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PubMed2000

Association of qacE and qacEDelta1 with multiple resistance to antibiotics and antiseptics in clinical isolates of Gram-negative bacteria.

Clinical isolates of Enterobacter cloacae, Citrobacter freundii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia were tested for resistance to antibiotics and to the antiseptics benzalkonium chloride and cetyltrimethylammonium bromide. Furthermore, they were examined for the presence of the resistance genes qacE and qacEDelta1. qacEDelta1 was detected by PCR in 10% of all (n=103) and in 81% of multiply antibiotic-resistant strains (n=15). qacE was found in only one of 37 P. aeruginosa strains. The minimum inhibitory concentrations of benzalkonium chloride, cetyltrimethylammonium bromide, and ethidium bromide were not significantly different for qacEDelta1/qacE-positive or -negative strains. Our data indicate that multiply antibiotic-resistant Gram-negative bacteria are not necessarily more resistant to quaternary ammonium compounds than antibiotic-sensitive strains even though qacE or qacEDelta1 is present.

Anti-Bacterial Agents↗

PubMed2006

Effect of mechanical and antiseptic therapy on peri-implant mucositis: an experimental study in monkeys.

OBJECTIVES: This experiment was performed to evaluate clinically and histologically the effect of mechanical therapy with or without antiseptic therapy on peri-implant mucositis lesions in nine cynomolgus monkeys. MATERIAL AND METHODS: Two ITI titanium implants were inserted into each side of the mandibles. After 90 days of plaque control and soft tissue healing, a baseline clinical examination was completed. Peri-implant lesions were induced by placing silk ligatures and allowing plaque to accumulate for 6 weeks. The clinical examination was then repeated, and the monkeys were randomly assigned to three treatment groups: group A, mechanical cleansing only; group B, mechanical cleansing and local irrigation with 0.12% chlorhexidine (CHX) and application of 0.2% CHX gel; and group C, control, no treatment. The implants in treatment groups A and B were treated and maintained according to the assigned treatment for two additional months. At the end of the maintenance period, a final clinical examination was performed and the animals were sacrificed for biopsies. RESULTS: The mean probing depths (PD) values at mucositis were: 3.5, 3.7, and 3.4 mm, and clinical attachment level (CAL) = 3.8, 4.1, and 3.9 mm for treatment groups A, B and C, respectively. The corresponding values after treatment were: PD = 1.7, 2.1, and 2.5 mm, and CAL=2.6, 2.6, and 3.1 mm. ANOVA of mean changes (Delta) in PD and CAL after treatment showed no statistical difference between the treatment groups. Comparison of the mean changes in PD and CAL after treatment yielded statistical differences between the control and treatment groups P < 0.01. According to the t-test, no statistical difference was found between treatment groups A and B for the PD reduction but there was a significant difference for the CAL change, P < 0.03. Group A had significantly more recession and less CAL gain than group B. Non-parametric tests yielded no significant differences in modified plaque index (mPlI) and gingival index (GI) after treatment between both treatment groups. Frequencies and percent distributions of the mPlI and GI scores changed considerably for both treatment groups when compared with the changes in the control group after treatment. With regard to the histological evaluation, no statistical differences existed between the treatments for any linear measurement. The proportion of inflammation found in the mucosal tissues of the control implants was greater than the one found for both treatment groups, P < 0.01. More importantly, both treatment groups showed a similar low proportion of inflammation after 2 months of treatment. CONCLUSIONS: Within the limitations of this experiment, and considering the supportive plaque control rendered, it can be concluded that for pockets of 3-4 mm: (1) mechanical therapy alone or combined with CHX results in the clinical resolution of peri-implant mucositis lesions, (2) histologically, both treatments result in minimal inflammation compatible with health, and (3) the mechanical effect alone is sufficient to achieve clinical and histologic resolution of mucositis lesions.

Animals↗

PubMed1981

Comparison of the bisbiguanide antiseptics alexidine and chlorhexidine. II. Clinical and in vitro staining properties.

A blind cross-over trial was carried out to compare the tooth and tongue staining associated with the use of a 0.035% alexidine and a 0.2% chlorhexidine mouthrinse. Twenty-two volunteers were divided into two groups termed "tea drinkers" and "non-tea drinkers". All volunteers were requested to refrain from oral hygiene measures throughout two 10-day periods when they rinsed twice a day with the preparation randomly allocated for the respective period. During both periods the members of the groups excluded coffee, red wine and port from their diet. The tea drinking group consumed seven cups of tea per day. Tooth and tongue staining was recorded for extent and severity at the end of each period. The amount of stain accumulating in the two groups was similar following the use of chlorhexidine and alexidine. However, for both chlorhexidine and alexidine the extent and severity of tooth and tongue staining were significantly increased in the tea drinking group. An in vitro study of tea staining of perspex blocks exposed twice a day to 0.035% solutions of alexidine or chlorhexidine throughout a 5-day period demonstrated significantly more staining with alexidine when measured spectrophotometrically. Visually however, the differences in the specimens were minimal. Saliva treatment of the perspex did not significantly alter the staining by alexidine or chlorhexidine. The results provide further evidence for a dietary aetiology to the staining associated with cationic antiseptics. However, alexidine at the concentration used offered no advantage in reducing the side effect of staining when compared with chlorhexidine.

Biguanides↗

PubMed1985

The effect of rinsing with Listerine antiseptic on the properties of developing dental plaque.

Plaque was collected from a group of volunteers who used either Listerine antiseptic (LA), its vehicle control (V), or a water control (C) twice daily in addition to their normal toothbrushing in a double-blind controlled clinical experiment. Following the 9-month clinical study, plaque collected from the supragingival surfaces of 20 teeth from each of 78 subjects was weighed wet, freeze dried, reweighed, resuspended, sonicated and estimated for protein. In addition, endotoxin activity was evaluated by means of the limulus lysate assay. A 52.6% reduction in wet weight was found LA versus C (p = 0.04); LA versus V showed a 55.1% reduction (p = 0.03). A 59.0% reduction in dry weight was found LA versus C (p = 0.01); LA versus V showed a 59.6% reduction (p = 0.01). A 59.7% reduction in plaque protein was seen LA versus C (p = 0.01); LA versus V showed a 59.2% decrease (p = 0.02). A 75.8% reduction in limulus lysate activity was found LA versus C (p = 0.01); LA versus V showed a decrease of 77.9% (p = 0.01). Our results demonstrate that LA has a dramatic effect on plaque toxic activity, as measured by a decrease in limulus lysate assay, as well as on its biomass.

Adult↗

PubMed1991

Effect of antiseptic mouthwashes on some clinical and microbiological findings in the mouths of lymphoma patients receiving cytostatic drugs.

51 patients suffering from Hodgkin's disease or non-Hodgkin's lymphoma participated in this double-blind, cross-over study in which 2 antiseptic mouthwashes were tested for their effects on various periodontal index scores and salivary microbial counts. All patients were receiving combination cytostatic treatment based on methotrexate and doxorubicin. The patients (49 +/- 14 years old, 28 men, 23 women) were allotted at random to 2 groups. One rinsed with a 0.12% chlorhexidine gluconate (CHX) solution, the other with a 0.025% amine-stannous fluoride (AmF + SnF) solution 2x daily for 2 weeks. Both groups then continued rinsing with a 0.05% sodium fluoride (F) solution for 2 weeks, before switching over to AmF + SnF or CHX, respectively. All solutions had been prepared in such a way that they had the same colour and taste. Visible plaque index and gingival bleeding index scores were significantly reduced after periods of rinsing with CHX solution (P less than 0.001) and AmF + SnF solution (P less than 0.05). Microbiological cultivations of saliva specimens revealed significant reductions in mutans streptococci immediately after commencing rinsing, while lactobacilli and yeast counts were not affected.

Amines↗

PubMed1997

Irritancy of antiseptics tested by repeated open exposures on the human skin, evaluated by non-invasive methods.

The aim of the study was to test the irritancy of 6 antiseptics in an open exposure model. The following agents were tested in their normal use concentrations using open exposures, 2x daily for 4 days in 20 subjects: chlorhexidine 4% (CH), chlorhexidine 0.5% in ethanol 70% (CE), ethanol 70% (ET), iodine 1% in ethanol 70% (IE), povidone-iodine 10% (PI) and sodium hypochlorite 0.25% (SH). Responses were evaluated by visual scoring, subjective irritancy scoring, stratum corneum hydration (Corneometer), transepidermal water loss and laser Doppler flowmetry. Exposure to SH had to be discontinued after 4 applications because of severe subjective irritation. The same held true for IE (7 applications), whereas the other agents were exposed 8x. All evaluation methods showed SH to be significantly more irritating than IE, which was in turn more irritating than CH, CE, ET and PI. Thus, it can be concluded that CH, CE, ET and PI were non-irritating in this open exposure model.

Adult↗

PubMed1985

Influence of antiseptic storage solutions on physical properties of endodontic guttapercha points.

The effect of three commonly used antiseptic storage solutions on some physical properties of endodontic guttapercha points was studied. The solutions tested were: 70% isopropyl alcohol, 5% chloramine and 0.5% chlorhexidine. As a control solution, physiologic saline was used. There was a marked decrease in the force necessary to bend the points after 1 month. With few exceptions, the greatest decrease was seen with solutions containing alcohol, i.e. chlorhexidine and isopropyl alcohol. The difference between aqueous and alcoholic storage solutions was also noted for linear dimensional changes. Physiologic saline and chloramine hardly affected the length of the points. The decrease in stiffness may add to the difficulties when handling guttapercha points of small dimensions in curved root canals. From this point of view it is therefore recommended to avoid storage of points in antibacterial solutions. Rather, an effective surface disinfecting of the points immediately prior to use would be desirable.

1-Propanol↗

PubMedDate not supplied

Vital bleaching agents and oral antiseptic: effect on anaerobic bacteria.

This in vitro study compared the antimicrobial effect of several at-home bleaching agents and an oral antiseptic against anaerobic bacteria that are commonly found in the oral cavity. Zones of inhibition produced by Rembrandt Lighten Bleaching Gel, Opalescence, and Peroxyl were measured and compared. All the materials produced zones of inhibition with the five bacteria used in the study.

Bacteroides↗

PubMed1987

The differential cytotoxicity of antiseptic agents.

The cytotoxicity of the antiseptic agents noxythiolin and chlorhexidine has been evaluated in-vitro using a range of tissue culture cell lines of differing degrees of neoplasticity. Noxythiolin appeared more cytotoxic than did chlorhexidine when tested against established neoplastic cell lines. By contrast, noxythiolin was not cytotoxic to normal control (non-neoplastic) cells. For chlorhexidine, the cytotoxic activity against control cells was similar to that observed for neoplastic cell lines. The results confirm an earlier observation of limited antitumour activity of noxythiolin solutions and, on the basis of differential cytotoxicity, confirm that noxythiolin is free from adverse effects against normal tissues and is safe for use as an antimicrobial agent applied to peritoneal surfaces and the healing wound.

Anti-Infective Agents, Local↗

PubMed2002

[Antimicrobial effects and efficacy on habitually hand-washing of strong acidic electrolyzed water--a comparative study of alcoholic antiseptics and soap and tap water].

The rate of bacterial elimination for the stamp method was compared with regular hand-washing (using soap and tap water), hygienic hand-washing (using alcoholic antiseptics), and hand-washing using strong acidic electrolyzed water (the SAEW method) in routine work. After routine work, the average number of bacteria remaining on the nurse's hands with using the SAEW-method, rubbing method and tap water method, were: 54 +/- 63, 89 +/- 190, 128 +/- 194 CFU/agar plate, respectively (n = 81). In this study. It was clarified that a much larger number of Bacillus sp. were detected for the rubbing method than for the other methods. After further nurse work, the most number of absorbed bacteria on a nurse's hands were counted after cleaning a patient's body. The rate of bacteria elimination for hand-washing with soap and tap water after taking care of a patient was insufficient, especially when before care was provided the number of bacteria on the nurse's hands were less than 100 CFU/agar plate. From these results, the following manual for sanitary hand washing is recommended: 1. At first, dirty hands should be cleaned and the number of bacteria should be reduced using soap and tap water or by scrubbing with disinfectants. 2. After the number of bacteria has been reduced, use the SAEW method routinely. 3. For care requiring a high level of cleanliness or if no tap water facilities are available, use the rubbing method. Finally, routine use of the SAEW method in ICU could be recommended with conventional disinfectants and soap and tap water on a case by case basis for less than adverse reactions, such as in the case of rough-hands or keeping a low level of bacteria on hands.

Anti-Infective Agents, Local↗

PubMed2003

[Cytotoxic effect of antiseptics: comparison In vitro. In vivo examination of strong acidic electrolyzed water, povidone-iodine, chlorhexidine and benzalkonium chloride].

Cytotoxic effect and guinea pig wound cure stage, pus fabrication presence in infected wound were compared with strong acidic electrolyzed water (AcEW) and povidone-iodine solution (PVP-I), chlorhexidine (CHG) and benzalkonium chloride (BAC). It gave the following results: In a cytotoxic test, the toxicity was recognized in 0.1%-0.01% PVP-I, in 0.0002-0.0004% CHG, in 10-0.1 micrograms/ml BAC, but there was no toxicity in AcEW. By a guinea pig wound cure process, no significance was recognized between each pharmaceutical agent in epidermal cell migration, but by an inflammation locus area, the significance was considerable in comparison with no-treatment. The pyopoiesis of P. aeruginosa infected wound was recognized in a ratio of 38.2% physiological saline, 27.3% CHG, 20.6% PVP-I and 12.1% AcEW. When pollution locus includes an infection image of bacteria, while draining AcEW instead of physiological saline, disinfection, indication was expected, and, as for the disorder in cure stage. I do not agree with that mentioned above. As for AcEW, availability by organism use was recognized for the cytotoxic effect of antiseptic instead of action of acceleration for wound cure.

Animals↗

PubMed1988

Antiseptic and antibiotic resistance plasmid in Staphylococcus aureus that possesses ability to confer chlorhexidine and acrinol resistance.

Plasmid pSAJ1 from a methicillin- and gentamicin-resistant strain of Staphylococcus aureus had am molecular size of 50 kilobases and conferred resistance not only to kanamycin, gentamicin, tobramycin, amikacin, benzalkonium chloride, acriflavin, and ethidium bromide but also to chlorhexidine. In addition, the cloned antiseptic resistance gene(s) manifested acrinol resistance in Escherichia coli.

Acridines↗

PubMed1993

The 3' conserved segment of integrons contains a gene associated with multidrug resistance to antiseptics and disinfectants.

Nucleotide sequence analysis of ORF1 from the integron on the broad-host-range plasmid R751 revealed that the first 94 of 110 codons of ORF1 from R751 are identical to ORF4, an open reading frame from the 3' conserved segment of other integrons found in gram-negative bacteria, after which point they diverged completely. The predicted products of both ORF1 and ORF4 share homology with the multidrug exporter QacC. Phenotypic analysis revealed that ORF1 specifies a resistance profile to antiseptics and disinfectants almost identical to that of qacC, whereas ORF4 specifies much lower levels of resistance to these compounds. ORF4, whose product lacks the C-terminal 16 amino acids of the ORF1 protein, may have evolved by the interruption of ORF1 from the insertion of a DNA segment carrying a sulI sulfonamide resistance determinant. Hence, ORF1 was designated qacE, and its partially functional deletion derivative, ORF4, was designated qacE delta 1. Fluorimetric experiments indicated that the mechanism of resistance mediated by QacE, the protein specified by qacE, is active export energized by proton motive force. Amino acid sequence comparisons revealed that QacE is related to a family of small multidrug export proteins with four transmembrane segments.

Amino Acid Sequence↗

PubMed2001

New method for evaluation of virucidal activity of antiseptics and disinfectants.

Counting culturable viruses adsorbed to cellulose nitrate filters (the VIRADEN method) is proposed as a simple procedure for the evaluation of the virucidal activity of antiseptics and disinfectants. The virucidal activities of two different doses of iodine, chlorine, glutaraldehyde, and chlorhexidine digluconate on poliovirus 1 were tested with a standardized procedure and with the VIRADEN method. The two procedures assayed provided similar results.

Anti-Infective Agents, Local↗

PubMed1997

Effect of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and mortality in Malawi: clinical trial.

OBJECTIVE: To determine if cleansing the birth canal with an antiseptic at delivery reduces infections in mothers and babies postnatally. DESIGN: Clinical trial; two months of no intervention were followed by three months of intervention and a final month of no intervention. SETTING: Queen Elizabeth Central Hospital (tertiary care urban hospital), Blantyre, Malawi. SUBJECTS: A total of 6965 women giving birth in a six month period and their 7160 babies. INTERVENTION: Manual wipe of the maternal birth canal with a 0.25% chlorhexidine solution at every vaginal examination before delivery. Babies born during the intervention were also wiped with chlorhexidine. MAIN OUTCOME MEASURES: Effects of the intervention on neonatal and maternal morbidity and mortality. RESULTS: 3635 women giving birth to 3743 babies were enrolled in the intervention phase and 3330 women giving birth to 3417 babies were enrolled in the non-intervention phase. There were no adverse reactions related to the intervention among the mothers or their children. Among infants born in the intervention phase, overall neonatal admissions were reduced (634/3743 (16.9%) v 661/3417 (19.3%), P < 0.01), as were admissions for neonatal sepsis (7.8 v 17.9 per 1000 live births, P < 0.0002), overall neonatal mortality (28.6 v 36.9 per 1000 live births, P < 0.06), and mortality due to infectious causes (2.4 v 7.3 per 1000 live births, P < 0.005). Among mothers receiving the intervention, admissions related to delivery were reduced (29.4 v 40.2 per 1000 deliveries, P < 0.02), as were admissions due to postpartum infections (1.7 v 5.1 per 1000 deliveries, P = 0.02) and duration of hospitalisation (Wilcoxon P = 0.008). CONCLUSIONS: Cleansing the birth canal with chlorhexidine reduced early neonatal and maternal postpartum infectious problems. The safety, simplicity, and low cost of the procedure suggest that it should be considered as standard care to lower infant and maternal morbidity and mortality.

Adult↗

PubMed1973

Preoperative sterilization of the perineum: a comparison of six antiseptics.

Nine preparations of six antiseptic substances were applied to the perineum of pregnant women at term in order to assess their efficacy in sterilizing the skin. The efficacy, in descending order of effectiveness, after three minutes' exposure, was p-chlor-m-xylenol in alcohol (surgical Dettol); chlorhexidine gluconate in detergent (Hibiscrub), followed by the aqueous preparations p-chlor-m-xylenol (Dettol), chlorhexidine gluconate (Hibitane), cetrimide (Cetavlon), povidoneiodine (Disadine), benzalkonium chloride (Resiguard), and merthiolate. Surgical Dettol was the only alcohol-based preparation used.

Alcohols↗

PubMed1979

Handwashing and antiseptic-containing soaps in hospital.

Two aspects of handwashing in hospital were considered. A study was carried out to examine the contamination of bar soap and containers, and the use of antiseptic soaps in reducing the resident flora of the skin. Swabs were collected from soap dishes on six wards and from a bacteriology laboratory on four consecutive days. The unmedicated bar soap was replaced by bar soap containing 2.5% povidone-iodine, and further swabs were collected over a period of seven days. Ninety-two isolates from 48 samples were obtained when unmedicated bar soap was used, and nine isolates from 42 samples when povidone-iodine (Betadine) soap was substituted. The number of organisms recovered when povidone-iodine soap was used was much reduced, and Pseudomonas spp were recovered in low numbers on only one occasion. Six laboratory workers took part in a study to compare bar soap with other agents-povidone-iodine soap, povidone-iodine surgical scrub, povidone-iodine alcoholic solution, chlorhexidine surgical scrub, and alcoholic chlorhexidine. Samples were collected after standard washes and after surgical gloves had been worn for 90 minutes. The effect of multiple washes was assessed by samples collected after six washes with the agent under study (three per day) followed by 90 minutes wearing surgical gloves. The average percentage reduction in normal flora obtained indicated that alcoholic chlorhexidine was superior to the other agents.

Anti-Infective Agents, Local↗

PubMed1983

Rotavirus inactivation by chemical disinfectants and antiseptics used in hospitals.

Nosocomial outbreaks of rotaviral gastroenteritis are a common occurrence. Although proper disinfection practices in the hospital environment are considered to be important in the prevention and control of such outbreaks, very little information has been available on the rotavirus-inactivating capacity of chemical disinfectants and antiseptics commonly used in hospitals. In view of this, 11 such products were selected and screened for their capacity to bring about at least a 3 log10 reduction in the plaque titre of rotavirus SA-11 after a contact time of 1-30 min. Consept "D" (1:100), D.R.X. (1:80), Dustbane Germicidal (1:80), Hibitane, and Wescodyne (1:200) were found to be ineffective under these test conditions even in the absence of an added organic load. The virucidal capacity of Savlon (1:200) and Zephiran was completely neutralized when single-strength tryptose phosphate broth was added to the virus-disinfectant mixture to simulate an organic load. Cidex (2% acid glutaraldehyde), Proviodine (10% solution of povidone-iodine), Septisol (0.75% hexachlorophene), and Sana Rinse (70% isopropylalcohol, 0.1% hexachlorophene) were able to produce at least a 3 log10 (99.9%) reduction in the virus plaque titre even in the presence of added organic matter. These findings should be of help in the prevention and control of outbreaks of rotaviral diarrhea in the hospital environment.

Anti-Infective Agents, Local↗