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PubMed1977

A comparison of the plaque-inhibiting effect of stannous fluoride and chlorhexidine.

A double blind clinical trial was undertaken in order to compare the plaque inhibiting effect of SnF2 (0.2% and 0.3%) with chlorhexidine (0.1%) applied as mouthrinses in a test panel of 12 dental hygienist students. The experimental series were performed in periods of four days. The mean Plaque Index values were 0.35 and 0.2 when employing SnF2 and 0.1 when chlorhexidine was used, whereas distilled water resulted in a mean value close to 1.0. The long-term effect of a 0.3% SnF2 solution was tested in another group of five students for a period of three weeks. The two trials confirmed previous reports claiming that SnF2 is effective as a plaque inhibitor and, furthermore, that this effect could be maintained for a period of at least three weeks. The staining problem was less than in similar studies using chlorhexidine.

Biguanides↗

PubMed1997

Surface ultrastructure of intact and in situ chlorhexidine-treated human buccal cells. A method for scanning electron microscopy.

Air-dried and ethanol-fixed buccal epithelial cell smears from five subjects were observed by scanning electron microscopy. The mucous pellicle was precipitated as a smooth haze covering the cells, and outlines of bacteria were found embedded within it. Rinsing the preparations under running water gradually diminished the mucous pellicle but not the cell-adherent bacteria. A more complete dissolution of the pellicle was accomplished by washing the buccal epithelial cells before smearing. After a chlorhexidine mouthrinse the buccal cells appeared distorted, with only a few adherent bacteria. Three days after the rinsing, the denatured appearance still persisted on many cells, however, simultaneously with the emergence of undenatured epithelial cells with adherent bacteria. The method introduced in this study is useful to investigate the bacteria-mucus-epithelial cell interactions. A possible mode of antibacterial activity of chlorhexidine in vivo may be that it destroys bacterial adhesins. The substantivity of chlorhexidine in the oral cavity may be linked to the turnover rate of the oral epithelial cells.

Adhesins, Bacterial↗

PubMed1985

Comparative efficiency of chlorhexidine and ethanol in umbilical cord care.

Recurrent epidemic spread of beta-hemolytic streptococci of Lancefield group A was seen in our maternity wards during a period when 70% ethanol was used for umbilical care. This prompted us to compare this regimen with one using 4% chlorhexidine in detergent for a period of 9 consecutive months. 2016 infants were studied. Umbilical colonization with group A, C and G streptococci was almost eliminated by use of 4% chlorhexidine in detergent and epidemic spread was not seen. Colonization rate of Staphylococcus aureus at the umbilical cord was reduced from 92% to 27%. The incidence of superficial infections during the first 4 postnatal weeks was reduced. Following the 9 months of comparative study 4% chlorhexidine in detergent has been routinely used in umbilical cord care at our hospital for more than 1 year without any epidemic spread of streptococci and with the same antibacterial efficiency.

Chlorhexidine↗

PubMed1990

Efficacy of chlorhexidine as a postmilking teat disinfectant for the prevention of bovine mastitis during lactation.

A natural exposure trial was conducted for 12 mo in a herd of 150 lactating Jersey cows to determine efficacy of a .35% chlorhexidine teat dip containing a glycerine emollient for the prevention of bovine intramammary infections. Right teats of cows were dipped in the experimental teat dip after milking machine removal and left teats were not dipped. The herd was free of Streptococcus agalactiae and had a low prevalence of Staphylococcus aureus. Most new major pathogen intramammary infections resulted from Streptococcus species, primarily Streptococcus uberis and Streptococcus dysgalactiae. New infections by Streptococcus species were significantly lower in teats dipped in chlorhexidine than in undipped teats. Overall efficacy of the chlorhexidine teat dip against major mastitis pathogens was 50%. The experimental teat dip also reduced coagulase-negative Staphylococcus species infections 49.0% and Corynebacterium bovis infections 65.2%. Overall efficacy against minor mastitis pathogens was 54.0%. No irritation or chapping of teats dipped in the experimental teat dip was observed.

Animals↗

PubMed1992

Colonization by Staphylococcus aureus on chapped teat skin: effect of iodine and chlorhexidine postmilking disinfectants.

The abilities of common postmilking teat disinfectant solutions and a teat skin ointment to retard Staphylococcus aureus colonization and promote healing of chapped skin were studied. Ten Holstein cows, free of S. aureus intramammary infections and mammary epidermal colonization, were used. All teats were experimentally chapped with 1N sodium hydroxide and dipped in S. aureus broth culture of 5 x 10(6) cfu/ml after three consecutive milkings. Postmilking teat disinfectant treatments were applied, starting after the second application of S. aureus broth culture, and were continued for the next 19 milkings. Quarters of each cow received one of the following postmilking teat treatments: 1% iodine plus 10% glycerin solution; .5% chlorhexidine plus 4.87% glycerin solution; 1% chlorhexidine ointment; and no postmilking treatment. After milking and before treatment application, samples of skin swabbings of the teat end and teat side and samples of milk were collected. Daily teat skin chapping visual scores were made to assess chapping and healing. Teat skin chapping decreased with time, and the decline was similar among treatments. The concentration of S. aureus recovered from teat skin swabbing solutions decreased over time. Staphylococcus aureus were recovered at significantly lower concentrations from swabbing solutions of teats that were dipped with iodine and chlorhexidine solutions as compared with untreated teats. Staphylococcus aureus was in marginally higher concentrations on ointment-treated teats than on dipped teats. Results indicate the importance of using postmilking teat dips on chapped teats and suggest no advantage in applying a disinfectant ointment to chapped teats to reduce S. aureus colonization and improve skin healing.

Analysis of Variance↗

PubMed2006

Results of gastroscope bacterial decontamination by enzymatic detergent compared to chlorhexidine.

AIM: To compare the efficacy of enzymatic detergent with chlorhexidine for gastroscope bacterial decontamination. METHODS: A prospective randomized controlled study was undertaken to evaluate the ability of these 2 agents to achieve high level disinfection in a gastroscope. A total of 260 samples were collected from 5 different gastroscopes. Manual cleaning was done for 10 min with these 2 agents separately (n = 130 each). Then all specimens underwent 2% glutaraldehyde soaking for 20 min. After 70% alcohol was rinsed, sterile normal saline was flushed into each gastroscope channel and 40 mL of sample was collected. The sample was sent for aerobic bacterial culture after membrane was filtered. A colony count greater than 200 cfu/mL was considered significant. RESULTS: The positive culture rate was 4.6% in the enzymatic detergent arm and 3.1% in the chlorhexidine arm. Pseudomonas species were the main organism detected from both groups (60%). Multiple organisms were found from 4 specimens (enzymatic detergent arm = 1, chlorhexidine arm = 3). CONCLUSION: The contamination rate of both types of cleaning solution is equivalent.

Acinetobacter baumannii↗

PubMed1992

Comparative effects of two topical antiseptics (chlorhexidine vs KMn04) on bacterial skin flora in atopic dermatitis.

In order to determine the efficacy and tolerance of two topical antiseptics, chlorhexidine vs KMn04 (diluted at 1:20,000), we compared their bacteriological and clinical effects in a randomized trial on 20 children with Atopic Dermatitis (AD) treated with topical steroids (desonide). After treatment, a clinical improvement was noted in the two groups, though without statistical differences. In vivo: Before treatment, Staphylococcus aureus (S.A.) density was high and predominant in both groups. After treatment, the decrease in S.A. was greater in the chlorhexidine group than in the KMn04 group, without significant difference. In vitro: At the clinical dilution used, there was a statistical difference (p < 0.05) between the number of killed bacteria in the chlorhexidine group (-3 log) and the number in the KMn04 group (-1 log). This study confirms the role and importance of the choice of a topical antiseptic in the treatment of AD.

Administration, Cutaneous↗

PubMed1997

[The effect of chlorhexidine varnish system on Streptococcus mutans in fissure plaques].

A chlorhexidine varnish system and a controlled releasing varnish were prepared by the authors. The release rate of chlorhexidine in vitro and the effects on S. mutans and S. sanguis in vivo were determined. The results showed that the system could selectively inhibit the growth of S. mutans in fissure plaque and had no effect on S. sanguis. The period of interaction between the layer of varnish and plaque was prolonged by the control-releasing reagent. The study suggests that the chlorhexidine varnish system is effective of anticaries and can maintain microflora balance in oral bacteria.

Adolescent↗

PubMed2001

Adjunctive use of chlorhexidine in oral candidoses: a review.

Oral candidosis is by far the commonest human fungal infection and manifests in a variety of clinical guises. The main reason for its high incidence appears to be the multiplicity of predisposing factors, which facilitate the conversion of oral commensal Candida to a parasitic existence. Despite the availability of a number of effective antimycotics for the treatment of oral candidoses, failure of therapy is not uncommon owing to the unique environment of the oral cavity where the flushing effect of saliva and the cleansing action of the oral musculature tend to reduce the drug concentration to sub-therapeutic levels. For these and other reasons chlorhexidine is widely prescribed in dentistry both as an antiseptic mouthwash and a denture disinfectant in order to supplement other antifungals. Chlorhexidine has a broad spectrum of antimicrobial activity including Candida albicans and other common non-albicans yeast species. In this review we outline the utility of chlorhexidine as an adjunct to conventional antimycotic therapy in the management of oral Candida infections.

Anti-Infective Agents, Local↗

PubMed2000

[Lavage of the birth canal with chlorhexidine: a new valid method for the prevention of perinatal infections].

Perinatal morbidity and mortality are due to various infective agents, mainly represented by beta-hemolytic group B Streptococcus. The perinatal disease related to this infection is distinguished in Early-onset, characterised by pneumonia and sepsis, and Late-onset which leads to sepsis, meningitis and pneumonia. Various strategies were therefore proposed to prevent transmission including immunisation and chemoprophylaxis. All these methods however present adverse effects and are most of all expensive to carry out. Taha et al. reported an interesting experience regarding the reduction of perinatal infections following the cleansing of the birth canal with a solution of Chlorhexidine 0.25% during labour (1996-1997). It seemed interesting for us to assess the applicability and efficacy of a new strategy of prophylaxis of perinatal infections in a Developing Country based on the association of two of the simple strategies proposed i.e.: cleansing the birth canal with chlorhexidine and chemoprophylaxis in cases with risk factors without culture screening. We studied two groups of patients: one in which cleansing of the birth canal was used and the second (control group) in which the old method already applied in the hospital (i.e. cleansing of the external genitals with Cetrimide 1%+ Chlorhexidine 0.1%) was carried out associated with antibiotic therapy when risk factors arose. We observed a total absence of neonatal mortality due to sepsis resulting from the association of the methods suggested even though the presence of sepsis evaluated through signs and symptoms like fever, poor feeding, apnoea or dyspnoea in newborns was similar in both groups.

Chlorhexidine↗

PubMed2000

Effect of chlorhexidine varnish on bacterial levels in plaque and saliva during orthodontic treatment.

The plaque-retentive effects of fixed orthodontic appliances may induce a rapid increase in the amount of plaque. The aim of the present study was to conduct a longitudinal clinical investigation on the antibacterial effect of chlorhexidine-containing Cervitec varnish during orthodontic treatment. Twenty-four subjects (9 male, 15 female), aged 16.5 +/- 2.5 years, participated in the study. At baseline, the subjects' DMF-S scores, stimulated salivary flow rates (ml/min) and levels of salivary Streptococcus mutans (SM) and lactobacilli (LB) were determined using Dentocult SM strip and Dentocult LB methods. After placing the orthodontic appliances, the subjects were treated with Cervitec or a placebo varnish around the bands and brackets. The chlorhexidine varnish was applied randomly in the first or second quadrant, and placebo varnish in the opposite quadrant, according to the split-mouth technique. The varnish application was repeated every 3 months to the same sites. Follow-up samples of saliva and plaque from around brackets and bands were collected at 1, 3, 6, 9 and 12 months. Plaque SM and salivary SM, as well as LB counts were determined as at baseline. The results showed that a significantly higher proportion of plaque samples belonged to the low-risk category (SM count10(5) CFU/ml) on the test side than on the placebo side. Distribution of salivary samples between the low-risk and high-risk categories (based on SM and LB counts) did not change significantly until the end of the follow-up period. The number of new carious lesions after debonding the fixed orthodontic appliance was significantly lower (p < 0.05) in the Cervitec-treated quadrant compared to the placebo varnish-treated quadrant. The results show that the chlorhexidine-containing varnish effectively reduced the number of SM in dental plaque around fixed orthodontic appliances.

Adolescent↗

PubMed2001

In vitro cytotoxicity of chlorhexidine gluconate, benzydamine-HCl and povidone iodine mouthrinses on human gingival fibroblasts.

Mouthrinses are frequently prescribed for the treatment of ulcerative diseases of the oral mucosa. In this study the in vitro cytotoxic effect of 0.2% chlorhexidine gluconate in water, 0.15% benzydamine-HCl in 8.5% ethanol and 1% povidone iodine in 10% ethanol were determined. Results of photographs and cell counts revealed that all the cells exposed to chlorhexidine gluconate, benzydamine-HCl and povidone iodine were immediately fixated onto the tissue culture surfaces. The three agents were then diluted in phosphate buffered saline to concentrations varying between 10% and 90% and fibroblasts were once again exposed to the dilutions of the test agents. Photographs were taken and cell concentrations in the wells were determined immediately after exposure and after 2, 4 and 24 hours. Results indicated that cells were immediately fixated by 10% chlorhexidine gluconate in water, 20% povidone iodine and 70% benzydamine-HCl. Fibroblasts survived and recovered from the exposure to 8.5% and 10% ethanol, which indicated that the fixation effect is not the result of the ethanol, but should be ascribed to the activity of the active ingredients in the mouthrinses.

Administration, Topical↗

PubMed1994

[Prevention of dental caries with chlorhexidine].

The presence of > or = 10(6) mutans streptococci per ml saliva may indicate a high caries risk or activity. Individuals exhibiting these high levels of mutans streptococci are ironically called 'millionaires'. It has been demonstrated that the reduction of the mutans streptococci with a series of chlorhexidine gel treatments, reduces the caries incidence in millionaire children. Recently, two chlorhexidine varnishes have been shown to reduce the mutans streptococci in plaque and saliva significantly. It may be expected that the application of these chlorhexidine varnishes may reduce caries incidence in 'millionaires'. It may also be possible to treat individual sites of the teeth that are at risk.

Chlorhexidine↗

PubMedDate not supplied

[Effect of chlorhexidine on Staphylococcus aureus hospital isolates under different environmental conditions].

Antiseptic agents are widely used in hospitals, being essential when prevention and control of nosocomial infections are required. It is necessary to consider several aspects that affect the biocide activity, since they have direct incidence in hospital hygiene, health and also in the nosocomial infection rate. Organisms belonging to Staphylococcus genus are involved in such infections and, digluconate of chlorhexidine is one of the most used antiseptic agents for human and animal health. The current study involved the evaluation of this biocide agent against 19 nosocomial isolates of Staphylococcus with and without organic substances and applying distilled water and water of 300 ppm hardness as dilution means. Results show that hard water was one of the factors that most highly affected the bactericidal activity of chlorhexidine. Moreover we found that it affected bactericidal activity more than the interference generated by organic substances. Our study proves that chlorhexidine is an effective antiseptic for these gram-positive microorganisms.

Abscess↗

PubMed1979

Electron-microscope study of the effect of chlorhexidine on Pseudomonas aeruginosa.

Electron micrographs of cytological damage to log phase Pseudomonas aeruginosa caused by low consentrations of chlorhexidine indicate an action primarily on the cytoplasmic membrane at concentration of 2.0--3.0 micrograms/ml chlorhexidine, and on the cytoplasmic membrane plus layers external to it at concentrations greater than 3.0 micrograms/ml. Evidence of two types of resistance to chlorhexidine is presented.

Cell Membrane↗

PubMed2002

[Resistance of Staphylococcus aureus strains to quaternary ammonium compounds and chlorhexidine].

The level of susceptibility of 90 different Staphylococcus aureus strains to chosen quaternary ammonium compounds: cetyltrimethyl ammonium bromide, benzalkonium chloride and benzethonium chloride as well as to chlorhexidine digluconate were examined. The examined strains consist of three groups: hospital originated MRSA, hospital originated MSSA and non-hospital MSSA. The significant differences between these groups were observed in they susceptibility to the investigated disinfectants. The obtained MIC values showed that the most resistant were hospital MRSA strains, where 55% was estimated as resistant to cetyltrimethyl ammonium bromide, 72% were resistant to benzalkonium chloride and benzethonium chloride and 7% were resistant to chlorhexidine digluconate. Among hospital originated MSSA 3% of strains were resistant to cetyltrimethyl ammonium bromide and 6% were resistant to benzalkonium chloride and benzethonium chloride. 14% non-hospital S. aureus strains were resistant to benzalkonium chloride and benzethonium chloride. None were resistant to chlorhexidine digluconate or cetyltrimethyl ammonium bromide.

Chlorhexidine↗

PubMed2003

[Determination of chlorhexidine acetate in disinfectant by high performance liquid chromatography].

A high performance liquid chromatography(HPLC) was described for the determination of chlorhexidine acetate in disinfectant on a C18 column using acetonitrile-0.02 mol/L potassium dihydrogen phosphate solution(pH2.5) (40:60) as mobile phase. The regression equation was linear when the chlorhexidine acetate concentration was lower than 1.00 g/L. The detection limit was 8 mg/L. The precision was less than 4.0% and the recovery varied from 99.8% to 115.2%. The method was more sensitive, rapid and simple than other HPLC methods, and the characteristic of low disturbance makes it especially important for the assay of chlorhexidine acetate in compound disinfectant comparing with titrimetry and UV spectrophotometry.

Chlorhexidine↗

PubMed1992

[Bacterial contamination of infant urine samples obtained from filter papers used in neuroblastoma-screening tests. (6) Protective effects of preaddition of chlorhexidine digluconate in filter papers or containers for urine on bacterial break-down of creatinine, vanillylmandelic acid and homovanillic acid].

The effects of chlorhexidine digluconate preadded to urine samples for a neuroblastoma-screening test in preventing the break-down of creatinine (Cre), vanillylmandelic acid (VMA), and homovanillic acid (HVA) by creatinine-cleaving bacteria and the influence of the added disinfectant on the HPLC determination of urinary Cre, VMA, vanillillactic acid (VLA) and HVA. Laboratory or field experiments showed that preadded disinfectant (0.02% volume) nearly completely inhibited the growth of the bacteria and satisfactorily protected urinary Cre, VMA, and HVA from bacterial decomposition. Chlorhexidine digluconate was comparable to benzalkonium chloride in its inhibitory effects on the growth and activities of creatinine-cleaving bacteria. Unlike benzalkonium chloride, chlorhexidine digluconate added to urine samples gave no troubles in subsequent analytical processes. Addition of the disinfectant (0.02% volume) to standard Cre, VMA, VLA, and HVA solution did not affect retention times and sensitivities in HPLC analyses. To estimate influences of the added disinfectant on the serial HPLC determinations of VMA, VLA, and HVA on a large number of urine samples (40, 80, 120, 160, 200, or 5, 500), HPLC analyses were performed on standard VMA, VLA, and HVA solution with repeated injection of the disinfectant in great amounts into a column. The results showed no appreciable changes in the retention times and sensitivities of VMA, VLA, and HVA, and almost complete elution of the disinfectant retained on the column were possible with water-methanol (1:1, 2:8) or methanol washing.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Infections↗