant, in presence of interfering substances, against polio-, adeno- and murine norovirus in suspension-, carrier- and four-field tests

Introduction

The aim of the study was to investigate whether the virucidal effectiveness of chlorine dioxid against adenovirus and murine norovirus can be improved by combining it with carboxylic acids and surfactants.

Method

The virucidal efficacy against polio-, adeno- and murine norovirus has been tested in presence of interfering substances in the quantitative suspension test according to EN 14476, the carrier test without mechanical action according to EN 16777, and in the four-field test according to EN 16615.Three chlorine-dioxide-based surface disinfectants were tested: a two-component cleaning disinfectant concentrate for large surfaces, a ready-to-use (RTU) foam, and an RTU gel.

Results

Cleaning and disinfecting preparations based on chlorine dioxide, applied at various concentrations, in combination with acetic acid or citric acid and surfactants, are virucidally active against polio-, adeno-, and norovirus after an exposure time of 5 minutes in presence of interfering substances.

Antimicrobial effects of chlorine dioxide in a hospital setting

Chlorine dioxide is a powerful disinfectant with strong antibacterial properties. We conducted a study at different sites of the Lebanese American University Medical Center-Rizk Hospital to determine the efficacy of the ECOM air mask in decreasing the particle load. Air cultures were obtained from three different locations, namely the patients' elevator, visitors' elevator and mobile clinic and the number of colonies grown on each type of agar was determined. We also measured particle counts at the three sites both at baseline and after placement of the ECOM air mask. After 7 days of ECOM air mask use, the numbers of colonies grown on all types of media was decreased by 20-100% versus the baseline values. The counts of particles of different diameters (0.3, 0.5 and 5 µm) were decreased at all three sampled sites. This study highlighted the efficacy of the ECOM air mask. The utility of the gaseous form of ClO2 as an antiseptic in the hospital setting appears promising.

A pilot study comparing the disinfecting effects of commercialized stable ClO2 solution (free of activation) with conventional H2O2 on dental unit waterlines in the dental practice setting

Disinfection of dental unit waterlines (DUWLs) plays a key role in control and prevention of nosocomial infection in a dental clinic. The most conventional disinfectant is hydrogen peroxide (H2O2), while chlorine dioxide (ClO2) has been considered however was limited by the "activation" procedures. With the availability of commercialized stable ClO2 solution (free of activation), direct application of ClO2 in the dental practice became possible. This study was designed to compare the disinfecting effects of stable 5 ppm of ClO2 solution with conventional 0.24% of H2O2 on DUWLs in dental practice. Studies of colony-forming units (CFUs), confocal laser scanning microscopy (CLSM) and scanning electron microscope (SEM) were employed for evaluation. In CFUs studies, we found that the efficiency of ClO2 was no less than those of H2O2. In the morphological studies, the stronger disinfecting effects of ClO2 was verified by both CLSM and SEM studies for removal and prevention of biofilm. Importantly, ClO2 solution achieved a better disinfecting efficiency not only at the surface of bacterial biofilm, but also, it has penetrating effects, presented disinfecting effects from the surface to the bottom of the biofilm. This pilot study provided evidence regarding the efficiency of stable ClO2 solution on disinfection of DUWLs in the dental practice setting. Application of stable ClO2 solution in dental practice is therefore become possible.

Evaluation of chlorine dioxide in liquid state and in gaseous state as virucidal agent against avian influenza virus and infectious bronchitis virus

The antiviral activity of chlorine dioxide (ClO2) in liquid (ClO2 gas dissolved liquid) and gaseous state against avian influenza virus (AIV) and infectious bronchitis virus (IBV) was evaluated. To evaluate the effect of ClO2 in liquid state, suspension tests (10 ppm) and carrier tests in dropping / wiping techniques (100 ppm) were performed. In the suspension test, virus titers were reduced below the detection limit within 15 sec after treatment, in spite of the presence of an accompanying organic matter. In the carrier test by dropping technique, AIV and IBV were reduced to below the detection limit in 1 and 3 min, respectively. Following wiping technique, no virus was detected in the wiping sheets after 30 sec of reaction. Both viruses adhering to the carriers were also reduced by 3 logs, thereby indicating that they were effectively inactivated. In addition, the effect of ClO2 gas against IBV in aerosols was evaluated. After the exposure of sprayed IBV to ClO2 gas for a few seconds, 94.2% reduction of the virus titer was observed, as compared to the pre-treatment control. Altogether, hence, ClO2 has an evident potential to be an effective disinfectant for the prevention and control of AIV and IBV infections on poultry farms.

Bridging the Gap: Can COVID-19 Research Help Combat African Swine Fever?

African swine fever (ASF) is a highly contagious and economically devastating disease affecting domestic pigs and wild boar, caused by African swine fever virus (ASFV). Despite being harmless to humans, ASF poses significant challenges to the swine industry, due to sudden losses and trade restrictions. The ongoing COVID-19 pandemic has spurred an unparalleled global research effort, yielding remarkable advancements across scientific disciplines. In this review, we explore the potential technological spillover from COVID-19 research into ASF. Specifically, we assess the applicability of the diagnostic tools, vaccine development strategies, and biosecurity measures developed for COVID-19 for combating ASF. Additionally, we discuss the lessons learned from the pandemic in terms of surveillance systems and their implications for managing ASF. By bridging the gap between COVID-19 and ASF research, we highlight the potential for interdisciplinary collaboration and technological spillovers in the battle against ASF.

Polyvinyl alcohol film with chlorine dioxide microcapsules can be used for blueberry preservation by slow-release of chlorine dioxide gas

Introduction

Chlorine dioxide (ClO₂) is a safe and efficient bactericide with unique advantages in reducing foodborne illnesses, inhibiting microbial growth, and maintaining the nutritional quality of food. However, gaseous ClO₂ is sensitive to heat, vibration, and light, which limits its application.

Methods

In this study, a ClO₂ precursor-stabilized ClO₂ aqueous solution was encapsulated by the double emulsion method, and a high-performance ClO₂ self-releasing polyvinyl alcohol (PVA) film was prepared to investigate its performance and effect on blueberry quality during storage.

Results

The self-releasing films had the best overall performance when the microcapsule content was 10% as the film's mechanical properties, thermal stability, and film barrier properties were significantly improved. The inhibition rates of Listeria monocytogenes and Escherichia coli were 93.69% and 95.55%, respectively, and the mycelial growth of Staphylococcus griseus was successfully inhibited. The resulting ClO₂ self-releasing films were used for blueberry preservation, and an experimental study found that the ClO₂ self-releasing antimicrobial film group delayed the quality decline of blueberries. During the 14-day storage period, no mold contamination was observed in the ClO₂ self-releasing film group, and blueberries in the antibacterial film group had higher anthocyanin accumulation during the storage period.

Discussion

Research analysis showed that films containing ClO₂ microcapsules are promising materials for future fruit and vegetable packaging.

Can nasal irrigation with chlorine dioxide be considered as a potential alternative therapy for respiratory infectious diseases? The example of COVID-19

Chlorine dioxide (ClO₂) is a high-level disinfectant that is safe and widely used for sterilization. Due to the limitations on preparing a stable solution, direct use of ClO₂ in the human body is limited. Nasal irrigation is an alternative therapy used to treat respiratory infectious diseases. This study briefly summarizes the available evidence regarding the safety/efficacy of directly using ClO₂ on the human body as well as the approach of nasal irrigation to treat COVID-19. Based on the available information, as well as a preliminary experiment that comprehensively evaluated the efficacy and safety of ClO₂, 25-50 ppm was deemed to be an appropriate concentration of ClO₂ for nasal irrigation to treat COVID-19. This finding requires further verification. Nasal irrigation with ClO₂ can be considered as a potential alternative therapy to treat respiratory infectious diseases, and COVID-19 in particular.

Metal nanoparticles and nanoparticle composites are effective against Haemophilus influenzae, Streptococcus pneumoniae, and multidrug-resistant bacteria

BACKGROUND

Treatment for lower respiratory tract infection caused by multidrug-resistant organisms (MDRO) are often limited. This study explored the activity of different metal nanoparticles against several respiratory pathogens including MDROs.

METHODS

Clinical isolates of carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Klebsiella pneumoniae (CRKP), Pseudomonas aeruginosa, Haemophilus influenzae, methicillin-resistant Staphylococcus aureus (MRSA), and Streptococcus pneumoniae were tested for in vitro susceptibilities to various antibiotics and nanoparticles. Minimum inhibitory concentrations (MICs) of silver-nanoparticle (Ag-NP), selenium-nanoparticle (Se-NP), and three composites solutions ND50, NK99, and TPNT1 (contained 5 ppm Ag-NP, 60 ppm ZnO-nanoparticle, and different concentrations of gold-nanoparticle or ClO₂) were determined by broth microdilution method.

RESULTS

Fifty isolates of each bacterial species listed above were tested. Ag-NP showed lower MICs to all species than Se-NP. The MIC₅₀s of Ag-NP for CRAB, CRKP, P. aeruginosa, and H. influenzae were <3.125 ppm, 25 ppm, <3.125 ppm, and <3.125 ppm, respectively, while those for S. pneumoniae and MRSA were >50 ppm and 50 ppm. Among CRAB, CRKP and P. aeruginosa, the MIC₅₀s of ND50, NK99, and TPNT1 for CRAB were the lowest (1/8 dilution, 1/8 dilution, and 1/8 dilution, respectively), and those for CRKP (>1/2 dilution, 1/2 dilution, and 1/2 dilution, respectively) were the highest. Both MRSA and S. pneumoniae showed high MIC₅₀s to ND50, NK99, and TPNT1.

CONCLUSIONS

Metal nanoparticles had good in vitro activity against Gram-negative bacteria. They might be suitable to be prepared as environmental disinfectants or inhaled agents to inhibit the growth of MDR Gram-negative colonizers in the lower respiratory tracts of patients with chronic lung diseases.

In vitro neurotoxicity evaluation of biocidal disinfectants in a human neuron-astrocyte co-culture model

Biocidal disinfectants (BDs) that kill microorganisms or pathogens are widely used in hospitals and other healthcare fields. Recently, the use of BDs has rapidly increased as personal hygiene has become more apparent owing to the pandemic, namely the coronavirus outbreak. Despite frequent exposure to BDs, toxicity data of their potential neurotoxicity (NT) are lacking. In this study, a human-derived SH-SY5Y/astrocyte was used as a co-culture model to evaluate the chemical effects of BDs. Automated high-content screening was used to evaluate the potential NT of BDs through neurite growth analysis. A set of 12 BD substances classified from previous reports were tested. Our study confirms the potential NT of benzalkonium chloride (BKC) and provides the first evidence of the potential NT of poly(hexamethylenebicyanoguanide-hexamethylenediamine) hydrochloride (PHMB). BKC and PHMB showed significant NT at concentrations without cytotoxicity. This test system for analyzing the potential NT of BDs may be useful in early screening studies for NT prior to starting in vivo studies.

The activity of T- and B-cell links of specific protection of chicken-broilers under the influence of synbiotic preparation “Biomagn” and “Diolide” disinfectant

One of the most actual problems of modern poultry farming is to increase the preservation of chickens and ensure high intensity of their growth at all stages of rearing. The development of alternative methods of prevention and treatment of infectious diseases of poultry involves the use of preparations of natural or organic origin, which have antagonistic properties against infectious agents and are able to balance the immune response. A prominent place in the system of disease prevention and increasing the resistance of animals and poultry is the development of modern probiotic and bactericidal preparations. In view of this, we studied the influence of the synbiotic preparations “Biomagn” in combination with the disinfectant “Diolide” on the state of the T- and B-cell links of the specific immunity of broiler chickens during the period of their rearing. The preparation “Biomagn” is based on representatives of the normal commensal microflora - non-pathogenic lactic acid bacteria with antibacterial and immunomodulatory properties and additional components: magnesium chloride, chitosan, xylanase, protease, cellulase, milk thistle meal, acidity regulator, betaine and emulsifier. The specified remedy is used to ensure optimal level of metabolism, increase immune function, growth, safety of animals and poultry. The results of the research showed that the use of the synbiotic preparation “Biomagn” in combination with the disinfectant “Diolide” had a positive influence on the activity of T- and B-cell links of specific defense of broiler chickens organism during the period of their rearing. This is evidenced by an increase in the amount of T-lymphocytes (total, active and theophylline-resistant) and B-lymphocytes in the blood and an increase in their functional activity due to the redistribution of the receptor apparatus of immunocompetent cells. In particular, a decrease in the number of functionally inactive T- and B-lymphocytes in the blood and an increase in the number of cells with low and medium degree of avidity. Therefore, the use of a set of studied immunotropic preparations is a promising direction in increasing the resistance and productivity of poultry. This allows in industrial conditions of maintenance, without loss of productivity, to respond to technological factors that can lead to immunodeficiency, disease and death of poultry.

Formulation of Chlorine-Dioxide-Releasing Nanofibers for Disinfection in Humid and CO2-Rich Environment

Background: Preventing infectious diseases has become particularly relevant in the past few years. Therefore, antiseptics that are harmless and insusceptible to microbial resistance mechanisms are desired in medicine and public health. In our recent work, a poly(ethylene oxide)-based nanofibrous mat loaded with sodium chlorite was formulated. Methods: We tested the chlorine dioxide production and bacterial inactivation of the fibers in a medium, modeling the parameters of human exhaled air (ca. 5% (v/v) CO2, T = 37 °C, RH > 95%). The morphology and microstructure of the fibers were investigated via scanning electron microscopy and infrared spectroscopy. Results: Smooth-surfaced, nanoscale fibers were produced. The ClO2-producing ability of the fibers decreased from 65.8 ppm/mg to 4.8 ppm/mg with the increase of the sample weight from 1 to 30 mg. The effect of CO2 concentration and exposure time was also evaluated. The antibacterial activity of the fibers was tested in a 24 h experiment. The sodium-chlorite-loaded fibers showed substantial antibacterial activity. Conclusions: Chlorine dioxide was liberated into the gas phase in the presence of CO2 and water vapor, eliminating the bacteria. Sodium-chlorite-loaded nanofibers can be sources of prolonged chlorine dioxide production and subsequent pathogen inactivation in a CO2-rich and humid environment. Based on the results, further evaluation of the possible application of the formulation in face-mask filters as medical devices is encouraged.

Chlorine Dioxide Inhibits African Swine Fever Virus by Blocking Viral Attachment and Destroying Viral Nucleic Acids and Proteins

African swine fever (ASF) is a highly contagious disease and provokes severe economic losses and health threats. At present no effective vaccine or treatment is available to prevent or cure ASF. Consequently, there is an urgent need to develop effective drugs against ASF virus (ASFV). Chlorine dioxide (ClO2), an ideal biocide, has broad-spectrum antibacterial activity and no drug resistance. Here, we found that ClO2 strongly inhibited ASFV replication in porcine alveolar macrophages (PAMs). The inhibitory effect of ClO2 occurred during viral attachment rather than entry, indicating that ClO2 suppressed the early stage of virus life cycle. ClO2 showed a potent anti-ASFV effect when added either before, simultaneously with, or after virus infection. Furthermore, ClO2 could destroy viral nucleic acids and proteins, which may contribute to its capacity of inactivating ASFV virions. The minimum concentration of degradation of ASFV nucleic acids by ClO2 is 1.2 μg/mL, and the degradation is a temperature-dependent manner. These have guiding significance for ClO2 prevention and control of ASFV infection in pig farms. In addition, ClO2 decreased the expression of ASFV-induced inflammatory cytokines. Overall, our findings suggest that ClO2 may be an ideal candidate for the development of novel anti-ASFV prophylactic and therapeutic drugs in swine industry.

A systematic review on chlorine dioxide as a disinfectant

The COVID-19 pandemic has tremendously increased the production and sales of disinfectants. This study aimed to systematically review and analyze the efficacy and safety of chlorine dioxide as a disinfectant. The literature relating to the use of chlorine dioxide as a disinfectant was systematically reviewed in January 2021 using databases such as PubMed, Science Direct, and Google Scholar. Inclusion criteria were studies that investigated the use of chlorine dioxide to assess the efficacy, safety, and impact of chlorine dioxide as a disinfectant. Out of the 33 included studies, 14 studies focused on the disinfectant efficacy of chlorine dioxide, 8 studies expounded on the safety and toxicity in humans and animals, and 15 studies discussed the impact, such as water treatment disinfection using chlorine dioxide. Chlorine dioxide is a safe and effective disinfectant, even at concentrations as low as 20 to 30 mg/L. Moreover, the efficacy of chlorine dioxide is mostly independent of pH. Chlorine dioxide can be effectively used to disinfect drinking water without much alteration of palatability and can also be used to destroy pathogenic microbes, including viruses, bacteria, and fungi from vegetables and fruits. Our review confirms that chlorine dioxide is effective against the resistant Mycobacterium, H1N1, and other influenza viruses. Studies generally support the use of chlorine dioxide as a disinfectant. The concentration deemed safe for usage still needs to be determined on a case-by-case basis.

Could polyhexanide and chlorine dioxide be used as an alternative to chlorhexidine? A systematic review

BACKGROUND

Maintenance of oral microbiota balance is the simplest way to prevent infectious oral diseases, through controlling dental biofilm. Combined use of mouthwash and mechanical removal has been shown to be a very effective way for this.

OBJECTIVES

To identify clinical studies comparing the antimicrobial effect and possible adverse effects and/or side effects of chlorhexidine-based mouthwashes with those of mouthwashes containing chlorine dioxide and/or polyhexanide, for controlling oral microbiota.

DESIGN AND SETTING

Systematic review designed by the stomatology sector of postgraduation in applied dental sciences of Bauru Dentistry School, University of São Paulo, Brazil.

METHODS

A systematic review was conducted using online databases (PubMed, Embase, Web of Science and Science Direct) up to April 8, 2020. The search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

The studies included comprised eight articles published between 2001 and 2017. A total of 295 young adults, adults and elderly people were evaluated (males 44.75% and females 55.25%). Three articles compared polyhexanide with chlorhexidine and five articles compared chlorine dioxide with chlorhexidine. No studies comparing all three mouthwashes were found. The concentrations of the study solutions were quite varied, and all rinses had an antimicrobial effect. In four studies, it was stated that no side effects or adverse effects had been found. Three studies did not address these results and only one study addressed side effects and/or adverse effects.

CONCLUSION

Mouthwashes containing chlorine dioxide and polyhexanide are viable alternatives to chlorhexidine, since they reduce oral biofilm and have little or no reported side or adverse effects.

Intestinal perforation associated with chlorine dioxide ingestion: an adult chronic consumer during COVID-19 pandemic

COVID-19 pandemic is one of the most devastating worldwide crises in recent years. During this pandemic, people have been exposed to products that have not been proven to be safe and effective against COVID-19. We present an adult chronic consumer of chlorine dioxide, in which a fatal outcome is described. This case demonstrates that for people searching products to protect themselves from COVID-19, unregulated access to industrial disinfectants represents a dangerous alternative. To date, there is no scientific evidence to uphold the use of chlorine dioxide or chlorine derivatives as preventive or therapeutic agents against COVID-19. Researchers and general population must take into consideration the fatal possible consequences of not following communications and warnings from health authorities and government institutions.

In vitro study of chlorine dioxide on porcine intestinal epithelial cell gene markers

BACKGROUND

Chlorine dioxide (ClO₂ ) is an inorganic, potent biocide and is available in highly purified aqueous solution. It can be administered as an oral antiseptic in this form.

OBJECTIVES

Our aim is to determine the level of inflammatory markers and cytochrome genes expressed by enterocytes exposed to different concentrations of hyperpure chlorine dioxide solution.

METHODS

Porcine jejunal enterocyte cell (IPEC-J2) cultures were treated with the aqueous solution of hyper-pure chlorine dioxide of various concentrations. We determined the alterations in mRNA levels of inflammatory mediators, such as IL6, CXCL8/IL8, TNF, HSPA6 (Hsp70), CAT and PTGS2 (COX2); furthermore, the expression of three cytochrome genes (CYP1A1, CYP1A2, CYP3A29) were analysed by quantitative PCR method.

RESULTS

The highest applied ClO₂ concentration reduced the expression of all three investigated CYP genes. The gene expression of PTGS2 and CAT were not altered by most concentrations of ClO₂ . The expression of IL8 gene was reduced by all applied concentrations of ClO₂ . TNF mRNA level was also decreased by most ClO₂ concentrations used.

CONCLUSIONS

Different concentrations of chlorine dioxide exhibited immunomodulatory activity and caused altered transcription of CYP450 genes in porcine enterocytes. Further studies are needed to determine the appropriate ClO₂ concentration for oral use in animals.

Evaluation of Stabilized Chlorine Dioxide in Terms of Antimicrobial Activity and Dentin Bond Strength

BACKGROUND

Antimicrobial agents are recommended for disinfection of the cavity following mechanical dental caries removal prior to application of restorative material. There is limited information about stabilized chlorine dioxide (ClO2) as a cavity disinfectant.

OBJECTIVE

The objective of this study is to determine the antimicrobial activity and effect on dentin bond strength of ClO2 compared to chlorhexidine digluconate (CHX), sodium hypochlorite (NaOCl) and ethanolic propolis extract (EPE).

METHODS

Antimicrobial activities of agents against oral pathogens (Staphylococcus aureus, Enterococcus faecalis, Streptococcus mutans, Lactobacillus acidophilus, Lactobacillus casei, Candida albicans, and Saccharomyces cerevisiae) and analyses of EPE were examined. Seventy-five mandibular third molars were sectioned, prepared and divided into five subgroups (n=15/group). Cavity disinfectants (2% CHX, 2.5% NaOCl, 30% EPE, 0.3% ClO2) were applied to etched dentin prior to adhesive and composite build-up. Shear bond strength (SBS) was evaluated with a universal testing machine at a crosshead speed of 0.5 mm/min. The SBS data were analyzed with one-way analysis of variance (ANOVA) and Tukey's post-hoc test (p <0.05). The failure modes were evaluated with a stereomicroscope.

RESULTS

It was determined that the compared disinfectants were showed different inhibition zone values against oral pathogens. ClO2 exhibited the highest antimicrobial activity, followed by CHX, NaOCI and EPE, respectively. No statistically significant difference was observed in the SBS values between the disinfectant treated groups and control group. The failure modes were predominantly mixed.

CONCLUSION

The use of 0.3% stabilized ClO2 as a cavity disinfectant agent exhibited high antimicrobial activity against oral pathogens and no adverse effects on SBS to etched dentin.

Effectiveness of Disinfection with Chlorine Dioxide on Respiratory Transmitted, Enteric, and Bloodborne Viruses: A Narrative Synthesis

A viral spread occurrence such as the SARS-CoV-2 pandemic has prompted the evaluation of different disinfectants suitable for a wide range of environmental matrices. Chlorine dioxide (ClO₂) represents one of the most-used virucidal agents in different settings effective against both enveloped and nonenveloped viruses. This narrative synthesis is focused on the effectiveness of ClO₂ applied in healthcare and community settings in order to eliminate respiratory transmitted, enteric, and bloodborne viruses. Influenza viruses were reduced by 99.9% by 0.5–1.0 mg/L of ClO₂ in less than 5 min. Higher concentration (20 mg/L) eliminated SARS-CoV-2 from sewage. ClO₂ concentrations from 0.2 to 1.0 mg/L ensured at least a 99% viral reduction of AD40, HAV, Coxsackie B5 virus, and other enteric viruses in less than 30 min. Considering bloodborne viruses, 30 mg/L of ClO₂ can eliminate them in 5 min. Bloodborne viruses (HIV-1, HCV, and HBV) may be completely eliminated from medical devices and human fluids after a treatment with 30 mg/L of ClO₂ for 30 min. In conclusion, ClO₂ is a versatile virucidal agent suitable for different environmental matrices.

Evaluation of 4% stabilized Sodium Hypochlorite activity in the repair of cutaneous excisional wounds in mice

Wounds are conditions largely present in the clinical routine, and even though frequent, their complete resolution can be challenging. Several solutions can aid or stimulate the healing process, and for this reason, this work used a stabilized solution of 4% sodium hypochlorite for the treatment of excisional wounds in mice. This study was carried out in two distinct stages: in the first stage, the optimal concentration of the chlorinated solution was determined by using the sponge implantation technique in mouse subcutaneous tissue to evaluate the dose-response curve; and in the second phase, this concentration was tested in an experimental model of excisional skin wounds in mice. Soluble collagen, hemoglobin, myeloperoxidase (MPO) and N-acetyl-β-D-glycosaminidase (NAG) activity were assessed, and total, type I and type III collagen deposition were quantified in both stages. Based on the results presented in the sponge implantation study, the chlorinated solution at 150 ppm (0.015%) was chosen for use in a preclinical trial of skin healing in mice. At 1, 3, 7 and 14 days of treatment, the % wound area repair in the group treated with 150 ppm chlorinated solution was higher when compared to the control group, with statistical differences at all time points (*p≤ 0.05 and **p≤ 0.01). 150 ppm chlorinated solution obtained from a stabilized 4% sodium hypochlorite solution was effective in accelerating cutaneous excision wound repair in mice, showing a positive influence on tissue repair.

Nanoparticle composite TPNT1 is effective against SARS-CoV-2 and influenza viruses

A metal nanoparticle composite, namely TPNT1, which contains Au-NP (1 ppm), Ag-NP (5 ppm), ZnO-NP (60 ppm) and ClO2 (42.5 ppm) in aqueous solution was prepared and characterized by spectroscopy, transmission electron microscopy, dynamic light scattering analysis and potentiometric titration. Based on the in vitro cell-based assay, TPNT1 inhibited six major clades of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with effective concentration within the range to be used as food additives. TPNT1 was shown to block viral entry by inhibiting the binding of SARS-CoV-2 spike proteins to the angiotensin-converting enzyme 2 (ACE2) receptor and to interfere with the syncytium formation. In addition, TPNT1 also effectively reduced the cytopathic effects induced by human (H1N1) and avian (H5N1) influenza viruses, including the wild-type and oseltamivir-resistant virus isolates. Together with previously demonstrated efficacy as antimicrobials, TPNT1 can block viral entry and inhibit or prevent viral infection to provide prophylactic effects against both SARS-CoV-2 and opportunistic infections.

Evaluation of the vital viability and their application in fungal spores' disinfection with flow cytometry

More attention was focused on fungi contamination in drinking water. Most researches about the inactivation of fungal spores has been conducted on disinfection efficiency and the leakage of intracellular substances. However, the specific structural damage of fungal spores treated by different disinfectants is poorly studied. In this study, the viability assessment methods of esterase activities and intracellular reactive oxygen species (ROS) were optimized, and the effects of chlorine-based disinfectants on fungal spores were evaluated by flow cytometry (FCM) and plating. The optimal staining conditions for esterase activity detection were as follows: fungal spores (10⁶ cells/mL) were stained with 10 μM carboxyfluorescein diacetate and 50 mM ethylene diamine tetraacetic acid at 33 °C for 10 min (in dark). The optimal staining conditions for intracellular ROS detection were as follows: dihydroethidium (the final concentration of 2 μg/mL) was added into fungal suspensions (10⁶ cells/mL), and then samples were incubated at 35 °C for 20 min (in dark). The cell culturability, membrane integrity, esterase activities, and intracellular ROS were examined to reveal the structural damage of fungal spores and underlying inactivation mechanisms. Disinfectants would cause the loss of the cell viability via five main steps: altered the morphology of fungal spores; increased the intracellular ROS levels; decreased the culturability, esterase activities and membrane integrity, thus leading to the irreversible death. It is appropriate to assess the effects of disinfectants on fungal spores and investigate their inactivation mechanisms using FCM.

Disinfectants In Interventional Practices

PURPOSE OF REVIEW

This review aims to provide relevant, aggregate information about a variety of disinfectants and antiseptics, along with potential utility and limitations. While not exhaustive, this review's goal is to add to the body of literature available on this topic and give interventional providers and practitioners an additional resource to consider when performing procedures.

RECENT FINDINGS

In the current SARS-CoV2 epidemiological environment, infection control and costs associated with healthcare-associated infections (HAIs) are of paramount importance. Even before the onset of SARS-CoV2, HAIs affected nearly 2million patients a year in the USA and resulted in nearly 90,000 deaths, all of which resulted in a cost to hospitals ranging from US$28 billion to 45 billion. The onset SARS-CoV2, though not spread by an airborne route, has heightened infection control protocols in hospitals and, as such, cast a renewed focus on disinfectants and their utility across different settings and organisms. The aim of this review is to provide a comprehensive overview of disinfectants used in the inpatient setting.

Use of α-cyclodextrin to Promote Clean and Environmentally Friendly Disinfection of Phenolic Substrates via Chlorine Dioxide Treatment

The use of chlorine dioxide to disinfect drinking water and ameliorate toxic components of wastewater has significant advantages in terms of providing safe water. Nonetheless, significant drawbacks toward such usage remain. These drawbacks include the fact that toxic byproducts of the disinfection agents are often formed, and the complete removal of such agents can be challenging. Reported herein is one approach to solving this problem: the use of α-cyclodextrin to affect the product distribution in chlorine dioxide-mediated decomposition of organic pollutants. The presence of α-cyclodextrin leads to markedly more oxidation and less aromatic chlorination, in a manner that is highly dependent on analyte structure and other reaction conditions. Mechanistic hypotheses are advanced to explain the cyclodextrin effect, and the potential for use of α-cyclodextrin for practical wastewater treatment is also discussed.

Acidified sodium chlorite solution: A potential prophylaxis to mitigate impact of multiple exposures to COVID-19 in frontline health-care providers

Limited availability of personal protective equipment is endangering first-line health-care providers treating patients with presumed or confirmed COVID-19 infections. This editorial has multiple objectives in regard to this reality: First, to raise awareness of the need for safe and effective prophylaxis to protect health-care providers with insufficient personal protective equipment from repeated exposures to COVID-19. Second, to summarize the scientific evidence in support of solutions of acidified sodium chlorite (ASC) and its daughter compounds, chlorous acid and chlorine dioxide, as potential targets for said prophylactic use. Third, to propose a regimented protocol using commercially available solutions of ASC having sufficient concentrations of chlorine dioxide for virucidal activity to support safe and effective prophylactic use. And fourth, to raise awareness of and compare other potential prophylactic options currently under investigation.

Chlorine dioxide-loaded poly(acrylic acid) gels for prolonged antimicrobial effect

Chlorine dioxide, the so-called "ideal biocide", can be successfully applied as an antiseptic agent based on its rapid and safe antimicrobial property. One of the significant limitations of its topical or oral use is that the chlorine dioxide residence time in aqueous solution is very short due to the volatility of the gas. Therefore, the primary purpose of the present study was to increase the duration of chlorine dioxide effect by creating a system capable of loading the gas for a prolonged time and gradually releasing it at the site of action. Poly(acrylic acid) gels of various chlorine dioxide and polymer concentrations were formulated to achieve this goal. A two-factor, three-level face-centred central composite design was applied for the formulation. The microstructure of the gels was tracked by positron annihilation lifetime spectroscopy based on the ortho-positronium (o-Ps) lifetime distributions with the residual chlorine concentrations, determined by iodometric titration and their antibacterial effects. The results indicate that the polymer possesses two functions. On the one hand, as a diffusion barrier inhibits the fugacity of the gaseous chlorine dioxide but on the other side, the polymer chains form an arranged supramolecular structure with the hydrated forms of chlorine dioxide thus resulting in its sustained fugacity. The latter showed optimum as a function of the polymer concentration in the investigated range (0.1-0.3% w/w). The o-Ps lifetime distributions confirmed the microstructural changes of the formulations and were in good agreement with the analytical and microbiological evaluation. The application of chlorine dioxide-loaded bioadhesive gels could be a promising alternative for the effective and safe treatment of topical infections.

Immunocompetent and Immunodeficient Mouse Models for Enterovirus 71 Pathogenesis and Therapy

Enterovirus 71 (EV71) is a global health threat. Children infected with EV71 could develop hand-foot-and-mouth disease (HFMD), encephalitis, paralysis, pulmonary edema, and death. At present, no effective treatment for EV71 is available. We reviewed here various mouse models for EV71 pathogenesis and therapy. Earlier studies relied on the use of mouse-adapted EV71 strains. To avoid artificial mutations arising de novo during the serial passages, recent studies used EV71 clinical isolates without adaptation. Several human receptors for EV71 were shown to facilitate viral entry in cell culture. However, in vivo infection with human SCARB2 receptor transgenic mice appeared to be more limited to certain strains and genotypes of EV71. Efficacy of oral infection in these transgenic models is extremely low. Intriguingly, despite the lack of human receptors, immunodeficient neonatal mouse models can still be infected with EV71 clinical isolates via oral or intraperitoneal routes. Crossbreeding between SCARB2 transgenic and stat1 knockout mice generated a more sensitive and user-friendly hybrid mouse model. Infected hybrid mice developed a higher incidence and earlier onset of CNS disease and death. Different pathogenesis profiles were observed in models deficient in various arms of innate or humoral immunity. These models are being actively used for antiviral research.

Inactivation of three genera of dominant fungal spores in groundwater using chlorine dioxide: Effectiveness, influencing factors, and mechanisms

Fungi in aquatic environments received more attention recently; therefore, the characteristics of inactivation of fungal spores by widely used disinfectants are quite important. Nonetheless, the inactivation efficacy of fungal spores by chlorine dioxide is poorly known. In this study, the effectiveness of chlorine dioxide at inactivation of three dominant genera of fungal spores isolated from drinking groundwater and the effects of pH, temperature, chlorine dioxide concentration, and humic acid were evaluated. The inactivation mechanisms were explored by analyzing the leakage of intracellular substances, the increase in extracellular adenosine triphosphate (ATP), deoxyribonucleic acid (DNA), and proteins as well as the changes in spore morphology. The kinetics of inactivation by chlorine dioxide fitted the Chick-Watson model, and different fungal species showed different resistance to chlorine dioxide inactivation, which was in the following order: Cladosporium sp.>Trichoderma sp. >Penicillium sp., which are much more resistant than Escherichia coli. Regarding the three genera of fungal spores used in this study, chlorine dioxide was more effective at inactivation of fungal spores than chlorine. The effect of disinfectant concentration and temperature was positive, and the impact of pH levels (6.0 and 7.0) was insignificant, whereas the influence of water matrices on the inactivation efficiency was negative. The increased concentration of characteristic extracellular substances and changes of spore morphology were observed after inactivation with chlorine dioxide and were due to cell wall and cell membrane damage in fungal spores, causing the leakage of intracellular substances and death of a fungal spore.

Is the Stella™ 5L system an effective cold sterilization technique for needle-based confocal miniprobes?

Background and Objective:

Needle-based confocal laser endomicroscopy (nCLE) under endoscopic ultrasound guidance is a newly developed imaging technique for pancreatic lesions and lymph nodes, enabling a subcellular level of resolution. The confocal miniprobe is an invasive instrument designed to be reused up to 10 times. Therefore, a method that ensures the complete elimination of microbial contaminants on the device is necessary. We studied the bactericidal efficacy of the Stella™ system, which purports to achieve this objective.

Materials and Methods:

The surfaces of three nCLE miniprobes were contaminated with suspensions of Bacillus atrophaeus (ATCC9372). One probe was randomly selected to count the bacterial load on the surface. The other two probes were manually cleaned and rinsed. One probe was randomly selected to count bacteria on the surface, and the other probe was sterilized using the Stella™ 5L endoscopic sterilization system before obtaining the bacterial count. The process was repeated for 20 cycles to evaluate the microbicidal efficacy of the Stella™ 5L endoscopic sterilization system. These miniprobes were immersed in the Stella Fuse disinfectant for 72 h. After the 72 h of immersion, the weight loss of probes was determined using a high precision electronic scale to examine corrosion following disinfection. The change in image quality was evaluated by an endoscopist.

Results:

From an initial contamination level of 4.48 × 10⁶ ± 1.57 × 10⁶ cfu/mL on the surface of the probes, the bacterial count was reduced to 4.25 × 10² ± 1.95 × 10² cfu/mL after manual cleaning (including enzyme washing), and no microorganisms were recovered after 20 cycles with the Stella™ 5L system. The probe weights before and after 72 h of immersion were 45.769 (45.768–45.771) g and 45.762 (45.752–45.768) g, respectively. No change in image quality was observed.

Conclusion:

This study shows that the Stella™ 5L system is capable of the complete elimination of microorganism contamination in a short period and avoids the toxicity of typical disinfectants. It is a safe, cheap, and efficient sterilization approach that provides a new option for nCLE miniprobe sterilization.