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PubMedDate not supplied

Antiseptic technology: access, affordability, and acceptance.

Factors other than antimicrobial activity of soaps and antiseptic agents used for hand hygiene by health personnel play a role in compliance with recommendations. Hand hygiene products differ considerably in acceptance by hospital personnel. If switching from a nonmedicated soap to an antiseptic agent or increased use of an existing antiseptic agent for hand hygiene prevented a few more infections per year, additional expenditures for antiseptic agents would be offset by cost savings.

Anti-Infective Agents, Local↗
PubMed2002

Antiseptics for preventing omphalitis.

BACKGROUND: Omphalitis may cause serious complications and contribute to neonatal morbidity and mortality. From January 1997 to August 1998, the incidence of omphalitis in the Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital had been increased from 0.9 to 17.4 per 1,000 live births. A prospective randomized trial using antiseptic applied directly to the umbilical stump was conducted aiming to reduce an epidemic outbreak of omphalitis in the newborn nursery. OBJECTIVE: To determine which antiseptic is appropriate for preventing omphalitis in the newborn infants. PATIENTS AND METHOD: Newborn infants delivered in the Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital were randomized into group A (Triple dye) or group B (70% Alcohol). The infant with omphalitis was assessed by a pediatrician or a neonatology fellow. At home, the same antiseptic will be continually applied to the umbilical stump daily until a few days after cord detachment. Relative risk was calculated and statistical significance was tested by Chi-square test. RESULTS: Four hundred and twenty-seven infants were enrolled. Birth weight, gestational age and gender of the infants in both groups were not different. There were no known maternal risk factors for omphalitis. Omphalitis was observed in 9/213 (4.2%) infants in group A and 23/214 (10.7%) infants in group B. The relative incidence rate between each group was statistically significant (p<0.01). Triple dye group was 60 per cent less likely to develop omphalitis compared to 70 per cent Alcohol group (RR 0.39, 95% CI: 0.19-0.83). The mean duration for cord detachment were 13.6 and 11.5 days in group A and group B, respectively. CONCLUSION: During an epidemic outbreak of omphalitis, Triple dye was the most appropriate and effective antiseptic to prevent omphalitis but could delay cord separation.

Anti-Infective Agents, Local↗
PubMed2005

[Chlorhexidine: the ideal antiseptic].

This article is a extensive bibliographical review about the characteristics of chlorhexidine as a cutaneous antiseptic. This antiseptic belongs to the biguanides (metformin) group and is very active against a large number of micro-organisms. Its systemic absorption is practically null, thus, it lacks any systemic toxicity. As a cutaneous antiseptic it has a rapid, long-lasting effect and is not inactive in the presence of organic matter and, due to its transparency it does not hide the evolution of wounds. Due to these properties, its recommendations for use have grown and consolidated over time until it has converted into one of the most effective, active and safe antiseptics for daily clinical practice.

Anti-Infective Agents, Local↗
PubMed2005

Microbial contamination of antiseptics and disinfectants.

OBJECTIVE: To study the bacterial contamination of antiseptics and disinfections in-use and the risk factors for contamination. MATERIAL AND METHOD: Bacterial contamination of antiseptics and disinfectants was done by culturing in-use solutions. Eight commonly used solutions were studied: alcohol 70%, chlorhexidine 4%, and 0.5%, povidone iodine 7.5% and 10%, tincture iodine 1-2%, lysol 2% and sodium hypochlorite 0.5%. RESULTS: The following risk factors for contamination were found : preparation by unskilled personnel, improper containers and prolonged use. Contamination with bacteria were found in 1.8% of 16,142 samples tested Highest rate of contamination was found in Lysol 2%. There was no contamination of povidone iodine 10% and tincture iodine 1-2%. Bacterial contamination of antiseptics and disinfectants was highest in provincial hospitals and was not found in university hospitals. The rates of contamination correlated with the duration of use. Most bacteria isolated were those found in the environment. CONCLUSION: The contamination of in-use antiseptics and disinfectants was as high as 1.8%. Risk factors for contamination were improper preparation and prolonged use.

Anti-Infective Agents, Local↗
PubMed1991

[Resistance of 700 gram-negative bacterial strains to antiseptics and antibiotics].

The sensitivity of 701 Gram negative strains, representing 16 species or bacterial genera, towards 4 antiseptics (cetrimide, chlorhexidine, hexachlorophene, mercuric chloride) and 6 antibiotics (ampicillin, streptomycin, erythromycin, chloramphenicol, kanamycin, tetracycline) was analysed. For 3 antiseptics (cetrimide, chlorhexidine, mercuric chloride) minimal inhibitory concentration distribution showed strains to be heterogeneous, particularly in the group Pseudomonas. Most strains were resistant to antibiotics. The statistical analysis of correlation showed positive resistance links between antiseptics (cetrimide, chlorhexidine, hexachlorophene) or between these antiseptics and antibiotics for S marcescens and Alcaligenes. Many strains proved resistant, at the same time, to mercuric chloride and to several antibiotics. These associations of resistance suggest either a common mechanism of action or a crossed resistance.

Anti-Bacterial Agents↗
PubMedDate not supplied

[The influence of antiseptic solutions used against AIDS on dental waxes, shellac bases, impression compound and zinc-oxide eugenol paste].

The influence of four antiseptic solutions on some dental materials was examined in this study. The antiseptic solutions were sodium chloride 10%, alcohol 75%, Cidex and Sterile pack fluid, whereas the dental materials were dental modelling wax, impression compound, shellac base plate and zinc-oxide eugenol paste. The change of weight and the change of length which were observed in 40 minutes were measured. According to our results the modelling waxes, as well as the impression paste are not influenced by the antiseptic solutions. The impression compound must not be sterilised in Sterile pack fluid, which dissolves it, but it can be floated in the rest of the solutions. The shellac base plates are influenced by all the antiseptic solutions studied, especially by alcohol 75% and Sterile pack fluid.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Sclerosing encapsulating peritonitis in rats induced by long-term intraperitoneal administration of antiseptics.

Continuous ambulatory peritoneal dialysis (CAPD) is an effective long-term treatment for renal failure. Sclerosing encapsulating peritonitis (SEP) is a rare but devastating complication of CAPD and may be caused by long-term peritoneal antiseptic exposure. We examined the peritoneal injury resulting from daily inoculations of moderately high concentrations of the following antiseptics: povidone-iodine, Dakin's solution, Amuchina, and Ampercide. After 4, 8, and 12 weeks of daily intraperitoneal injections in rats, a 10% solution of povidone-iodine in dialysis fluid caused a condition that mirrors human SEP. Animals had poor early weight gain, and gross necropsy examination revealed intestinal adhesions and a mesothelium that was sclerotically thickened. From 4 to 8 weeks the 10% povidone-iodine-injected animals showed progressive conditions and the prevalence of multiple encapsulating adhesions increased from 0/6 to 4/4, p = 0.005. Marked visceral mesothelial thickening in the 10% povidone-iodine-injected animals was quantitated after 4, 8, and 12 weeks at 92.0 +/- 11.6, 151.5 +/- 28.8, and 206.0 +/- 36.2 micron, respectively. Rats injected with dialysis fluid (controls) had normal-appearing mesothelial surfaces measured at 1.8 +/- 0.2, 2.4 +/- 0.2, and 2.2 +/- 0.2 micron after 4, 8, and 12 weeks, respectively. The marked thickening of the mesothelium in the 10% povidone-iodine group compared with the controls was highly significant, p less than 10(-8). We conclude that povidone-iodine, the most commonly used antiseptic in CAPD, caused severe tissue injury, whereas other antiseptic solutions, Dakin's, Amuchina, and Ampercide, at the similar dilution did not appear to cause mesothelial injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

[Activity of an antiseptic against mycobacteria].

Since the publication of Afnor standards for the determination of bactericidal activity we have studied different antiseptics. Most were inactive on the test strains of Mycobacteria, M. smegmatis. We investigated one antiseptic that did exhibit bactericidal activity against M. smegmatis to find out whether this product's spectrum included other mycobacteria such as those responsible for skin diseases (M. marinum, M. ulcerans, M. chelonei and M. fortuitum). We used the dilution-neutralization method (NF T 72-150) according to all the Afnor requisites, changing only the strains (5 mycobacterial strains recently recovered from clinical specimens), culture conditions, and, for some studies, temperature (21 degrees C and 32 degrees C) and time of contact (5 and 30 minutes). Under Afnor standard conditions (5 mn at 21 degrees C), the tested antiseptic in a concentration of 90% was bactericidal only for M. smegmatis. For the other strains, inhibition was limited (M. fortuitum) or nearly non-existent (M. chelonei). Another series of tests at 32 degrees C showed bactericidal activity (5 log reduction) in 5 minutes for all strains including M. marinum. Despite the fact that these results are of limited practical usefulness, they show 1) that trials under strict conditions can be carried out with all Mycobacteria (including slow growing species), and 2) that broad spectrum bactericidal antiseptics are available.

Anti-Infective Agents, Local↗
PubMed1979

[On the contamination of the citric acid fermentation. II. Sodium 5-nitrofurylacrylate as an antiseptic against representatives of the Enterobacteriaceae (author's transl)].

In context with the first communication which deals with the characterization of the so-called brown contamination called forth by Enterobacteriaceae in the citric acid fermentation of molasses, the present paper describes the screening of antiseptic substances able to suppress the contamination mentioned without damaging the normal growth of the producing mould Aspergillus niger and its ability of producing citric acid. Among the substances tested the sodium salt of 5-nitrofurylacrylic acid (5-NFA) excelled partly because of its antiseptic effect in relatively small concentrations and partly because the mould tolerates appreciable amounts of this antiseptic. Therefore there may be applied, in the presence of a heavy contamination, relatively high concentrations of the antiseptic without fear of damaging the producing mould. Usually a dose of 10 to 15 mg 5-NFA in 11 of medium was sufficient to suppress the brown contamination.

Acrylates↗
PubMed1984

[Determination of the virucidal activity of antiseptics by a gel filtration method].

The authors propose a method for determining the virucidal potency of antiseptics, in which separation of antiseptic from virus is achieved by filtration through a gel of Sephadex LH20. The antiseptic is trapped within the gel while the virus passes through. Thus, the cytotoxic effect of the antiseptic, which usually hinders virus titration, is eliminated. Two filtration devices were developed: one is a polypropylene syringe, and the other is made of stainless steel. Determination of the effect of four products on poliovirus type I shows that this method allows classification of their activities.

Anti-Infective Agents, Local↗
PubMed1980

Definition, prophylactic value and toxic hazard in the use of antiseptics.

Antiseptics are mainly microbiostatic, relatively insoluble compounds, with little ability to penetrate into the skin or the mucous membranes. They can be used prophylactically or therapeutically on various areas of the body surface (skin and the mucous membranes, e.g., of mouth, intestinal-, respiratory-, and urogenital tract). If used in this way, they do not generally cause toxic effects, though sensitization to safe antiseptics may occur. The use of chemotherapeutic agents as antiseptics should be avoided wherever possible, because of the risk of emergence of resistant bacteria; but it would be clearly indicated if this were the only way to save a patient's life. Resistance to antiseptics is less likely to emerge than to antibiotics.

Anti-Infective Agents, Local↗
PubMed1994

[Evaluation of the cytotoxicity of antiseptics used in current practice on cultures of fibroblasts and keratinocytes].

Infection is the greatest problem in burn patients and topical antiseptics must be chosen with great care especially when cultured skin is grafted. We examined the cytotoxicity of 6 antiseptics commonly used on cultured human fibroblasts and keratinocytes. Cultured cells were exposed for 15 min to Hibitane (chlorhexidine), Biseptine (chlorhexidine + benzalkonium chloride + benzylic alcool), dermic Betadine (polvidone iodine + nonoxinol), scrub Betadine (polyvidone iodine + quaternary ammonium) and gynecologic Betadine (polyvidone iodine). The cell viability was determined using the MTT test. At therapeutic concentration all the antiseptics were cytotoxic for fibroblasts and keratinocytes. The data suggest that the antiseptics must be used in function of the time of the grafting of the cultured epithelium.

Benzalkonium Compounds↗
PubMed1994

[Relationship between the level of minimal inhibitory concentrations of five antiseptics and the presence of qacA gene in Staphylococcus aureus].

The Polymerase Chain Reaction (PCR) was used to detect the qacA gene which encodes antiseptic resistance in 186 clinical isolates of Staphylococcus aureus. The results were compared with those obtained by MIC determination of 4 antiseptics (benzalkonium chloride, hexamidine, chlorhexidine, acriflavine) and for ethidium bromide. The qacA gene was not detected among the 32 susceptible S. aureus strains, but was found in the 70 (85%) of the 82 S. aureus strains resistant to all 5 antiseptics. The gene was also detected in 70 (45%) of the 154 remaining strains that were resistant to at least one antiseptic.

Acriflavine↗
PubMed1976

[Estimation of the activity of an antiseptic agent on skin microbial flora under various conditions].

The bacterial flora of the skin of the fore-arm was studied in fifteen normal subjects by a modified Williamson and Kligman technique. The quantitative results were in agreement with those found in other laboratories which indicates the reproducibility of the method. The action of an antiseptic containing 0.5 p. cent of benzalkonium chloride was studied under three conditions or single application of the antiseptic for five consecutive days and for 24 hours after the application of an occlusive dressing. The bacterial flora of the skin showed marked quantitative variations from one subject to another and, in the same subject, from one time to another. Evaluation of the activity of an antiseptic should take into consideration these physiological variations and also various conditions of use in practice. Are discussed also the factors leading to standardisation of the methods and the criteria of evaluation of the activity of antiseptics on the skin.

Bacteria↗
PubMed2000

Handwashing compliance by health care workers: The impact of introducing an accessible, alcohol-based hand antiseptic.

CONTEXT: Under routine hospital conditions handwashing compliance of health care workers including nurses, physicians, and others (eg, physical therapists and radiologic technicians) is unacceptably low. OBJECTIVES: To investigate the efficacy of an education/ feedback intervention and patient awareness program (cognitive approach) on handwashing compliance of health care workers; and to compare the acceptance of a new and increasingly accessible alcohol-based waterless hand disinfectant (technical approach) with the standard sink/soap combination. DESIGN: A 6-month, prospective, observational study. SETTING: One medical intensive care unit (ICU), 1 cardiac surgery ICU, and 1 general medical ward located in a 728-bed, tertiary care, teaching facility. PARTICIPANTS: Medical caregivers in each of the above settings. INTERVENTIONS: Implementation of an education/ feedback intervention program (6 in-service sessions per each ICU) and patient awareness program, followed by a new, increasingly accessible, alcohol-based, waterless hand antiseptic agent, initially available at a ratio of 1 dispenser for every 4 patients and subsequently 1 for each patient. MAIN OUTCOME MEASURE: Direct observation of hand-washing for 1575 potential opportunities monitored over 120 hours randomized for both time of day and bed locations. RESULTS: Baseline handwashing compliance before and after defined events was 9% and 22% for health care workers in the medical ICU and 3% and 13% for health care workers in the cardiac surgery ICU, respectively. After the education/feedback intervention program, handwashing compliance changed little (medical ICU, 14% [before] and 25% [after]; cardiac surgery ICU, 6% [before] and 13% [after]). Observations after introduction of the new, increasingly accessible, alcohol-based, waterless hand antiseptic revealed significantly higher handwashing rates (P<.05), and handwashing compliance improved as accessibility was enhanced-before 19% and after 41% with 1 dispenser per 4 beds; and before 23% and after 48% with 1 dispenser for each bed. CONCLUSIONS: Education/feedback intervention and patient awareness programs failed to improve handwashing compliance. However, introduction of easily accessible dispensers with an alcohol-based waterless handwashing antiseptic led to significantly higher handwashing rates among health care workers.

Adult↗
PubMed1976

Nosocomial pseudobacteremia. Positive blood cultures due to contaminated benzalkonium antiseptic.

Pseudomonas cepacia or Enterobacter species or both were isolated from blood cultures of 79 patients in a community hospital between April 1971 and March 1972. No common exposures other than venipuncture correlated with positive blood cultures. Pseudomonas cepacia, Enterobacter, and other Gram-negative enteric bacteria were cultured from aqueous benzalkonium chloride used for skin antisepsis prior to ordinary and blood culture venipuncture. Contamination of blood cultures by organisms from the antiseptic most likely accounted for positive cultures in 35 to 38 patients (92%) with P cepacia. The remaining three patients had repeated blood cultures positive for P cepacia and circumstantial clinical evidence of bacteremia; they may have contracted disease through exposure to the contaminated antiseptic. Substitution of an iodine-alcohol antiseptic abruptly reduced the isolation of P cepacia and Enterobacter.

Bacteria↗
PubMed1976

Inflammable antiseptics and theatre fires.

This paper describes an investigation designed to find out if theatre fires could be started by the antiseptic painted on the patient's skin being ignited by cautery or diathermy. It was found that hot wire cautery or diathermy generated enough heat to ignite all alcohol-based antiseptics even if these contained as little as 20 per cent alcohol. They could also cause iodine to explode in the presence of nitrous oxide, and nobecutane to explode in the presence of nitrous oxide or increased oxygen. The likelihood of these combinations causing fires is discussed, and it is recommended that when diathermy or cautery is to be used near the surface of the body, either an aqueous-based antiseptic is used or if spirit solutions are required they are carefully dried off before proceeding.

Anti-Infective Agents, Local↗
PubMed1984

Intraperitoneal antiseptics in experimental bacterial peritonitis.

A model of bacterial peritonitis, using mice infected with Escherichia coli, has been used to assess the protective effects of intraperitoneal treatment with antiseptics. Of the five antiseptics tested, only chlorhexidine gluconate had any protective effect, concentrations of 0.05 and 0.02 per cent reducing the mortality to 14 and 50 per cent respectively. The other antiseptics, taurolin, noxytiolin, povidone iodine and hypochlorite were all ineffective. Delayed treatment with chlorhexidine was not as effective as instillation immediately postinfection.

Animals↗