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Yadav R, Kumar R, Kathpalia M, Ahmed B, Dua K, Gulati M, Singh S, Singh PJ, Kumar S, Shah RM, Deol PK, Kaur IP. Innovative approaches to wound healing: insights into interactive dressings and future directions. J Mater Chem B 2024. [PMID: 38946466 DOI: 10.1039/d3tb02912c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
The objective of this review is to provide an up-to-date and all-encompassing account of the recent advancements in the domain of interactive wound dressings. Considering the gap between the achieved and desired clinical outcomes with currently available or under-study wound healing therapies, newer more specific options based on the wound type and healing phase are reviewed. Starting from the comprehensive description of the wound healing process, a detailed classification of wound dressings is presented. Subsequently, we present an elaborate and significant discussion describing interactive (unconventional) wound dressings. Latter includes biopolymer-based, bioactive-containing and biosensor-based smart dressings, which are discussed in separate sections together with their applications and limitations. Moreover, recent (2-5 years) clinical trials, patents on unconventional dressings, marketed products, and other information on advanced wound care designs and techniques are discussed. Subsequently, the future research direction is highlighted, describing peptides, proteins, and human amniotic membranes as potential wound dressings. Finally, we conclude that this field needs further development and offers scope for integrating information on the healing process with newer technologies.
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Affiliation(s)
- Radhika Yadav
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160014, India.
| | - Rohtash Kumar
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160014, India.
| | - Muskan Kathpalia
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160014, India.
| | - Bakr Ahmed
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160014, India.
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Monica Gulati
- Discipline of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Sachin Singh
- Discipline of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Pushvinder Jit Singh
- Tynor Orthotics Private Limited, Janta Industrial Estate, Mohali 160082, Punjab, India
| | - Suneel Kumar
- Department of Biomedical Engineering, Rutgers the State University of New Jersey, Piscataway, NJ 08854, USA
| | - Rohan M Shah
- Department of Chemistry and Biotechnology, School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora West, VIC 3083, Australia
| | - Parneet Kaur Deol
- GHG Khalsa College of Pharmacy, Gurusar Sadhar, Ludhiana, Punjab, India.
| | - Indu Pal Kaur
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160014, India.
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Olzowy B, Müller S, Cidlinsky NA, Guderian D. [Antiseptics in otorhinolaryngology-a substance overview]. HNO 2024; 72:452-460. [PMID: 38592477 DOI: 10.1007/s00106-024-01456-5] [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] [Accepted: 03/07/2024] [Indexed: 04/10/2024]
Abstract
For preoperative skin antisepsis, alcohol-containing iodine solutions and octenidine are suitable. For wound antisepsis, polyhexanide and hypochlorous acid (HOCL) are also available, but only PVP-iodine and HOCL can be applied to cartilage. Chlorhexidine should only be used as mouth- and bodywash for Staphylococcus aureus (MRSA) decolonization. For the many other throat antiseptics, evidence of clinical efficacy is lacking. For decolonization of the nares, polyhexanide and octenidine are available as nasal gels, but these are inferior to mupirocin for MRSA decolonization. PVP-iodine and HOCL are safe to use for nasal irrigation, but only HOCL has proven effective to improve symptoms of chronic rhinosinusitis. All antiseptics exhibit a certain ototoxicity. With an intact eardrum, acetic acid-containing eardrops can be used to prevent and treat external otitis and myringitis. When the eardrum is perforated, only alcohol-free PVP-iodine and HOCL may be used.
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Affiliation(s)
- Bernhard Olzowy
- HNO-Zentrum Landsberg, Ahornallee 2a, 86899, Landsberg, Deutschland.
| | - Sarina Müller
- Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | | | - Daniela Guderian
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Frankfurt a.M., Goethe-Universität, Frankfurt am Main, Deutschland
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Castiello G, Caravella G, Ghizzardi G, Conte G, Magon A, Fiorini T, Ferraris L, Devecchi S, Calorenne V, Andronache AA, Saracino A, Caruso R. Efficacy of Polyhexamethylene Biguanide in Reducing Post-Operative Infections: A Systematic Review and Meta-Analysis. Surg Infect (Larchmt) 2023; 24:692-702. [PMID: 37870810 DOI: 10.1089/sur.2023.199] [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] [Indexed: 10/24/2023] Open
Abstract
Background: Post-operative infections are a substantial cause of morbidity and mortality worldwide. Polyhexamethylene biguanide (PHMB) is an antimicrobial agent that has been used in various surgical settings to prevent infections. However, the literature on its efficacy in reducing post-operative infections remains unclear. Materials and Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of PHMB in reducing post-operative infections. The risk of bias and methodologic quality of the included studies were also assessed. Results: The systematic review included nine RCTs, and eight were included in the meta-analysis that showed that the use of PHMB was associated with a reduction in the rate of post-operative infections. The overall effect size was statistically significant, with moderate heterogeneity across the included studies (log Peto's odds ratio [OR], -0.890; 95% confidence interval [CI], -1.411 to -0.369; I2 = 41.89%). However, the diversity in the application of PHMB and the potential influence of other factors, such as adherence to infection prevention protocols and organizational-level variables, underscore the need for further primary studies. Conclusions: Polyhexamethylene biguanide appears to be a promising intervention for reducing post-operative infections. However, more high-quality, well-designed RCTs are needed to confirm these findings and to explore the most effective ways to use PHMB within specific infection prevention bundles. Future research should also aim to control for potential confounding factors to provide a more comprehensive understanding of the efficacy of PHMB in reducing post-operative infections.
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Affiliation(s)
- Gianluca Castiello
- Intensive Care Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Giuseppe Caravella
- Pharmacy Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Greta Ghizzardi
- Health Professions Directorate, Bachelor in Nursing Course, ASST Lodi, Lodi, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Tiziana Fiorini
- Health Professions Directorate, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Laurenzia Ferraris
- Hospital Infection Control Committee, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Simona Devecchi
- Paediatric Care Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Veronica Calorenne
- Intensive Care Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Andreea Alina Andronache
- Paediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Antonio Saracino
- Paediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Rosario Caruso
- Clinical Research Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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Nair S, Zhu A, Jaffry M, Choudhry H, Dastjerdi MH. Povidone-Iodine Adverse Effects and Alternatives for Ocular Procedures. J Ocul Pharmacol Ther 2023; 39:207-214. [PMID: 36763602 DOI: 10.1089/jop.2022.0122] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Purpose: Povidone-iodine (PVI), also known as Betadine, is a widely used antiseptic agent used in several fields of medicine. In ophthalmology, it is applied as a preoperative antiseptic to prevent infectious complications that can result from surgical procedures. PVI's safety and efficacy have been extensively studied and represented in the literature; however, the incidence of adverse effects has been reported in conjunction. The aim of this paper is to compile information regarding PVIs use, safety profile, adverse effects, and possible alternatives through a review of the existing literature. Methods: Literature was compiled utilizing the database PubMed and Google Scholar using specified keywords with a total of 86 reviewed articles, after excluding search results that did not meet the inclusion criteria. Results: While the allergic potential to PVI is a highly contested topic, there are several nonallergic adverse effects of PVI that should not be overlooked. These effects include chemical burn, cytotoxic effects, and general patient discomfort. In light of these adverse effects, alternatives to PVI may be considered. However, there has been little research identifying feasible alternatives in preoperative intraocular procedures. Alternatives including chlorhexidine, polyhexamethylene biguanide (polyhexanide), and octenidine were identified as potential substitutes for PVI. Conclusions: Further study is needed to provide robust evidence regarding the efficacy profiles of these alternatives in comparison with PVI and to demonstrate comparable tolerance to PVI in intraocular procedures.
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Affiliation(s)
- Smriti Nair
- Department of Ophthalmology and Visual Science, Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Aretha Zhu
- Department of Ophthalmology and Visual Science, Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Mustafa Jaffry
- Department of Ophthalmology and Visual Science, Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Hassaam Choudhry
- Department of Ophthalmology and Visual Science, Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Mohammad H Dastjerdi
- Department of Ophthalmology and Visual Science, Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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The Impact of Antiseptic-Loaded Bacterial Nanocellulose on Different Biofilms-An Effective Treatment for Chronic Wounds? J Clin Med 2022; 11:jcm11226634. [PMID: 36431111 PMCID: PMC9692265 DOI: 10.3390/jcm11226634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction: Pathogenic biofilms are an important factor for impaired wound healing, subsequently leading to chronic wounds. Nonsurgical treatment of chronic wound infections is limited to the use of conventional systemic antibiotics and antiseptics. Wound dressings based on bacterial nanocellulose (BNC) are considered a promising approach as an effective carrier for antiseptics. The aim of the present study was to investigate the antimicrobial activity of antiseptic-loaded BNC against in vitro biofilms. Materials and Methods: BNC was loaded with the commercially available antiseptics Prontosan® and Octenisept®. The silver-based dressing Aquacel®Ag Extra was used as a positive control. The biofilm efficacy of the loaded BNC sheets was tested against an in vitro 24-hour biofilm of Staphylococcus aureus and Candida albicans and a 48-hour biofilm of Pseudomonas aeruginosa. In vivo tests using a porcine excisional wound model was used to analyze the effect of a prolonged treatment with the antiseptics on the healing process. Results: We observed complete eradication of S. aureus biofilm in BNC loaded with Octenisept® and C. albicans biofilm for BNC loaded with Octenisept® or Prontosan®. Treatment with unloaded BNC also resulted in a statistically significant reduction in bacterial cell density of S. aureus compared to untreated biofilm. No difference on the wound healing outcome was observed for the wounds treated for seven days using BNC alone in comparison to BNC combined with Prontosan® or with Octenisept®. Conclusions: Based on these results, antiseptic-loaded BNC represents a promising and effective approach for the treatment of biofilms. Additionally, the prolonged exposure to the antiseptics does not affect the healing outcome. Prevention and treatment of chronic wound infections may be feasible with this novel approach and may even be superior to existing modalities.
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Niro A, Pignatelli F, Fallico M, Sborgia A, Passidomo F, Gigliola S, Nacucchi A, Sborgia G, Boscia G, Alessio G, Boscia F, Addabbo G, Reibaldi M, Avitabile T. Polyhexamethylene biguanide hydrochloride (PHMB)-properties and application of an antiseptic agent. A narrative review. Eur J Ophthalmol 2022; 33:11206721221124684. [PMID: 36083163 DOI: 10.1177/11206721221124684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
The prevention and management of ocular surface infections is still one of the great challenges for ophthalmologists. The spread of antimicrobial resistance makes it necessary to use antiseptic substances with a broad antimicrobial spectrum. Polyhexamethylene biguanide hydrochloride (Polyhexanide, PHMB) is a broad-spectrum antiseptic with excellent tolerance and a low-risk profile. Its physicochemical action on the phospholipid membrane and DNA replication or repair mechanism, prevents or impedes the development of resistant bacterial strains. PHMB revealed its effective against numerous organisms like viruses, Gram-negative and Gram-positive bacteria, and fungi. Polyhexanide is commonly used as preservative in commercially available disinfecting solutions for contact lens care and in ophthalmic formulations at different concentrations ranging from 1 µg/ml to 50 µg/ml. The administration of 0.02% (200 µg/ml) PHMB is often the first-line therapy of Acanthamoeba keratitis. However, to date, only one close-out randomized controlled study tested the efficacy of 0.02% PHMB in Acanthamoeba keratitis and a phase III study is still ongoing. This paper reviews the antiseptic agent PHMB, focusing on biochemical mechanisms, safety profile and applications in ophthalmology.
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Affiliation(s)
- Alfredo Niro
- Eye Clinic, Hospital "SS. Annunziata", ASL Taranto, Taranto, Italy
| | | | - Matteo Fallico
- Department of Ophthalmology, University of Catania, Catania, Italy
| | | | - Fedele Passidomo
- Eye Clinic, Hospital "SS. Annunziata", ASL Taranto, Taranto, Italy
| | - Samuele Gigliola
- Eye Clinic, Hospital "SS. Annunziata", ASL Taranto, Taranto, Italy
| | | | - Giancarlo Sborgia
- Eye Clinic, Department of Medical Science, Neuroscience and Sense Organs, 9295University of Bari, Bari, Italy
| | - Giacomo Boscia
- Eye Clinic Section, Department of Surgical Sciences, 9314University of Turin, Turin, Italy
| | - Giovanni Alessio
- Eye Clinic, Department of Medical Science, Neuroscience and Sense Organs, 9295University of Bari, Bari, Italy
| | - Francesco Boscia
- Eye Clinic, Department of Medical Science, Neuroscience and Sense Organs, 9295University of Bari, Bari, Italy
| | - Giuseppe Addabbo
- Eye Clinic, Hospital "SS. Annunziata", ASL Taranto, Taranto, Italy
| | - Michele Reibaldi
- Eye Clinic Section, Department of Surgical Sciences, 9314University of Turin, Turin, Italy
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Didecyldimethylammonium Chloride- and Polyhexamethylene Guanidine-Resistant Bacteria Isolated from Fecal Sludge and Their Potential Use in Biological Products for the Detoxification of Biocide-Contaminated Wastewater Prior to Conventional Biological Treatment. BIOLOGY 2022; 11:biology11091332. [PMID: 36138811 PMCID: PMC9495721 DOI: 10.3390/biology11091332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022]
Abstract
Simple Summary Every year, more than a million tons of fecal sludge (FS) containing biocides based on quaternary ammonium compounds and guanidine derivatives, which are widely used for FS deodorization and control of microbial activity, are generated in the environmentally safe toilet complexes of Russian Railways trains. Higher disposal costs for such biocide-contaminated FS due to activated sludge toxicity increases pressure on sanitary equipment servicing companies («Ecotol Service» LLC) to more efficiently discharge FS to wastewater treatment plants. In this work, we have developed a new environmentally friendly approach to reducing the toxicity of FS, based on the use of biological products from biocide-resistant bacterial strains isolated from FS. Our approach has proven to be effective in a series of FS biodegradation experiments, biological oxygen demand tests, and a newly developed disk-diffusion bioassay. Abstract Toxic shock caused by the discharge of biocide-contaminated fecal sludge (FS) from chemical toilets to conventional wastewater treatment plants (WWTP) can be a major problem in activated sludge operation. It is necessary to develop new environmental approaches to mitigate the toxicity of biocides in order to avoid degrading the performance of WWTP. “Latrina”, a chemical toilet additive containing didecyldimethylammonium chloride and polyhexamethylene guanidine, is widely used in environmentally safe toilet complexes (ESTC) on Russian railway trains to deodorize FS and control microbial activity. In this work, seven biocide-resistant bacterial strains were isolated and identified from the FS of ESTC. The values of the minimum inhibitory and bactericidal concentrations of biocides for the isolated strains were 4.5–10 times higher than for the collection microorganisms. The bacterium Alcaligenes faecalis DOS7 was found to be particularly resistant to “Latrina”, the minimum inhibitory concentration of which was almost 30 times higher than recommended for ESTC. Biological products based on isolated bacterial strains proved to be effective for FS biodegradation under both aerobic and anaerobic conditions. The results of the biochemical oxygen demand test and the newly developed disk-diffusion bioassay confirmed that isolated strains contribute to reducing toxicity of biocidal agents in FS. Hyper-resistance, non-pathogenicity, and potential plant growth-promoting ability make A. faecalis DOS7 promising for use in various biological products for wastewater treatment and bioremediation of soils contaminated with biocides, as well as in agriculture to increase plant productivity.
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Argel S, Castaño M, Jimenez DE, Rodríguez S, Vallejo MJ, Castro CI, Osorio MA. Assessment of Bacterial Nanocellulose Loaded with Acetylsalicylic Acid or Povidone-Iodine as Bioactive Dressings for Skin and Soft Tissue Infections. Pharmaceutics 2022; 14:1661. [PMID: 36015286 PMCID: PMC9412879 DOI: 10.3390/pharmaceutics14081661] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Bacterial nanocellulose (BNC) is a novel nanomaterial known for its large surface area, biocompatibility, and non-toxicity. BNC contributes to regenerative processes in the skin but lacks antimicrobial and anti-inflammatory properties. Herein, the development of bioactive wound dressings by loading antibacterial povidone-iodine (PVI) or anti-inflammatory acetylsalicylic acid (ASA) into bacterial cellulose is presented. BNC is produced using Hestrin-Schramm culture media and loaded via immersion in PVI and ASA. Through scanning electron microscopy, BNC reveals open porosity where the bioactive compounds are loaded; the mechanical tests show that the dressing prevents mechanical wear. The loading kinetic and release assays (using the Franz cell method) under simulated fluids present a maximum loading of 589.36 mg PVI/g BNC and 38.61 mg ASA/g BNC, and both systems present a slow release profile at 24 h. Through histology, the complete diffusion of the bioactive compounds is observed across the layers of porcine skin. Finally, in the antimicrobial experiment, BNC/PVI produced an inhibition halo for Gram-positive and Gram-negative bacteria, confirming the antibacterial activity. Meanwhile, the protein denaturation test shows effective anti-inflammatory activity in BNC/ASA dressings. Accordingly, BNC is a suitable platform for the development of bioactive wound dressings, particularly those with antibacterial and anti-inflammatory properties.
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Affiliation(s)
- Shaydier Argel
- Nanotechnology Engineering Program, School of Engineering, Universidad Pontificia Bolivariana, Circular 1 #70-01, Medellin 050031, Colombia
| | - Melissa Castaño
- Nanotechnology Engineering Program, School of Engineering, Universidad Pontificia Bolivariana, Circular 1 #70-01, Medellin 050031, Colombia
| | - Daiver Estiven Jimenez
- Nanotechnology Engineering Program, School of Engineering, Universidad Pontificia Bolivariana, Circular 1 #70-01, Medellin 050031, Colombia
| | - Sebastian Rodríguez
- Nanotechnology Engineering Program, School of Engineering, Universidad Pontificia Bolivariana, Circular 1 #70-01, Medellin 050031, Colombia
| | - Maria Jose Vallejo
- Nanotechnology Engineering Program, School of Engineering, Universidad Pontificia Bolivariana, Circular 1 #70-01, Medellin 050031, Colombia
| | - Cristina Isabel Castro
- Nanotechnology Engineering Program, School of Engineering, Universidad Pontificia Bolivariana, Circular 1 #70-01, Medellin 050031, Colombia
- New Materials Research Group, Universidad Pontificia Bolivariana, Circular 1 #70-01, Medellin 050031, Colombia
| | - Marlon Andres Osorio
- Nanotechnology Engineering Program, School of Engineering, Universidad Pontificia Bolivariana, Circular 1 #70-01, Medellin 050031, Colombia
- New Materials Research Group, Universidad Pontificia Bolivariana, Circular 1 #70-01, Medellin 050031, Colombia
- Biology Systems Research Group, School of Health Science, Universidad Pontificia Bolivariana, Cl. 78b #72a-159, Medellin 050034, Colombia
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9
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Davis SC, Gil J, Solis M, Higa A, Mills A, Simms C, Pena PV, Li J, Raut V. Antimicrobial effectiveness of wound matrices containing native extracellular matrix with polyhexamethylene biguanide. Int Wound J 2022; 19:86-99. [PMID: 33955663 PMCID: PMC8684887 DOI: 10.1111/iwj.13600] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/30/2022] Open
Abstract
A variety of wound matrix materials that are designed to help heal both acute and chronic wounds are currently available. Because wounds often encounter opportunistic microbes that can delay healing, the effectiveness of these materials is often suboptimal, resulting in delayed or compromised wound healing. The importance of reducing and controlling wound microbes is well recognised and there are several antimicrobial options available to address this unmet clinical need. This study compares the antimicrobial and wound healing capabilities, both in vivo and in vitro against methicillin-resistant Staphylococcus aureus (MRSA) USA 300, for the following compounds: Collagen Wound Matrix-Anti Microbial (CWM-AM); Collagen Wound Matrix-Anti Microbial XT (CWM-AM XT); Antimicrobial Hydrofiber Wound Dressing (AHWD); Dermal Scaffold with Silver (DRSAg); Collagen Extracellular Matrix (CEM); Collagen Wound Matrix (CWM); Matrix Wound Dressing with Silver (MWDAg); Cadexomer Iodine Gel (CIG); Triple Antibiotic Ointment (TAO); and Antimicrobial Wound Gel (AWG). For the in vitro zone of inhibition assay, AWG and CIG had the largest diffused areas, followed by CWM-AM and CWM-AM XT. Furthermore, CWM-AM, CWM-AM XT, AWG, and CIG exhibited a persistent antimicrobial activity for up to 10 days after incubation. However, in the cytotoxicity studies performed using human fibroblasts, CWM-AM and CWM-AM XT had no detrimental effects in cell proliferation and viability, while AWG and CIG were cytotoxic and prohibitive for cell proliferation. Treatments were then assessed for microbiology and wound healing efficacy using an in vivo porcine deep reticular dermal wound model. CWM-AM XT displayed the greatest in vivo antimicrobial activity against MRSA USA300 and expedited the reepithelialisation at a faster rate than other treatment groups. This study shows that a novel collagen matrix containing an antimicrobial agent can reduce the bacterial load and support healing.
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Affiliation(s)
- Stephen C. Davis
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Joel Gil
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Michael Solis
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Alexander Higa
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | | | - Colin Simms
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Pilar Valencia Pena
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Jie Li
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Vivek Raut
- Organogenesis Inc.CantonMassachusettsUSA
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10
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Luca-Pozner V, Nischwitz SP, Conti E, Lipa G, Ghezal S, Luze H, Funk M, Remy H, Qassemyar Q. The use of a novel burn dressing out of bacterial nanocellulose compared to the French standard of care in paediatric 2nd degree burns - A retrospective analysis. Burns 2021; 48:1472-1480. [PMID: 34924226 DOI: 10.1016/j.burns.2021.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/18/2021] [Accepted: 11/23/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE Paediatric burn care is a delicate discipline which benefits from special attention. Despite being highly effective, the current standard of care for second degree burns in the largest paediatric burn center in France - exposure to infrared light - involves long hospital stays, straining economic and professional resources, especially in times of a pandemic. The present study investigated this standard of care and compared it to the use of a bacterial nanocellulose dressing. MATERIALS AND METHODS A retrospective analysis of two groups has been performed: the control group assessed thirty consecutive children treated with the standard of care, and the intervention group assessed thirty consecutive children treated with the bacterial nanocellulose dressing. Parameters evaluated were: healed wounds, additional treatments, rate of infections, hospital length of stay, pain experience and overall satisfaction. RESULTS The two groups did not differ significantly in terms of age and TBSA. A significant reduction in hospital length of stay (p < .001) and pain experience (p < .001) could be observed. In terms of healed wounds, additional treatments and infections, the two groups were equally matched (p > .05) with satisfactory results in both groups. Tendencies towards better results could be seen in the intervention group. CONCLUSION The use of bacterial nanocellulose wound dressings is an important tool in the armamentarium of today's burn surgeons. Satisfying results were achieved, ameliorating burn care for children. Future studies are indicated to further support its value and assess the economic impact.
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Affiliation(s)
- V Luca-Pozner
- Armand Trousseau Hospital, Department of Plastic and Reconstructive Surgery, 28 Av du Dr Arnold Netter, Paris, France; Sorbonne University, 91-105 Boulevard de l'Hopital, Paris, France
| | - S P Nischwitz
- COREMED - Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
| | - E Conti
- Armand Trousseau Hospital, Department of Plastic and Reconstructive Surgery, 28 Av du Dr Arnold Netter, Paris, France
| | - G Lipa
- Armand Trousseau Hospital, Department of Plastic and Reconstructive Surgery, 28 Av du Dr Arnold Netter, Paris, France
| | - S Ghezal
- Armand Trousseau Hospital, Department of Plastic and Reconstructive Surgery, 28 Av du Dr Arnold Netter, Paris, France
| | - H Luze
- COREMED - Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - M Funk
- EVOMEDIS GmbH, Graz, Austria
| | - H Remy
- Armand Trousseau Hospital, Department of Plastic and Reconstructive Surgery, 28 Av du Dr Arnold Netter, Paris, France
| | - Q Qassemyar
- Armand Trousseau Hospital, Department of Plastic and Reconstructive Surgery, 28 Av du Dr Arnold Netter, Paris, France; Sorbonne University, 91-105 Boulevard de l'Hopital, Paris, France
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11
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He N, Li H, Li L, Cheng C, Lu X, Wen J, Wang X. Polyguanidine-modified adsorbent to enhance marine applicability for uranium recovery from seawater. JOURNAL OF HAZARDOUS MATERIALS 2021; 416:126192. [PMID: 34492956 DOI: 10.1016/j.jhazmat.2021.126192] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/27/2021] [Accepted: 05/20/2021] [Indexed: 06/13/2023]
Abstract
The marine applicability of adsorbents intended for recovering uranium from seawater is crucial. For such applicability, the materials must exhibit anti-biofouling properties, seawater pH adaptability (pH~8), and salt tolerance. Extracting uranium from seawater is a long-term project; hence, biofouling, high salt concentrations, and weak alkaline environments negatively affect the adsorption of uranium and damage the recovered materials. Most studies on the extraction of uranium from seawater focus on increasing the adsorption capacity of the employed adsorbent, while its marine applicability is neglected. In the present study, three types of guanidine polymer (GP)-modified acrylic fibers were prepared to investigate the impact of the introduced structure on the marine applicability of the fibers. After screening, the introduction of polyhexamethylene biguanidine (PHMB) is observed to produce PAO-PHMB-A, characterized by excellent marine applicability. The enhanced properties include high antimicrobial activity (109 CFU/mL, 99.71%), good salt tolerance, and optimal adsorption at a pH of 8. Owing to the synergistic effect of its functional groups, the PAO-PHMB-A material exhibits excellent adsorption performance (525.89 mg/g), as well as high selectivity and durability. More importantly, long-term marine tests revealed that PAO-PHMB-A shows a remarkable uranium adsorption capacity (30 d, 3.19 mg/g) and excellent antibacterial activity. Considering its excellent marine applicability and good adsorption performance, the PAO-PHMB-A material developed in this work could serve as a potential adsorbent for engineering applications associated with uranium recovery from seawater.
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Affiliation(s)
- Ningning He
- Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900, China; State Key Laboratory of Environment-friendly Energy Materials, Southwest University of Science and Technology, Mianyang 621900, China
| | - Hao Li
- Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900, China; Collaborative Innovation Center of Advanced Nuclear Energy Technology, Institute of Nuclear and New Energy Technology, Tsinghua University, Beijing 100084, China
| | - Luyan Li
- Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900, China
| | - Chong Cheng
- Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900, China
| | - Xirui Lu
- State Key Laboratory of Environment-friendly Energy Materials, Southwest University of Science and Technology, Mianyang 621900, China
| | - Jun Wen
- Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900, China.
| | - Xiaolin Wang
- China Academy of Engineering Physics, Mianyang 621900, China.
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12
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Antimicrobial Activity of Xibornol and a Xibornol-Based Formulation Against Gram-Positive Pathogens of the Respiratory Tract. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1369:101-106. [PMID: 34387849 DOI: 10.1007/5584_2021_664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Xibornol is known since the 70s and a xibornol-based formulation is commercialized as spray suspension for the antisepsis of the oral cavity and as adjuvant in pharyngeal infections caused by Gram-positive microorganisms. Herein, we evaluated the antimicrobial activity of xibornol and the xibornol-based formulation against common pathogens of the upper and lower respiratory tract.Our results indicate that xibornol alone and the xibornol-based formulation have strong antibacterial action against Streptococcus pneumoniae, Streptococcus pyogenes, and Staphyloccus aureus, as well as against the two emerging pathogens Actinomyces israelii and Corynebacterium ulcerans. These findings highlight the antimicrobial potential of these drugs in the topical control of pathogenic Gram-positive bacteria of the respiratory tract.
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13
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Rippon MG, Rogers AA, Ousey K. Estrategias de protección antimicrobiana en el cuidado de heridas: evidencia para el uso de apósitos recubiertos con DACC. J Wound Care 2021; 30:21-35. [PMID: 34558974 DOI: 10.12968/jowc.2021.30.latam_sup_1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Antimicrobial resistance (AMR) is one of the most serious health threats globally. The development of new antimicrobials is not keeping pace with the evolution of resistant microorganisms, and novel ways of tackling this problem are required. One of such initiatives has been the development of antimicrobial stewardship programmes (AMS). The use of wound dressings that employ a physical sequestration and retention approach to reduce bacterial burden offers a novel approach to support AMS. Bacterial-binding by dressings and their physical removal can minimise their damage and prevent the release of harmful endotoxins. OBJECTIVE To highlight AMS to promote the correct use of antimicrobials and to investigate how dialkylcarbamyl chloride (DACC)-coated dressings can support AMS. METHOD MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar were searched to identify articles relating to AMS, and the use of wound dressings in the prevention and treatment of wound infections. The evidence supporting alternative wound dressings that can reduce bioburden and prevent wound infection in a way that does not kill or damage the microorganisms were reviewed. RESULTS The evidence demonstrated that using bacterial-binding wound dressings that act in a physical manner (eg, DACC-coated dressings) to preventing infection in both acute and hard-to-heal wounds does not exacerbate AMR and supports AMS. CONCLUSION Some wound dressings work via a mechanism that promotes the binding and physical sequestration and removal of intact microorganisms from the wound bed (eg, a wound dressing that uses DACC technology to prevent/reduce infection). They provide a valuable tool that aligns with the requirements of AMS by effectively reducing wound bioburden without inducing/selecting for resistant bacteria.
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Affiliation(s)
| | | | - Karen Ousey
- Huddersfield University, Reino Unido.,School of Nursing, Faculty of Health at the Queensland University of Technology, Australia.,Royal College of Surgeons in Ireland, Dublin, Irlanda
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14
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Polyhexamethylene biguanide discs versus unmedicated dressings for prevention of central venous catheter-associated infection in the intensive care unit: A pilot randomised controlled trial to assess protocol safety and feasibility. Aust Crit Care 2021; 35:512-519. [PMID: 34321181 DOI: 10.1016/j.aucc.2021.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/16/2021] [Accepted: 05/25/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Central venous catheters are prone to infectious complications, affecting morbidity, mortality and healthcare costs. Polyhexamethylene biguanide-impregnated discs at the catheter insertion site may prevent local and bloodstream infection; however, efficacy has not been established in a critical care setting. OBJECTIVE The objective of this study was to pilot test polyhexamethylene biguanide-impregnated discs compared to standard unmedicated dressings for central venous catheter infection prevention in critically ill patients. METHODS This was a single-centre pilot randomised controlled trial. Adults admitted to intensive care requiring a central venous catheter for >72 h were eligible. Patients with a current bloodstream infection, concurrent central venous catheter, chlorhexidine or polyhexamethylene biguanide allergy, or sensitive skin were excluded. Patients were randomised to receive standard central venous catheter dressings with/without polyhexamethylene biguanide discs. OUTCOME MEASURES The primary outcome was feasibility, defined by patient eligibility, recruitment, retention, protocol adherence, missing data, and staff satisfaction. Secondary outcomes included: central line-associated infection; primary bloodstream infection; local infection; skin complications; device/dressing dwell time; serious adverse events, and cost-effectiveness. RESULTS Of 309 patients screened, 80 participants were recruited with 98% (n = 78) receiving an internal jugular catheter which dwelled for a median of 5 days (interquartile range = 4.0, 6.0). Feasibility criteria were predominantly met (recruitment 88%; retention 100%; protocol fidelity 91%); however, eligibility criteria were not met (32%; most commonly owing to short predicted catheter dwell). Staff acceptability criteria were met, with 83% of staff scoring dressing application and removal ≥7 on a numerical rating scale. There were no central line-associated bloodstream infections and no local infections. Insertion site itch occurred in 4% (control [n = 0], intervention [n = 3]) of participants, while 32% (24/76) reported pain, and 46% (35/76) tenderness. CONCLUSIONS Polyhexamethylene biguanide discs appear safe for central venous catheter infection prevention. Feasibility of a large efficacy trial was established with some modifications to screening processes. Large, adequately powered randomised controlled trials are needed to test the infection prevention hypotheses.
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Alves PJ, Barreto RT, Barrois BM, Gryson LG, Meaume S, Monstrey SJ. Update on the role of antiseptics in the management of chronic wounds with critical colonisation and/or biofilm. Int Wound J 2021; 18:342-358. [PMID: 33314723 PMCID: PMC8244012 DOI: 10.1111/iwj.13537] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/04/2020] [Accepted: 11/07/2020] [Indexed: 12/22/2022] Open
Abstract
Biofilms play a major role in delaying chronic wounds from healing. A wound infiltrated with biofilm, or "critically colonised" wound, may become clinically infected if the number of microbes exceeds a critical level. Chronic wound biofilms represent a significant treatment challenge by demonstrating recalcitrance towards antimicrobial agents. However, a "window of opportunity" may exist after wound debridement when biofilms are more susceptible to topical antiseptics. Here, we discuss the role of antiseptics in the management of chronic wounds and biofilm, focusing on povidone-iodine (PVP-I) in comparison with two commonly used antiseptics: polyhexanide (PHMB) and silver. This article is based on the literature reviewed during a focus group meeting on antiseptics in wound care and biofilm management, and on a PubMed search conducted in March 2020. Compared with PHMB and silver, PVP-I has a broader spectrum of antimicrobial activity, potent antibiofilm efficacy, no acquired bacterial resistance or cross-resistance, low cytotoxicity, good tolerability, and an ability to promote wound healing. PVP-I represents a viable therapeutic option in wound care and biofilm management, with the potential to treat biofilm-infiltrated, critically colonised wounds. We propose a practical algorithm to guide the management of chronic, non-healing wounds due to critical colonisation or biofilm, using PVP-I.
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Affiliation(s)
- Paulo J. Alves
- Wounds Research LaboratoryUniversidade Católica PortuguesaPortoPortugal
| | | | | | - Luc G. Gryson
- Belgian Defence Military Medical ComponentBrusselsBelgium
| | - Sylvie Meaume
- Department of Geriatrics and Wound Care UnitHospital Rothschild, APHP Assistance Publique Hôpitaux de Paris, Sorbonne UniversitéParisFrance
| | - Stan J. Monstrey
- Department of Plastic SurgeryGhent University HospitalGhentBelgium
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16
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Rippon MG, Rogers AA, Ousey K. Antimicrobial stewardship strategies in wound care: evidence to support the use of dialkylcarbamoyl chloride (DACC)- coated wound dressings. J Wound Care 2021; 30:284-296. [PMID: 33856907 DOI: 10.12968/jowc.2021.30.4.284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Traditionally, infections are treated with antimicrobials (for example, antibiotics, antiseptics, etc), but antimicrobial resistance (AMR) has become one of the most serious health threats of the 21st century (before the emergence of COVID-19). Wounds can be a source of infection by allowing unconstrained entry of microorganisms into the body, including antimicrobial-resistant bacteria. The development of new antimicrobials (particularly antibiotics) is not keeping pace with the evolution of resistant microorganisms and novel ways of addressing this problem are urgently required. One such initiative has been the development of antimicrobial stewardship (AMS) programmes, which educate healthcare workers, and control the prescribing and targeting of antimicrobials to reduce the likelihood of AMR. Of great importance has been the European Wound Management Association (EWMA) in supporting AMS by providing practical recommendations for optimising antimicrobial therapy for the treatment of wound infection. The use of wound dressings that use a physical sequestration and retention approach rather than antimicrobial agents to reduce bacterial burden offers a novel approach that supports AMS. Bacterial-binding by dressings and their physical removal, rather than active killing, minimises their damage and hence prevents the release of damaging endotoxins. AIM Our objective is to highlight AMS for the promotion of the judicious use of antimicrobials and to investigate how dialkylcarbamoyl chloride (DACC)-coated dressings can support AMS goals. METHOD MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar were searched to identify published articles describing data relating to AMS, and the use of a variety of wound dressings in the prevention and/or treatment of wound infections. The evidence supporting alternative wound dressings that can reduce bioburden and prevent and/or treat wound infection in a manner that does not kill or damage the microorganisms (for example, by actively binding and removing intact microorganisms from wounds) were then narratively reviewed. RESULTS The evidence reviewed here demonstrates that using bacterial-binding wound dressings that act in a physical manner (for example, DACC-coated dressings) as an alternative approach to preventing and/or treating infection in both acute and hard-to-heal wounds does not exacerbate AMR and supports AMS. CONCLUSION Some wound dressings work via a mechanism that promotes the binding and physical uptake, sequestration and removal of intact microorganisms from the wound bed (for example, a wound dressing that uses DACC technology to successfully prevent/reduce infection). They provide a valuable tool that aligns with the requirements of AMS (for example, reducing the use of antimicrobials in wound treatment regimens) by effectively reducing wound bioburden without inducing/selecting for resistant bacteria.
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Affiliation(s)
| | | | - Karen Ousey
- WoundCareSol Consultancy, UK.,School of Nursing, Faculty of Health at the Queensland University of Technology, Australia.,Royal College of Surgeons in Ireland, Dublin, Ireland
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17
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Hoang TPN, Ghori MU, Conway BR. Topical Antiseptic Formulations for Skin and Soft Tissue Infections. Pharmaceutics 2021; 13:558. [PMID: 33921124 PMCID: PMC8071503 DOI: 10.3390/pharmaceutics13040558] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/06/2021] [Accepted: 04/10/2021] [Indexed: 01/22/2023] Open
Abstract
Skin and soft tissue infections (SSTIs) are usually acute conditions of inflammatory microbial occupation of the skin layers and underlying soft tissues. SSTIs are one of the most frequent types of infection, typically requiring medical intervention and contribute to morbidity and mortality in both primary care and hospitalised patients. Due to the dramatic rise of antibiotic resistance, antiseptic agents can be potential alternatives for the prevention and treatment of SSTIs. Notably, they are commonly recommended in many global practical guidelines for use in per- and post- operative procedures. A range of antiseptics, including chlorhexidine, triclosan, alcohol, and povidone-iodine, are used and are mainly formulated as traditional, simple dosage forms such as solutions and semi-solids. However, in recent years, there have been studies reporting the potential for nanotechnology in the delivery of antiseptics. In this review, we have collated the scientific literature that focuses on topical antiseptic formulations for prevention and treatment of SSTIs, and have divided findings into traditional and advanced formulations. We conclude that although nanotechnological formulations have demonstrated potential advantages for delivering drugs; nevertheless, there is still scope for traditional formulations and further development of optimised topical formulations to address the rise of antimicrobial resistance.
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Affiliation(s)
- Thi Phuong Nga Hoang
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK; (T.P.N.H.); (M.U.G.)
| | - Muhammad Usman Ghori
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK; (T.P.N.H.); (M.U.G.)
| | - Barbara R. Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK; (T.P.N.H.); (M.U.G.)
- Institute of Skin Integrity and Infections Prevention, University of Huddersfield, Huddersfield HD1 3DH, UK
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18
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Jones IA, Joshi LT. Biocide Use in the Antimicrobial Era: A Review. Molecules 2021; 26:molecules26082276. [PMID: 33919993 PMCID: PMC8071000 DOI: 10.3390/molecules26082276] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 12/12/2022] Open
Abstract
Biocides are widely used in healthcare and industry to control infections and microbial contamination. Ineffectual disinfection of surfaces and inappropriate use of biocides can result in the survival of microorganisms such as bacteria and viruses on inanimate surfaces, often contributing to the transmission of infectious agents. Biocidal disinfectants employ varying modes of action to kill microorganisms, ranging from oxidization to solubilizing lipids. This review considers the main biocides used within healthcare and industry environments and highlights their modes of action, efficacy and relevance to disinfection of pathogenic bacteria. This information is vital for rational use and development of biocides in an era where microorganisms are becoming resistant to chemical antimicrobial agents.
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19
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Filatova A, Bibaeva Y, Kozlov S, Nistratova M, Avdeenko V. Functional state of the udder of cows after the treatment of the udder nipples with hygiene products during milking. BIO WEB OF CONFERENCES 2021. [DOI: 10.1051/bioconf/20213606035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
During the experiments, it was found that the latent period of the breast-feeding reflex is 22.8% less, the milking time is 10.8% less. The average milking intensity increases by 22.7%, intravenous pressure - by 19.4%, with an increase in single milk yield by 15.3%. The concentration of Staph. aigees, Strep. agalactiae, was lower when the nipples were immersed in a solution of hygiene products "Chlorhexidine bigluconate-aloe" and "Teasfoam Supercow-olive oil" before and after milking, compared with untreated nipples. Controlled treatment of the udder nipples and mammary gland with the hygienic product "HGB aloe" before and after cow milking with high milk yields in 2.4% of animals prevents hyperkeratosis of the udder nipples and in 12.1% subclinical mastitis, against 5.4% heperkeratosis and 26.5% subclinical mastitis of control groups of dairy cows. Using hygienic products, an increase in milk yield in cows is provided by 18.45...22.0%, and the functioning of the udder by 16.45...26.34 %. To improve the functioning of the udder during lactation in cows, hygiene products "Chlorhexidine bigluconate-aloe" or "Teasfoam Supercow–olive oil" should be used to treat the udder nipples before and after each milking.
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20
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Mencucci R, Favuzza E, Bottino P, Mazzantini C, Zanotto E, Pellegrini-Giampietro DE, Landucci E. A new ophthalmic formulation containing antiseptics and dexpanthenol: In vitro antimicrobial activity and effects on corneal and conjunctival epithelial cells. Exp Eye Res 2020; 201:108269. [PMID: 32980315 DOI: 10.1016/j.exer.2020.108269] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/01/2020] [Accepted: 09/22/2020] [Indexed: 12/20/2022]
Abstract
Antibiotic resistance is increasing even in ocular pathogens, therefore the interest towards antiseptics in Ophthalmology is growing. The aim of this study was to analyze the in vitro antimicrobial efficacy and the in vitro effects of an ophthalmic formulation containing hexamidine diisethionate 0.05%, polyhexamethylene biguanide (PHMB) 0.0001% disodium edetate (EDTA) 0.01%, dexpanthenol 5% and polyvinyl alcohol 1.25% (Keratosept, Bruschettini, Genova, Italy) on cultured human corneal and conjunctival cells. The in vitro antimicrobial activity was tested on Staphylococcus aureus, Methicillin-Resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Streptococcus pneumoniae, Streptococcus pyogenes and Streptococcus mitis. For each microbial strain 10 μL of a 0.5 MacFarland standardized bacterial inoculum were incubated at 25 °C with 100 μL of ophthalmic solution for up to 6 h. After different periods of time, samples were inoculated on blood agar with 5% sheep blood. Moreover, a 0.5 MacFarland bacterial inoculum was seeded in triplicate on Mueller-Hinton Agar or on Mueller-Hinton Fastidious Agar; then a cellulose disc soaked with 50 μL of ophthalmic solution was applied on the surface of agar and plates were incubated for 18 h at 37 °C, in order to evaluate the inhibition of bacterial growth around the disc. Human corneal and conjunctival epithelial cells in vitro were incubated for 5, 10 and 15 min with Keratosept or its components. The cytotoxicity was assessed through the release of cytoplasmic enzyme lactate dehydrogenase (LDH) into the medium immediately after exposure to the drugs; the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed to evaluate the metabolic cell activity. Our results show that Keratosept ophthalmic solution gave an average logarithmic (log) reduction of bacterial load of 2.14 ± 0.35 within 6 h of exposure (p-value < 0.05 versus control saline solution). On agar plates, all microbial strains, excluding P. Aeruginosa, showed an inhibition zone of growth around the Keratosept-soaked discs. Keratosept and its components after 5 and 10 min did not show any cytotoxic effect on cultured corneal and conjunctival cells, and only after 15 min a significant reduction of cell viability and an increase of cytotoxicity compared to control (vehicle) was seen; dexpanthenol 5% and polyvinyl alcohol accelerated the wounding of corneal cells in vitro. In conclusion, Keratosept showed good antimicrobial activity on the tested strains; the ophthalmic solution and its components were safe and non-toxic for the corneal and conjunctival epithelial cells for 5 and 10 min at the concentrations analyzed, and dexpanthenol 5% and polyvinyl alcohol promoted the wounding of corneal cells.
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Affiliation(s)
- Rita Mencucci
- Eye Clinic, Department of Neurosciences, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
| | - Eleonora Favuzza
- Eye Clinic, Department of Neurosciences, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
| | - Paolo Bottino
- AOU Città della Salute e della Scienza di Torino, Microbiology and Virology Unit, Turin, Italy.
| | - Costanza Mazzantini
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy.
| | - Elisa Zanotto
- AOU Città della Salute e della Scienza di Torino, Microbiology and Virology Unit, Turin, Italy.
| | - Domenico E Pellegrini-Giampietro
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy.
| | - Elisa Landucci
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy.
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21
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Keirouz A, Radacsi N, Ren Q, Dommann A, Beldi G, Maniura-Weber K, Rossi RM, Fortunato G. Nylon-6/chitosan core/shell antimicrobial nanofibers for the prevention of mesh-associated surgical site infection. J Nanobiotechnology 2020; 18:51. [PMID: 32188479 PMCID: PMC7081698 DOI: 10.1186/s12951-020-00602-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/05/2020] [Indexed: 12/12/2022] Open
Abstract
The state-of-the-art hernia meshes, used in hospitals for hernia repair, are predominantly polymeric textile-based constructs that present high mechanical strength, but lack antimicrobial properties. Consequently, preventing bacterial colonization of implanted prosthetic meshes is of major clinical relevance for patients undergoing hernia repair. In this study, the co-axial electrospinning technique was investigated for the development of a novel mechanically stable structure incorporating dual drug release antimicrobial action. Core/shell structured nanofibers were developed, consisting of Nylon-6 in the core, to provide the appropriate mechanical stability, and Chitosan/Polyethylene oxide in the shell to provide bacteriostatic action. The core/shell structure consisted of a binary antimicrobial system incorporating 5-chloro-8-quinolinol in the chitosan shell, with the sustained release of Poly(hexanide) from the Nylon-6 core of the fibers. Homogeneous nanofibers with a "beads-in-fiber" architecture were observed by TEM, and validated by FTIR and XPS. The composite nanofibrous meshes significantly advance the stress-strain responses in comparison to the counterpart single-polymer electrospun meshes. The antimicrobial effectiveness was evaluated in vitro against two of the most commonly occurring pathogenic bacteria; S. aureus and P. aeruginosa, in surgical site infections. This study illustrates how the tailoring of core/shell nanofibers can be of interest for the development of active antimicrobial surfaces.
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Affiliation(s)
- Antonios Keirouz
- Laboratory for Biomimetic Membranes and Textiles, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland
- School of Engineering, Institute for Materials and Processes, The University of Edinburgh, Robert Stevenson Road, Edinburgh, EH9 3FB, UK
| | - Norbert Radacsi
- School of Engineering, Institute for Materials and Processes, The University of Edinburgh, Robert Stevenson Road, Edinburgh, EH9 3FB, UK
| | - Qun Ren
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland
| | - Alex Dommann
- Center for X-Ray Analytics, Empa, Swiss Federal Laboratories for Materials Science and Technology, Überlandstrasse 129, CH-8600, Dübendorf, Switzerland
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Visceral Surgery, Inselspital University Hospital Bern and University Bern, Freiburgstrasse 18, CH-3010, Bern, Switzerland
| | - Katharina Maniura-Weber
- Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland
| | - René M Rossi
- Laboratory for Biomimetic Membranes and Textiles, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland
| | - Giuseppino Fortunato
- Laboratory for Biomimetic Membranes and Textiles, Empa, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland.
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Ceri M, Yilmaz SR, Unverdi S, Kurultak I, Duranay M. Effect of Local Polyhexanide Application in Preventing Exit-Site Infection and Peritonitis: A Randomized Controlled Trial. Ther Apher Dial 2019; 24:81-84. [PMID: 31066988 DOI: 10.1111/1744-9987.12836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 11/30/2022]
Abstract
Topical antibiotic and antiseptic agents have been documented to reduce exit-site infection (ESI) and peritonitis in PD. The aim of this randomized controlled study was to evaluate the efficacy of polyhexanide in the prevention of ESI and peritonitis. Patients were excluded if they had active infection, > 18 years of age, ESI and peritonitis within the previous 4 weeks, received PD for less than 3-months and history of allergy to either drug. All patients were followed up until catheter removal, death, switch to dialysis, transplantation or the end of the study. ESI, tunnel infection, peritonitis, catheter removal and microorganism cause of catheter-related infection were recorded prospectively during clinic follow-up. A total of 88 patients (41 povidone-iodine group; 47 polyhexanide group) were enrolled with a total follow-up duration of 480 and 555 patient-months for povidone-iodine and alternating group, respectively. There were no significant differences in the age, sex, BMI, time of PD, rate of DM, and S. aureus carriage state. A total of 8 ESI and 25 peritonitis episodes were detected during the study. ESI and peritonitis rates tended to be lower in polyhexanide group compared with the povidone-iodine group (0.06 episodes/patient-year vs. 0.12 episodes/patient-year; 0.26 episodes/patient-year vs. 0.32 episodes/patient-year, respectively), but were not significant statistically. Moreover, catheter removal was similar in both groups (0.04 / patient-year vs. 0.05 / patient-year). Polyhexanide is efficient and safe for the prevention of ESI and peritonitis and it may be used as an alternative procedure for the care of healthy exit sites.
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Affiliation(s)
- Mevlut Ceri
- Department of Nephrology, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Seref Rahmi Yilmaz
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Selman Unverdi
- Department of Nephrology, Sanko University Faculty of Medicine, Gaziantep, Turkey
| | - Ilhan Kurultak
- Department of Nephrology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Murat Duranay
- Department of Nephrology, Ankara Education and Research Hospital, Ankara, Turkey
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Chrysouli M, Banti C, Milionis Ι, Koumasi D, Raptopoulou C, Psycharis V, Sainis I, Hadjikakou S. A water-soluble silver(I) formulation as an effective disinfectant of contact lenses cases. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 93:902-910. [DOI: 10.1016/j.msec.2018.08.061] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/28/2018] [Accepted: 08/30/2018] [Indexed: 01/22/2023]
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Boucher C, Henton MM, Becker PJ, Kirberger RM, Hartman MJ. Comparative efficacy of three antiseptics as surgical skin preparations in dogs. Vet Surg 2018; 47:792-801. [PMID: 30004127 DOI: 10.1111/vsu.12913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 03/06/2018] [Accepted: 05/07/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the antimicrobial efficacy of a 2% chlorhexidine gluconate and 70% ethanol solution (CG+A) with that of F10 Skin Prep Solution (F10) and electrochemically activated water (EAW) when used as a surgical preparation in canine patients. STUDY DESIGN Prospective randomized clinical study. SAMPLE POPULATION One hundred sixteen dogs presented for ovariohysterectomy. METHODS Dogs were randomly divided into 1 of the 3 antiseptic groups (CG+A, F10, EAW). Skin samples with replicating organism detection and counting plates were taken at 4 different perioperative sites and time intervals (postskin preparation, postskin antisepsis, 2 hours after the second sample, and at the end of surgery) during ovariohysterectomies performed by students. The colony forming unit (CFU) counts from each sample were quantified according to the level of bacterial contamination. Zero CFU was defined as no contamination, 1-12 CFU was defined as low contamination, and greater than 12 CFU was defined as high contamination. The 3 antiseptics were compared with respect to the level of contamination. RESULTS There was no difference in the level of colonization between the antiseptics at the first sampling time (P = .454). However, the level of contamination for CG+A was lower compared with F10 and EAW at the second, third, and fourth sampling times (P = .001, P = .01, P = .02, respectively). CONCLUSION CG+A was more effective at achieving a zero CFU count and low levels of contamination compared with F10 and EAW for surgical preparation in dogs undergoing ovariohysterectomy. CLINICAL SIGNIFICANCE This study does not provide evidence to support the use of F10 and EAW instead of CG+A for the surgical skin preparation of dogs undergoing ovariohysterectomy.
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Affiliation(s)
- Charles Boucher
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | | | - Piet J Becker
- Research Office, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Robert M Kirberger
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Marthinus J Hartman
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
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Samuelson C, Kaur H, Kritsotakis EI, Goode SD, Nield A, Partridge D. A daily topical decontamination regimen reduces catheter-related bloodstream infections in haematology patients. J Infect 2018; 76:132-139. [DOI: 10.1016/j.jinf.2017.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 10/18/2022]
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Zanchin TN, Serafini CB, Brandão FS, Nery JADC. Polyhexanide 0.2% in treatment of trophic foot ulcers in leprosy - preliminary study. An Bras Dermatol 2018; 93:145-147. [PMID: 29641721 PMCID: PMC5871386 DOI: 10.1590/abd1806-4841.20186655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 03/14/2017] [Indexed: 11/30/2022] Open
Abstract
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which affects peripheral nerves, skin and mucous membranes. The impairment of neural function as well as sensory or sensory-motor disabilities in leprosy continue to be a problem that requires careful attention in the management of patients with the aim to avoid or minimize their progression to prevent sequelae. One of the most common characteristics of these ulcers is the tendency to chronicity, with variable therapeutic response. In this article, we shall discuss the therapeutic management of thirteen trophic leprosy ulcers in eight patients using polyhexanide 0.2% products.
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Affiliation(s)
- Túlio Neutzling Zanchin
- Department of Dermatology, Instituto de
Dermatologia Prof. Rubem David Azulay - Santa Casa da Misericórdia do Rio de
Janeiro (IDPRDA-SCMRJ) - Rio de Janeiro (RJ), Brazil
| | - Cássio Battisti Serafini
- Department of Tropical Dermatology, Hospital
Central do Exército (HCE) - Rio de Janeiro (RJ), Brazil
| | - Francine Silva Brandão
- Department of Sanitary Dermatology,
(DST/Hansen's disease), Instituto de Dermatologia Prof. Rubem David Azulay -
Santa Casa da Misericórdia do Rio de Janeiro (IDPRDA-SCMRJ) - Rio de Janeiro
(RJ), Brazil
| | - José Augusto da Costa Nery
- Department of Sanitary Dermatology,
(DST/Hansen's disease), Instituto de Dermatologia Prof. Rubem David Azulay -
Santa Casa da Misericórdia do Rio de Janeiro (IDPRDA-SCMRJ) - Rio de Janeiro
(RJ), Brazil
- Laboratory of Leprosy and Outpatient Clinic
Sousa Araújo - Instituto Oswaldo Cruz - Fundação Oswaldo Cruz (IOC- Fiocruz) -
Rio de Janeiro (RJ), Brazil
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