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Antiseptic activity of some antidental plaque chemicals on Streptococcus mutans biofilms.

S. mutans is one of the bacterial species involved in the initiation of cariogenic dental plaque. In situ, antiseptic activity evaluation of dental plaque chemicals is fairly difficult. A dynamic biofilm model of S. mutans on Tygon support is suitable for the quantification of antiseptic activity and the comparison of commercial chemical formulations, submitted or not to the french standards and Pharmacopea. Some of these chemicals, especially quaternary ammonia solutions, do not reduce living bacteria counts by 10E5 as AFNOR specifies. In the case of dental plaque, antiseptic activity is probably not the only relevant parameter: biofilm dissociation is rather more relevant because the dead or living bacteria adhere to the teeth, favouring the establishment of a new active biofilm. Two proceedings can be followed: support surface can be modified, or bacteria exopolymers synthesis can be inhibited to prevent cell adherence; the disruption of the biofilm glycocalyx can be achieved with enzymes or surfactants.

Alkaloids↗

The antiseptic effect of a quick drying rubbing type povidone-iodine alcoholic disinfectant solution.

A quick drying rubbing type disinfectant of non-water non-towel type is an antiseptic method suitable for practical use in intensive care units where emergency situations are common. We determined the antiseptic efficacy and safety of a quick drying rubbing type povidone-iodine alcoholic disinfectant solution (HAD Hand Wash) in comparison with benzalkonium chloride alcoholic lotion. The bacterial reduction rate obtained by hand washing with a single 3 ml application was 93.8% for HAD Hand Wash and 94.1% for benzalkonium chloride alcoholic lotion. Thus, excellent antiseptic efficacy was obtained with both disinfectants. Roughening of hand skin which appeared in association with HAD Hand Wash solution was transient and mild in nature in all of the cases, indicating the high safety of this disinfectant. It is justified to say from these findings that HAD Hand Wash is useful as a hand and finger disinfectant.

Antisepsis↗

A comparison of three commercially available antiseptics against opportunist gram-negative pathogens.

Two test methods, a skin replica test and the Kelsey Sykes test have been used to compare the efficacy of three antiseptics against three Gram-negative micro-organisms in an attempt to select the most suitable. The results of both tests showed that an antiseptic containing added ethylenediaminetetraacetic acid was superior to the other two. The skin test showed that this superiority was apparent in both the immediate and the persistant bactericidal activity of the antiseptic towards all three Gram-negative micro-organisms.

Anti-Bacterial Agents↗

[Kinetics of in vitro bactericidal activity of the antiseptic biseptine combining 3 active principles].

Biseptine, is an association of chlorhexidine digluconate, benzalkonium chloride and benzylic alcohol. Little is known, in literature, on this antiseptic, used for cutaneous antisepsis. We studied killing kinetic of Biseptine, at different concentrations, on 4 AFNOR bacterial strains. Killing curves were studied at antiseptic concentration of 90 to 0.1% in 10 ml of distilled water. Bacterial counts were determined after neutralization in liquid medium. Synergy of chlorhexidine and benzalkonium chloride in Biseptine, allowed to obtain similar bactericidal activity than Hibitane champ with chlorhexidine concentrations 2 fold less. At 90, 50, 25, 10 and 5% concentrations, bactericidal activity (5 log10 reduction of the initial bacterial count) was effective in one minute. After 5 to 15 minutes, activity persisted at 1 and 0.5% concentrations. The 0.1% solution was inefficacious. This report disclosed an important security margin in antiseptic activity.

Anti-Infective Agents, Local↗

Hexachlorophene emulsions and antiseptic skin care of newborn infants.

This paper reviews 81,756 live births and 858 infant deaths occurring during the years 1959 to 1969. Sixty-three instances of central nervous system vacuolation are reported. Prematurity is shown to be a necessary prerequisite for central nervous system vacuolation to occur during routine antiseptic skin care of newborn infants with 3% hexachlorophene emulsions. Hyperbilirubinaemia is a contributory factor in such premature infants. Long-term clinical follow-up studies show that, should central nervous system vacuolation occur in premature infants, there is no resultant detriment to their immediate clinical progress and physical and neurological development. Normal newborn infants weighing more than 2,000 g do not develop such central nervous system vacuolation during routine antiseptic skin care. The writers conclude that there is no rationale for regulations to restrict the use of 3% hexachlorophene emulsions in routine antiseptic skin care of normal newborn infants and that the benefits of such use far outweigh any possible risks from central nervous system vacuolation.

Autopsy↗

[Amebicide activity of antiseptics and an antibiotic on 2 Acanthamoeba isolated from corneal ulcers].

PURPOSE: To study the in vitro amoebicidal activity of antiseptics and antibiotics. METHODS: Antiseptics (hexamidine, chlorhexidine, picloxydine, PHMB, polyvidone iodine) and an antibiotic (colimycine) were tested on two Acanthamoeba isolates from corneal ulcers under soft contact lenses. The appearence of trophozoïts and the increase of the number of cysts show their viability. RESULTS: Four antiseptics and colimycin proved to be active in vitro on the two Acanthamoeba isolates: hexamidin 0.1% after 3 to 6 hours incubation, picloxydin 0.05% after 1 to 3 hours incubation (Wilcoxon test, p < 0.05), chlorhexidin 0.02% after 3 hours (Wilcoxon test, p < 0.01), PHBM 0.02% after 3 hours (Wilcoxon test, p < 0.01) and colimycin 125,000 Ul/ml after 1 to 3 hours incubation. Polyvidone iodine proved ineffective. CONCLUSION: Our results confirm that hexamidin, chlorhexidin and PHMB have an amoebicidal activity on the two stains, and show that colimycine, which has already been tested, has also an amoebicidal activity; picloxydine is effective after 1 to 3 hours; there is a considerable variability which exists between the isolates and the sensitivity of the isolates is time-dependent. Medical polytherapy is therefore necessary especially if the sensitivity of the Acanthamoeba has not been tested.

Acanthamoeba↗

The effect of antiseptics on the healing wound: a study using the rabbit ear chamber.

The effects of several antiseptic agents on granulation tissue were studied using rabbit ear chambers as models of the healing wound. This enabled us to study dynamically the action of these agents on the microcirculation of the wound. All the agents tested caused some adverse effect, but in the cases of hypochlorite antiseptics Eusol and Chloramine T, blood flow in the capillary circulation of the granulation tissue ceased and the process of repair was subsequently delayed. A laser Doppler flowmeter was used to measure these changes in local perfusion which reflected the toxic effects seen on microscopy of the ear chamber.

Animals↗

Antiseptic catheter gel and urinary tract infection after short-term postoperative catheterization in women.

This paper compares the rates of postoperative urinary tract infection (UTI) when an antiseptic lubricating gel was used at catheter insertion in 132 women and not used in 387 women. 519 consecutive patients admitted for elective gynaecological surgery were studied prospectively. Antibiotics were not used. Mean catheterization time was 1.4 days (range 1-3). Postoperative UTI occurred in 17.4% and 18.3% of the patients, respectively (p = 0.95). Therefore, using antiseptic anaesthetic gel at catheter insertion does not appear to reduce the risk of UTI associated with short-term transurethral catheterization after gynecological surgery.

Adult↗

Efficacy and local tolerability of povidone iodine and octenidine hydrochloride solution for the antiseptic preparation of the orificium urethrae.

In a randomized clinical study, 61 hospitalized men were examined to test the local tolerability and antimicrobial efficacy of antiseptic treatment of the genitals with povidone iodine versus octenidine hydrochloride solution. Antibacterial efficacy was established by comparing the total aerobic bacterial colony count from standardized swabs from the orificium urethrae externum before, immediately after, and 30 and 60 min after antisepsis. Tolerability was assessed by dermatoscopy, applying a scale to rate the criteria of reddening, erosions and microbleeding. pH-value was taken and the nitracin yellow test carried out at several intervals. Patients assessed sensations (itching, burning, warmth, cold tension) in visual analogue scales. The test for equivalence in efficacy of both antiseptic agents produced no significant result (P = 0.3). The sum score of tolerability produced a better result for povidone iodine. In addition, the drop in the pH value after observed antisepsis with povidone iodine provides an additional protective mechanism against bacterial colonization.

Administration, Cutaneous↗

[Effectiveness of an improved antiseptic in treatment of contaminated soft tissue wounds].

A novel antiseptic biguanide has been shown to be more bactericidal and tissue compatible in vitro than other antiseptics. In our controlled, prospective and randomized double-blind study on patients with bacteria-contaminated wound types 2-4, one group (n = 45) was treated with humid cotton swab dressings of 0.2% Lavasept solution compared with Ringer solution (n = 35). No deterioration of wound healing was observed in either group. Lavasept treatment resulted in faster and significant reduction of gram-positive germs. The tissue compatibility of Lavasept was evaluated as significantly better than Ringer solution.

Adult↗

Antiseptic wick: does it reduce the incidence of wound infection following appendectomy?

The role of prophylactic antibiotics is well established for contaminated wounds, but the use of antiseptic wound wicks is controversial. The aim of this work was to study the potential use of wound wicks to reduce the rate of infection following appendectomy. This prospective randomized controlled clinical trial was conducted at a university hospital in the department of surgery. The subjects were patients undergoing appendectomy for definite acute appendicitis. They were randomized by computer to primary subcuticular wound closure or use of an antiseptic wound wick. For the latter, ribbon gauze soaked in povidone-iodine was placed between interrupted nylon skin sutures. Wicks were soaked daily and removed on the fourth postoperative day. All patients received antibiotic prophylaxis. They were reviewed while in hospital and 4 weeks following operation for evidence of wound infection. The main outcome measures were wound infection, wound discomfort, and cosmetic result. The overall wound infection rate was 8.6% (15/174). In patients with wound wicks it was 11.6% (10/86) compared to 5.6% (5/88) in those whose wounds were closed by subcuticular sutures (p = NS). We concluded that the use of wound wicks was not associated with decreased wound infection rates following appendectomy. Subcuticular closure is therefore appropriate in view of its greater convenience and safety.

Adolescent↗

Septic arthritis following intra-articular steroid injection of the knee--a survey of current practice regarding antiseptic technique used during intra-articular steroid injection of the knee.

Septic arthritis is a potential catastrophic complication of intra-articular steroid injection. There is lack of evidence regarding the precautions that should be taken to avoid such a complication, as well as how often it is encountered. The aim of this study was to evaluate the antiseptic precautions taken during intra-articular steroid injection of the knee in the United Kingdom (UK), and estimate how often septic arthritis is encountered by health professionals in the UK following steroid injection of the knee. A questionnaire was posted to 100 orthopaedic surgeons, 100 rheumatologists and 50 general practitioners (GPs), asking them about the cases of septic arthritis following intra-articular steroid injection of the knee that they encountered during their practice and the precautions they take when injecting knees. The response rate was 76.4%; 57.6% of the respondents used alcohol swabs to clean the skin, and the remaining 42.4% used chlorhexidine or Betadine. Only 16.3% used sterile towels to isolate the injection site. There were 32.5% of respondents who routinely used sterile gloves when injecting, and a total of 46.6% used either sterile or non-sterile gloves. Also, 91.1% changed needles between drawing the steroid and injecting it into the joint. Only 24 respondents (12.6%) had encountered septic arthritis after steroid injection of the knee (18 once, 3 twice, 2 three times, 1 several times). We concluded that septic arthritis post intra-articular steroid injection of the knee is probably rare. There is a wide variation in the precautions taken to avoid such a complication. However, the trend seems to be towards minimal use of antiseptic techniques. Further large prospective studies are needed to determine how frequently septic arthritis of the knee is encountered post steroid injection, and the exact precautions that should be taken to avoid it.

Adult↗

Antiseptic compounds still active against bacterial strains isolated from surgical wound infections despite increasing antibiotic resistance.

The in vitro activities of povidone iodine, potassium peroxymonosulfate, and dimethyldidecylammonium chloride were investigated against 379 nosocomial isolates of Staphylococcus aureus and Pseudomonas aeruginosa responsible for surgical wound infections in patients operated on between July 1995 and June 2001. Overall, the isolates were inhibited by the antiseptics at concentrations below those used routinely. In spite of increasing resistance to the various antibiotics used to treat surgical wound infections, no significant variation in the susceptibility to antiseptics was demonstrated during this 6-year study.

Anti-Infective Agents, Local↗

Current use of skin and wound cleansers and antiseptics.

Out of the tumult of a turbulent, eight-century-long background of surgical skin and wound cleansing methods has come a set of basic principles that serve as performance specifications for new developments. Alcohol remains the superior skin antiseptic. Its characteristic rapid-drying effect and consequent loss of bactericidal action can be overcome by maintaining wetness or by admixture with emollients or longer-acting antiseptics. Today's combinations of cleaners, alcohol, and either iodophores or chlorhexidine have emerged from previous eras characterized by the use of metallic compounds, halogen compounds, and tincture of iodine. Published guidelines are important but must be looked upon as current consensus rather than standard practice.

Anti-Infective Agents, Local↗

Quantitative analysis of quaternary ammonium antiseptics using thin-layer densitometry.

A thin-layer chromatography method for quantitative analysis of quaternary ammonium antiseptics is described. Silanized silica gel was used as the stationary phase. The mobile phase consisted of methanol-25% (m/v) sodium acetate solution-acetone (65:35:20). The method is able to separate the chain homologues of benzalkonium chloride, cetylpyridinium chloride and cetrimide. Detection was performed using a colour reaction with potassium triiodide solution. The different homologues were quantified using UV densitometry at 400 nm. A number of commercial samples was analysed using this method. From the results it appears that it is worthwhile to have a limit test for the composition of quaternary ammonium antiseptics in pharmacopoeial monographs, the more so as the antibacterial activity depends on it.

Acetates↗

Antiseptic resistance in JK and other coryneforms.

Resistance to five antiseptics was compared in a group of JK coryneform isolates containing plasmids with resistance in cured derivatives of these isolates and in non-JK coryneforms. No evidence of plasmid-mediated resistance was found, but JK coryneforms were more resistant to some antiseptics, particularly DNA-binding compounds, than non-JK coryneforms.

Actinomycetales↗

Effective inactivation of human immunodeficiency virus with chlorhexidine antiseptics containing detergents and alcohol.

The antiseptics 4% chlorhexidine gluconate detergent formulation containing 4% isopropyl alcohol (Hibiclens/Hibiscrub) and 0.5% chlorhexidine gluconate in 70% isopropyl alcohol with emollients (Hibistat/Hibisol) efficiently inactivated human immunodeficiency virus (HIV) produced in cell culture within 15 seconds. These antiseptics were completely effective at 1:100 and 1:5 dilutions, respectively. Therefore, use of these products according to the manufacturer's instructions (i.e. undiluted) for routine disinfection of hands following contact with HIV-contaminated materials, as well as immediate disinfection of abrasions or cuts exposed to HIV, should have significant protective effects.

1-Propanol↗

Dietary staining in vitro by mouthrinses as a comparative measure of antiseptic activity and predictor of staining in vivo.

Extrinsic staining of teeth is a side-effect of some antiseptic mouthrinses. However, few of the many rinse products available to the general public have been investigated for their propensity to cause staining. Dietary factors play an aetiological role in staining and have been used in vitro to study and compare the activity of rinses. The aim of this study was to assess rinse products for staining in vitro and, through the staining reaction, to compare the activity of products containing the same ingredients. Perspex blocks, with or without saliva pretreatment, were soaked in rinses for 2 min, washed and placed in a standard tea solution for 60 min and then the optical density (OD) read on a spectrophotometer. The cycle was repeated 10 times for saliva and 17 times for no saliva specimens or until the maximum OD was exceeded. A series of three separate experiments was performed by this method. The maximum OD was not exceeded by any product before seven passages and therefore data were compared at six passages. For most products OD increased with saliva pretreatment. Some cetylpyridinium chloride (CPC) rinses stained comparably to a chlorhexidine rinse. CPC rinses, most of which contained the same concentration of the antiseptic, varied considerably in their propensity to induce staining and one was little different to water controls. A 0.1% chlorhexidine rinse stained slightly more than a 0.2%. A phenolic/essential oil product produced some staining but zinc, triclosan and other essential oil rinses did not stain.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗