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PubMed1973

Use of 4 per cent chlorhexidine detergent solution (Hibiscrub) and other methods of skin disinfection.

In a comparison of three antiseptic detergent preparations for hand washing, Hibiscrub, a 4% chlorhexidine detergent solution, caused a significantly greater estimated immediate reduction of skin flora (86.7% +/- 3.0) than was obtained with Dermofax, a 0.75% chlorhexidine detergent solution (55.5% +/- 5.1), or with Disadine scrub, a povidone iodine detergent preparation (68% +/- 6.8). After six applications the mean estimated reductions of skin flora were 99.2% +/- 0.2 for Hibiscrub, 97.7% +/- 0.7 for povidone iodine, and 91.8% +/- 1.6 for Dermofax.After a series of hand washings with Hibiscrub, as with a hexachlorophane detergent preparation, a further large reduction of skin flora, shown by bacterial counts of hand sampling, was obtained by a second phase of disinfection consisting of two minutes' application on gauze swabs of 0.5% chlorhexidine digluconate in 70% ethanol; a further wash with Hibiscrub, in place of alcoholic chlorhexidine, for the second phase of disinfection caused an increase rather than a reduction in the yield of bacteria on skin sampling. Unlike this "two-phase" disinfection, the application for 30 minutes of compresses soaked in 10% aqueous povidone iodine or in 0.5% aqueous chlorhexidine digluconate did not cause a greater reduction in skin flora than that obtained by the conventional two minutes' application on gauze of 0.5% chlorhexidine in 70% ethanol.Chlorocresol (0.3%) liquid soap (the base used for Ster-Zac liquid hexachlorophane soap) caused a mean reduction of skin flora when used for hand washing of 29% after one application and 72% after six applications spread over two days. This formulation, though less active and more variable as a detergent skin antiseptic than chlorhexidine, hexachlorophane, or povidone iodine detergent preparations, is an inexpensive disinfectant soap which could be useful in catering establishments. Alcoholic cetrimide applied as for disinfection of an operation site caused a reduction of skin flora greater than that shown by aqueous cetrimide but comparable to that shown by 70% ethyl alcohol in previous experiments.

Analysis of Variance↗
PubMed2002

Evaluation of the disinfective efficacy of povidone-iodine with the use of the transparent film dressing OpSite Wound.

To determine the duration of efficacy of disinfection with povidone-iodine (PVP-I) conducted before application of OpSite Wound (Smith and Nephew, UK), bacteriological evaluation was carried out. In 9 healthy adults, 3 sites on the forearms or other parts were chosen for application of OpSite Wound after adequate disinfection with PVP-I. As compared to the bacterial count score of 1.67-2.00 before disinfection, a significant reduction of the score was observed on removal of OpSite Wound on days 1, 2 and 3. The score of 0.5-0.67 immediately after disinfection did not change or deteriorate until removal of OpSite Wound. This finding supports the fact that unnecessary dressing changes could be avoided postoperatively for at least 3 days by disinfection with PVP-I and application of OpSite Wound particularly for operations categorized as 'clean surgery'.

Adult↗
PubMed2006

Assessment of povidone-iodine disinfectant compatibility with antimicrobial incise drape and adhesion inhibition on the skin using a gas chromatography/mass spectrometry approach.

According to orthopedists' reports, substitution of the original for a generic povidone-iodine (PVP-I) disinfectant could have led to some adhesion problems of antimicrobial incise drapes on the field of operation with the consequence of increasing the infection risk. Three methods have been used to assess the case: (a) a gas chromatography/mass spectrometry (GC-MS) approach quantifying methimazole formation from carbimazole, (b) in vitro adhesion experiments on a smooth glass plate surface and (c) the analysis of intrasurgical procedures. GC-MS results confirmed the higher potency of the original compared to the generic PVP-I. In vitro comparison of the adhesion on a PVP-I-pretreated glass surface showed no difference between the disinfectants and no significant destruction of the adhesive layer. However, due to different surgery preparation procedures, the remaining free skin surface granting sufficient adhesion differed if the intervening surgeon himself or his assistant prepared the field of operation. As a conclusion, the original PVP-I disinfectant is confirmed as the first-choice disinfectant for the field of operation. Adhesion problems were arising with new surgical staff and thus different preparation procedures. Exchanging PVP-I disinfectants cannot explain the adhesion problems of drapes and antimicrobial incise foils on the skin.

Adhesiveness↗
PubMed2006

Acanthamoeba keratitis and contact lens disinfecting solutions.

OBJECTIVES: To report cases of culture-proved Acanthamoeba keratitis in Greece over a 10-year period and to evaluate the effectiveness of the commonly used commercial contact lens disinfecting systems in clinical cases of Acanthamoeba keratitis. MATERIAL AND METHODS: During the years 1994-2004, 45 contact lens wearers and 3 non-contact lens wearers presenting with symptoms and signs of keratitis underwent corneal sampling. The scrapings obtained were inoculated directly onto appropriate culture media for bacteria, fungi and Acanthamoeba. All proved positive for Acanthamoeba. The contact lenses and contact lens disinfecting solutions (16 one-step 3% hydrogen peroxide and 3 multipurpose solutions) of 19/45 patients with culture-proven Acanthamoeba keratitis were cultured for bacteria, fungi and Acanthamoeba. RESULTS: Acanthamoeba was isolated from contact lenses and contact lens disinfecting solutions in all 19 cases of Acanthamoeba keratitis studied. CONCLUSIONS: The main risk factor for corneal infection in contact lens wearers is the use of contact lens disinfecting systems ineffective at killing Acanthamoeba cysts and trophozoites, as well as bacteria and fungi. Improvement or development of new contact lens disinfecting systems by manufacturers is needed to prevent Acanthamoeba keratitis.

Acanthamoeba↗
PubMed2006

Current clinical applications of photo-activated disinfection in restorative dentistry.

UNLABELLED: The traditional treatment of dental caries has been limited to bulk removal of the diseased tissue. Recently, disinfection rather than the removal of all the carious tissue has been advocated with the aim of more effective and conservative treatment. In endodontics, prognosis is dependent on the complete disinfection of the root canal system. Evidence exists that Photo-Activated Disinfection is more effective than traditional chemo-mechanical canal preparation. Photo-Activated Disinfection may also have a place in the treatment of other infective oral conditions, including periodontal disease. CLINICAL RELEVANCE: Removal or disruption of micro-organisms and their ecosystem is important in many branches of restorative dentistry. A novel disinfection system is now available which has the potential to improve treatment methods and prognoses.

Anti-Infective Agents↗
PubMed1996

Full- versus partial-mouth disinfection in the treatment of periodontal infections. Long-term clinical observations of a pilot study.

A classical treatment for chronic adult periodontitis consists of four to six consecutive sessions of scaling and root planing at a 1- to 2-week interval. Such a so-called "quadrant or sextant therapy" might result in a reinfection of a previously disinfected area by bacteria from an untreated region. The purpose of this study was to investigate, over an 8-month period, the clinical benefits of full-mouth disinfection within a 24-hour period in the control of chronic periodontitis. Ten adult patients with advanced chronic periodontitis were randomly assigned to a test and a control group. The control group received the standard scheme of initial periodontal therapy, consisting of scaling and root planing of the four quadrants was performed within 24 hours and immediately followed by a thorough supra- and subgingival chlorhexidine application to limit any transfer of bacteria. The latter involved tongue brushing with a 1% chlorhexidine gel for 60 seconds, mouthrinsing with a 0.2% chlorhexidine solution twice for 60 seconds, repeated subgingival irrigation of all pockets with a 1% chlorhexidine gel (3 times within 10 minutes), and mouthrinsing twice daily with a 0.2% chlorhexidine solution during 2 weeks. In addition, both groups received thorough oral hygiene instructions. The plaque index, gingival index, probing depth, gingival recession, and bleeding on probing were recorded prior to professional cleaning and at 1, 2, 4, and 8 months afterwards. Although the test group scored higher plaque indices than the control group, especially at months 2 and 4, the gingival index and bleeding tendency showed similar improvements with time. However, when the gingival/plaque ratio was considered, the latter was lower in the test group at all follow-up visits. For pockets > or = 7 mm, full-mouth disinfection showed a significantly (P = 0.01) higher reduction in probing depth at each follow-up visit with, at month 8, a reduction of 4 mm (from 8 mm to 4 mm), in comparison to 3 mm (from 8 mm to 5 mm) for the classical therapy. The increase in gingival recession in the full-mouth disinfection group remained below 0.7 mm, while in the control group it reached 1.9 mm after 8 months. This resulted in a gain of clinical attachment level of 3.7 mm for the test group versus 1.9 mm for the control group. A radiographical examination also indicated a superior improvement for the test group when compared to the control group. This pilot study suggests that a full-mouth disinfection in one day results in an improved clinical outcome in chronic periodontitis as compared to scalings per quadrant at 2-week intervals over several weeks.

Adult↗
PubMed1999

Microbiological evaluation of contact lenses and contact lens disinfection solutions in an asymptomatic population and in medical personnel.

PURPOSE: To compare the contamination of contact lenses and contact lens disinfection solutions in a population of contact lenses wearers comprised of medical personnel and non-medical subjects. METHODS: Forty-six medical personnel working in an infectious environment and 35 non-medical subjects were enrolled in the study. Contact lenses and contact lens disinfecting solutions were cultured and potential pathogens were isolated. RESULTS: The frequency of isolation of pathogens from the contact lenses of medical personnel was significantly higher than from non-medical subjects. There was no growth in both the contact lens and the disinfecting solution cultures in 56.5% of the subjects in the medical personnel group, and in 57.1% of non-medical group of subjects. Both the contact lens and disinfecting solution cultures were positive in 21.7% of the medical personnel group, while in the non-medical group, only 2.9% of subjects had positive cultures. CONCLUSIONS: Microbacterial contamination of contact lenses and disinfection solution was more frequent in the medical personnel group compared with non-medical subjects. In the medical personnel group, the most frequently isolated microorganism was Staphylococcus albus (19.8%), which is seen in hospital infections. Because soft and rigid gas permeable contact lens usage was approximately equal, we conclude that medical personnel are more prone to contamination.

Adolescent↗
PubMed2001

Disinfection efficacy of contact lens care solutions against ocular pathogens.

PURPOSE: Three commercially available products labeled as multi-purpose contact lens solutions, one multi-purpose disinfecting solution, and a hydrogen peroxide system were evaluated for antimicrobial activity according to the current International Organization for Standardization (ISO) and the U.S. Food and Drug Administration (FDA) stand-alone procedure for disinfecting products. One multi-purpose solution was selected to assess its antimicrobial activity against two human corneal isolates of Pseudomonas aeruginosa. METHODS: Products were challenged with bacteria and fungi, and following a specified period, aliquots of inoculated test solution were neutralized and plated on validated recovery media. After incubation the number of viable microorganisms was enumerated and mean log reductions determined. RESULTS: ReNu MultiPlus (Bausch & Lomb, Rochester, NY), AOSEPT (CIBA Vision Corporation, Duluth, GA), and Opti-Free Express with Aldox (Alcon Laboratories, Ft. Worth, TX) were the only lens care products that met the stand-alone criteria for all required microorganisms within their minimum recommended disinfection time. Of these, ReNu MultiPlus provided the greatest overall antimicrobial activity. ReNu MultiPlus demonstrated a significantly higher mean log reduction of Staphylococcus aureus and Serratia marcescens than Opti-Free Express. ReNu MultiPlus also gave a higher mean log reduction of S. aureus and S. marcescens than AOSEPT, and a higher mean log reduction of Candida albicans and Fusarium solani than AOSEPT, Complete Comfort Plus (Allergan, Irivine, CA), and Solo-Care (CIBA Vision Corp.) (at 4 hours). Both Complete Comfort Plus and Solo-Care (at 4 hours) met the primary acceptance criteria for bacteria; however, neither product possessed enough antimicrobial activity to meet the minimum criteria for yeast or mold. ReNu Multiplus was effective against corneal isolates of P. aeruginosa. CONCLUSION: ReNu MultiPlus, AOSEPT, and Opti-Free Express met the requirements of the stand-alone primary criteria for disinfecting solutions. ReNu MultiPlus demonstrated the greatest overall disinfection efficacy, as well as excellent activity against clinical strains of P. aeruginosa.

Anti-Bacterial Agents↗
PubMedDate not supplied

Effects of dentin disinfectants on the shear bond strength of all-ceramics to dentin.

This study investigated the effect of dentin disinfectants on the shear bond strength of all-ceramic restorations luted with two different dual-polymerizing systems to dentin. Dentin disinfectants chlorhexidine gluconate-based Concepsis and benzalkonium chloride-based Tubulicid Red were applied in combination with Variolink 2 and Resilute. The buccal surfaces of non-carious extracted human premolars were flattened to expose dentin and subsequently polished with 600-grit wet silicon carbide paper. Each dual-polymerizing luting system had two test groups and a control group. Dentin from the test groups was first treated with dentin disinfectants, then the all-ceramic restorations were luted with dual polymerizing systems. The dentin without disinfectant application and ceramic restoration was used as a control. After the all-ceramic samples were luted to all treated surfaces, the specimens were thermocycled and tested for shear bond strength until failure. Analysis of the fractured dentin surfaces was performed using Optical Microscope-Nikon ECLIPSE ME 600 (Nikon Co, Tokyo, Japan) at between 10x and 1000x magnifications and the images were analyzed with Image Analyzer LUCIA 4.21 (Nikon Co). The data were analyzed with one-way ANOVA and Duncan test at a significance level of p<0.05. Application of the two dentin disinfectants increased the shear bond strength of both the Variolink 2 and Resilute systems, but this increase was statistically significant only in Tubulicid Red treated specimens (p<0.05). Surface analysis showed that all the specimens showed the adhesive failure mode between the dentin and composite luting agent interface.

Acid Etching, Dental↗
PubMed1988

[The effectiveness of a skin disinfectant with a cation active additive].

Within the scope of studies on efficacy of skin disinfection an alcoholic preparation with a cation-active substance (Octeniderm) was tested by way of the quantitative cotton swab method. To study the remanent effectiveness the skin of the upper arm was contaminated with Staph. epidermidis (10(2), 10(3) and 10(6)/cm2 skin) a) 1 minute and b) 2 h after disinfection. Swabs of the contaminated skin areas were taken after 1 min, 10 min and 2 h. It was shown, that Octeniderm compared with 70% Isopropanol and with the preparation without the active substance lead to a significant higher reduction of the contamination flora. Recent studies showed, that alcoholic disinfection of skin areas with many sebaceous glands was as good as inefficacious. A first experiment with Octeniderm on the forehead brought a significant better effect than 70% Isopropanol, but too the mean log reduction factors (RF) amount only to 0.76 for the aerobic and 0.64 for the anaerobic bacteria (exposure time of the disinfectant: 10 min) respectively 0.75 (aerobe) and 0.95 (anaerobe) one hour after disinfection.

1-Propanol↗
PubMed1999

Iodine and disinfection: theoretical study on mode of action, efficiency, stability, and analytical aspects in the aqueous system.

Although they have been in use for nearly 170 years, the mode of action of iodine-based disinfectants is not yet clearly understood, as is manifested, for example, in diverging judgements about the relevance of the individual iodine species. Although studies based on calculated equilibrium concentrations in pure iodine solutions have already been done, there is a lack of knowledge about iodine solutions in the presence of additional iodide which would be of intrinsic importance for disinfection practice. Therefore, a re-calculation was undertaken considering variations of this parameter in the pH range 0-14. The presented calculations concern fresh iodine solutions not affected by disproportionation (iodate formation) and provide information about the equilibrium concentrations of the species I, I2, I3, I5-, I6(2-), HOI, O1-, HI2O-, IO2- and H2OI+. Additional iodide and the pH value have a very pronounced influence on the individual equilibrium concentrations (several powers of ten); hence, conditions can be indicated where the number of species of virtual importance is drastically reduced. In the most common case with iodine in the presence of additional iodide at pH < 6, only I-, I2 and I3- play a role. In the absence of additional iodide, at pH 8-9 and at high dilution (c(I2) < 10(-5) M), on the other hand, HOI accounts for over 90% of the oxidation capacity. At high iodide concentration (e.g., Lugol's solution) the species I5- and I6(2-) make up 8.2% of the oxidation capacity. The iodine cation H2OI+, frequently quoted as an active agent in disinfection, is without any relevance under the conditions occurring in practice, as are IO- and HI2O- which become important only at pH > 10. The stability problem (i.e. rate of iodate formation) arising at pH > 6 can be reduced to hypoiodous acid, as manifested in the simple rate law d[IO3]/dt = 0.25 [HOI]3/[H+] which allows an estimation of stability under weakly alkaline conditions. The results of this study allow us to deduce general qualities of aqueous iodine solutions, such as reactivity, stability, and analytical aspects, and to estimate major disinfection-orientated properties such as microbicidal activity, irritation, and incorporation effects. Though the calculations consider primarily preparations devoid of polymeric organic compounds capable of complexing iodine species, the results can be largely transferred to iodophoric preparations.

Disinfectants↗
PubMed1997

[Effectiveness of alcoholic hand disinfectants against methicillin resistant Staphylococcus aureus].

In order to determine the efficacy of hand disinfectants based on alcohol against three MRSA strains and 3 methicillin-susceptible S. aureus strains (MSSA), 1-propanol (60%) as well as Sterillium and Spitaderm were investigated in the quantitative suspension test at various dilutions and reactions times (15, 30 and 60s). All undiluted disinfectants revealed reduction factors > 6 against MRSA and MSSA after 30s. Diluted disinfectants (50%) were significantly less effective against MRSA at short reaction times (15 s) (p < 0.05). Sterillium in a dilution of 50% did not reach 5 reduction factors against either MRSA or MSSA after 30 s. The impact of an appropriate use of hand disinfectants in order to break chains of infections with MRSA is obvious.

1-Propanol↗
PubMed1990

Prevention of acquired immunodeficiency syndrome and hepatitis B. Part III: Disinfection of hydrophilic silicone rubber impression materials.

The effect of glutaraldehyde solution, an effective disinfectant for viruses, on the dimensional stability of hydrophilic silicone rubber impression materials was evaluated in this study. Disinfection with 2% glutaraldehyde solution showed a slight expanding effect on the dimensional stability of the hydrophilic silicone rubber impression materials (less than 0.03%). It was revealed that glutaraldehyde can be used for the disinfection of hydrophilic silicone rubber impression materials. Attention should be paid, however, to the conditions for investment or casting to eliminate the expanding effect of this disinfecting procedure.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Disinfection of dental stone casts: antimicrobial effects and physical property alterations.

OBJECTIVES: The purpose of this study was to evaluate the effectiveness of disinfecting solutions incorporated into dental stone casts against a standard and representative group of microorganisms and to note changes in the physical properties of the casts. METHODS: Irreversible hydrocolloid impressions were contaminated individually with Escherichia coli, Staphylococcus aureus, Enterobacter cloacae, Pseudomonas aeruginosa, Klebsiella pneumoniae, Actinobacter calcoaceticus, Bacillus subtilis, Mycobacterium phlei and Candida albicans. Four readily available disinfecting solutions (glutaraldehyde, povidone-iodine, chlorhexidine and sodium hypochlorite) were added to the die stone mix used to pour up the impressions. The set cast surfaces were swabbed at 1 h and 24 h, the samples plated on agar and incubated at 37 degrees C for 24 h and 3 d for M. phlei. Subsequently, colony forming units were counted. The physical properties assessed were setting time, setting expansion, compressive strength, detail reproduction and delayed expansion of the stone. RESULTS: Only glutaraldehyde and povidone-iodine killed all contaminating microorganisms within 1 h, while the 1:5 dilution of sodium hypochlorite solution was equally effective after 24 h. Two percent glutaraldehyde was the most effective disinfectant with the least adverse effects on the physical properties of the set cast. Although povidone-iodine caused a decrease in the compressive strength of the set cast, it can be considered to be a sound alternative. SIGNIFICANCE: This study supports the concept of incorporating disinfectants into model stone as a standard operating procedure for impressions of unknown history and, most sensibly, all dental impressions.

Analysis of Variance↗
PubMed1993

Assessment of chemical disinfectants against human immunodeficiency virus: overcoming the problem of cytotoxicity and the evaluation of selected actives.

The aim of this study was to develop a standardised technique for assessing the virucidal activity of commercial disinfectants against human immunodeficiency virus (HIV). In the absence of any model procedure for HIV a protocol based on German DVV guidelines was developed. A major difficulty associated with such studies is the cytotoxic effect of the biocide on the target cells used in infectivity assays. This problem is most commonly overcome by dilution of the virus-disinfectant mixture, however, this requires high titre (> or = 10(7) TCID50) virus which is difficult to achieve with HIV. We employed a simple washing technique which effectively removed cytotoxicity while retaining infectivity. Incorporated into a standard suspension test, this method supported by virus isolation procedures was sensitive and reproducible. The reliability of the procedure was confirmed by evaluating the efficacy of some commercially available cidals which were known to be cytotoxic; namely two instrument disinfectants, Sactimed-I-Steril, an aldehyde based product, Sactimed-I-Sinald a guanide/quaternary-ammonium combination, and Levermed, an alcohol based hand disinfectant.

Cell Line↗
PubMed1989

Hospital use of chlorine disinfectants in a hepatitis B endemic area--a prevalence survey in twenty hospitals.

A survey was conducted to assess the uses of chlorine disinfectants in twenty hospitals in Hong Kong. In the 149 areas visited, the charge nurses were interviewed on the use of chlorine disinfectants. A high proportion of uses (44%) were not at the recommended dilution and only 88 (57%) of the 154 samples were within +/- 10% of the manufacturers quoted chlorine content. Samples with inadequate chlorine were found among all six types of chlorine disinfectants, although sodium dichloroisocyanurate tablets conformed to the quoted strength on 88% occasions. Higher usage frequency and better dilution practices were noted for hospitals with a disinfectant policy.

Chlorine↗
PubMed1990

Rationalizing whole body disinfection.

As part of the preparation for a large prospective trial investigating the effect of preoperative whole body disinfection on the postoperative wound infection rate, this preliminary volunteer study was carried out to establish (a) the optimum number of preoperative washes required to achieve a maximum level of skin disinfection and (b) if showering or bathing is a more efficient method of skin disinfection. Ten healthy volunteers were recruited. The results show a significant decrease (p less than 0.005) in the skin flora after the first and second showers (a decrease of 93.55% and 77.49% respectively), but no further significant fall with subsequent showers. There was a significant fall (p less than 0.005) in skin flora after a single bath (a decrease of 70.98%) with subsequent baths producing no further significant reduction in skin flora. From these results it is recommended that three preoperative showers with 4% chlorhexidine detergent be used as an optimum preoperative whole body disinfection regimen. Three showers ensures against less thorough washing by the patients compared to the healthy volunteers in the study and fits easily into a preoperative regimen.

Adult↗
PubMedDate not supplied

An investigation of the bactericidal and fungicidal effects of certain disinfectants by use of a capacity test.

The bactericidal and fungicidal effects of five disinfectants and one combination of two disinfectants were tested using a modified Kelsey-Sykes method in which living microorganisms suspended in a sterilized yeast suspension ("dirty" conditions) and in sterile distilled water ("clean" conditions) were added to the disinfectants in three stages. Six bacteria and two fungal organisms were employed as test microbes. Results showed that formaldehyde was virtually inactive at the dilution tested (1/50), whereas phenol and the combination propylene-phenoxetol + benzalkonium chloride were moderately effective, the latter compound being better. Glutaraldehyde was manifestly the most effective of the disinfectants tested, followed by tricresol. At a 1/50 dilution, chloramine proved to have a surprisingly strong fungicidal effect on Candida albicans and Aspergillus fumigatus under "dirty" conditions, whereas the same fungal organisms proved rather resistant to chloramine under "clean" conditions. The same was demonstrated--though less markedly--when higher dilutions of chloramine were used. The search for an explanation is still in progress. At relatively high dilutions, chloramine also proved quite effective against most of the test bacteria, especially under "clean" conditions. It is recommended that the yeast suspension be replaced by normal horse serum 20% v/v when testing the efficacy of chloramine against fungal strains under "dirty" conditions.

Bacteria↗