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Interaction of Bacillus subtilis spores with sodium hypochlorite, sodium dichloroisocyanurate and chloramine-T.

Solutions of chlorine-releasing agents (CRAs) show varying activity against Bacillus subtilis spores; sodium hypochlorite (NaOCl) shows higher activity than sodium dichloroisocyanurate (NaDCC) which is more active than chloramine-T. Investigations with coat- and cortex-extracted spores indicate that resistance to CRAs depends not only on the spore coat but also the cortex. Whereas extraction of alkali-soluble coat protein increased sensitivity to NaOCl and NaDCC, degradation of coat and cortex material was required to achieve significant activity with chloramine-T. NaOCl (in the presence and absence of NaOH) and NaDCC (in the presence of NaOH only) produced degradation of spore coat and cortex material which may be related to their rapid sporicidal action at low concentrations under these conditions. By contrast, chloramine-T produced no degradation of cortex peptidoglycan and was only effective against normal and alkali-treated spores at high concentrations, requiring extraction of peptidoglycan with urea/dithiothreitol/sodium lauryl sulphate (UDS) or UDS/lysozyme to achieve significant activity at low concentrations. Results suggest that the sporicidal action of CRAs is associated with spore coat and cortex degradation causing rehydration of the protoplast allowing diffusion to the site of action on the underlying protoplast.

Bacillus subtilis↗

Response of the human eye to accidental exposure to sodium hypochlorite.

Sodium hypochlorite is used in endodontic therapy as an intracanal irrigant during hand, mechanical, and ultrasonic instrumentation of the root canal space. Regardless of the technique utilized, particular attention must be given to the appropriate and safe use of this chemical solution. A case is presented in which a 5.25% sodium hypochlorite solution was accidentally splashed in a patient's eyes during endodontic therapy. Ocular irrigation was performed immediately and continued for 10 min. The patient was promptly taken to an ophthalmologist for further treatment and follow-up. When chemical trauma of the eye by sodium hypochlorite solution is sustained, the entire surface of the affected eye(s) and the fornices must be thoroughly irrigated. This is best accomplished with a continuous stream of normal saline from a 1-I bag which is attached to an intravenous line with a 16-gauge Teflon catheter placement sleeve affixed to the distal end of the line. Arrangements must then be made for immediate evaluation, treatment, and consultation by an ophthalmologist.

Adolescent↗

[Detoxication and disinfection by sodium hypochlorite].

Sodium hypochlorite electrochemically derived from aqueous sodium chloride solutions is the most convenient and physiological source of active oxygen. It is not toxic, easily excreted, has low molecular weight, small sizes, which allows it to readily penetrate through the cellular membranes and hence can oxidize toxins that are present not only in blood, but also in tissues, which is of great clinical practical value. The high reactivity and nonspecificity of sodium hypochlorite open ample scope for its wide medical applications.

Animals↗

Hypersensitivity to sodium hypochlorite.

Sodium hypochlorite (NaOCl), the most commonly used irrigant in endodontics, is known to produce allergic reactions. This fact, however, is rarely mentioned in endodontic texts. Until now, only two cases of adverse reaction describing accidental injection of NaOCl have been reported. In the current study a case is presented in which hypersensitivity to household bleach was proven with skin patch tests. The clinician was warned of the possible health hazard from using NaOCl in this patient by the past medical history. Endodontic therapy was carried out with an irrigant not containing NaOCl after the allergy to NaOCl was verified. Treatment was uneventful. It is suggested that before any endodontic treatment in which sodium hypochlorite is to be used, the patient should be asked about hypersensitivity to household bleaching materials.

Adolescent↗

Comparison of sodium hypochlorite and sodium dichloroisocyanurate disinfectants: neutralization by serum.

A comparison has been made of the activity against Pseudomonas aeruginosa of sodium hypochlorite (NaOCl) and sodium dichloroisocyanurate (NaDCC) solutions containing 0-40% and 0-70% horse serum respectively. The degree of inactivation of NaOCl and of NaDCC solutions by different concentrations of horse serum is expressed in terms of a neutralization coefficient, which demonstrates that NaDCC solutions are less prone to inactivation by serum than are NaOCl solutions, the disparity diverging as serum concentration is increased. In 30% serum an NaDCC solution containing 4000 ppm of available chlorine exhibited similar bactericidal activity to an NaOCl solution containing 17,000 ppm available chlorine.

Blood↗

A comparison of sodium hypochlorite and sodium dichloroisocyanurate products.

A comparison of commercial sodium hypochlorite (NaOCl) and sodium dichloroisocyanurate (NaDCC) products was made. Solutions of NaOCl and NaDCC containing the same levels of available chlorine (av.Cl) exhibited very similar bactericidal activities, despite significant differences in pH. A level of 12.5 ppm av. Cl achieved a greater than 5 log 10 reduction of Staphylococcus aureus in 2 min. A level of 5 ppm av.Cl achieved a greater than 5 log 10 reduction of Pseudomonas aeruginosa in 2 min whilst approximately 100 ppm av.Cl achieved the same reduction in the presence of 1% horse serum, and approximately 200 ppm av.Cl in the presence of 2% horse serum, indicating inactivation levels of around 95 and 97.5% respectively. Tablets of NaDCC were stable but solutions were unstable and decomposed much faster than NaOCl solutions of the same strength. Batch-to-batch variability of different NaOCl and NaDCC products was investigated; whilst NaDCC products always contained the minimum level of av.Cl specified, concentrated NaOCl products sometimes did not due to inherent instability.

Disinfectants↗

Bactericidal and cytotoxic effects of sodium hypochlorite and sodium dichloroisocyanurate solutions in vitro.

The antimicrobial and cytotoxic effects of sodium hypochlorite (NaOCl) and sodium dichloroisocyanurate (NaDCC) were evaluated and compared in vitro. The minimal inhibitory concentration and minimal bactericidal concentration of NaOCl and NaDCC were tested for Streptococcus sobrinus, Streptococcus salivarius, Enterococcus faecalis, and Streptococcus mutans. The cytotoxic effect was assessed by using human fibroblast tissue culture. Survival rate was assessed by a protein determination method. Results showed that the minimal inhibitory concentration and minimal bactericidal concentration values of NaOCl and NaDCC for the tested bacteria were in a similar range. NaDCC in concentrations higher than 0.02%, and NaOCl in concentrations higher than 0.01% were lethal to fibroblasts. In conclusion it seems that both agents were very effective in killing bacteria, and their cytotoxicity to fibroblasts in tissue culture was similar.

Anti-Infective Agents, Local↗

Long-term in vivo carcinogenicity tests of potassium bromate, sodium hypochlorite, and sodium chlorite conducted in Japan.

Long-term in vivo carcinogenicity tests of potassium bromate (KBrO3), sodium hypochlorite (NaClO), and sodium chlorite (NaClO2) have been conducted in Japan from 1977 to 1985. In these investigations, groups of approximately 50 male and 50 female F344 rats or B6C3F1 mice were given solutions of the compounds as their drinking water ad libitum at two dose levels determined on the basis of preliminary 13-week tests. Control animals were given distilled water. The carcinogenic potential of KBrO3 was tested by administering doses of 500 or 250 ppm to rats for 110 weeks. Significantly elevated incidences of renal cell tumors in males and females and mesotheliomas of the peritoneum in males as compared to controls were observed. When female mice were given KBrO3 at doses of 1000 or 500 ppm for 78 weeks, no significant differences in tumor incidences between experimental and control groups were apparent. NaClO was administered to male and female rats, respectively, at doses of 1000 or 500 ppm and 2000 or 1000 ppm for 104 weeks. In mice, NaClO was given at doses of 1000 or 500 ppm to either sex for 103 weeks. The incidences of tumors in NaClO-treated and control animals of both sexes were not significantly different in both rat and mouse studies. NaClO2 was given to rats of both sexes at a dose of 600 or 300 ppm for 85 weeks. No statistically significant differences were observed in the incidences of tumor formation between NaClO2-treated and control groups of both sexes. NaClO2 was administered to mice at a concentration of 500 or 250 ppm for 85 weeks. In males, the combined incidences of hyperplastic nodules and hepatocellular carcinomas of the liver in a low-dose group, and adenomas and adenocarcinomas of the lung in a high-dose group, were marginally increased compared to controls (p less than 0.05). However, these incidences in treated males were within the range of values of historical control data in our program. We concluded that KBrO3 was carcinogenic in rats of both sexes. NaClO was not carcinogenic in either rats and or mice under the conditions of the present studies. Although NaClO2 was shown to be noncarcinogenic in rats, the results for mice were evaluated as inconclusive. Also the results of two-stage mouse skin carcinogenesis using KBrO3, NaClO, and NaClO2 are presented. The necessity for further testing of oxidant chemicals to determine potential carcinogenic and/or promoting effects is suggested in view of the recently proposed role of active oxygen species in carcinogenesis.

Animals↗

Quantitative suspension test for the evaluation of disinfectants for swimming pool water: experiences with sodium hypochlorite and sodium dichloroisocyanurate.

To evaluate products intended for disinfection of water in swimming pools a quantitative suspension test was designed based on the principle of the Dutch standard suspension test (SST). As artifical swimming pool water a buffered bovine albumin solution (BBAS) was used. The microbicidal potency of BBAS chlorinated with sodium hypochlorite (NaOC1) for 5 min to free chlorine concentractions of 0.3, 0.5 and 1 mg/1 appeared to meet the tentative standard of 4 decimals reduction (D.R.) within 5 min against the bacterial test strains used, e.g. Staph, aureus, Str. faecalis, P. aeruginosa, E. coli and Prot. mirabilis. Usually an exposure time of 30 s was sufficient to obtain this reduction. The kill C. albicans to that extent approx. 1 mg/1 free chlorine was needed. The redox potential of BBAS chlorinated as described above amounted to approx. 600 mV or higher values. When BBAS was chlorinated for 5 min with sodium dichloroisocyanurate (NaDCC) addition of 8 mg/1 of this substance was required to obtain about the same microbicidal potency as that of BBAS chlorinated with NaOC1 to 0.3 mg/1 free chlorine. The redox potential in the former solution was found to be above 600 mV. The microbicidal potency of BBAS chlorinated for 5 minutes with 2 mg/1 NaDCC was virtually zero and with 4 mg/1 NaDCC suboptimal. These findings correlated well with the redox potentials of 262 mV and 432 mV, respectively, measured in the latter solutions. Addition of cyanuric acid to BBAS before chlorination resulted in lower killing rates, although the free chlorine concentration, determined with the FAS-DPD method, seemed to be increased. It is concluded that in swimming pool water chlorinated with chloroisocyanurates the redox potential might be a better indicator for the microbicidal potency than the free chlorine concentration determined with the FAS-DPD method.

Albumins↗

The antibacterial properties of sodium hypochlorite and sodium dichloroisocyanurate as hospital disinfectants.

The antibacterial activity of unbuffered sodium dichloroisocyanurate (NaDCC) (pH 6.6) and of sodium hypochlorite (NaOCl) buffered to pH 7.2, 9.0 and 10.6 was compared. Under clean conditions, solutions of NaDCC at pH 6.6 or NaOCl at pH 7.2 and 9.0 with 100-200 mg l-1 available chlorine showed satisfactory disinfectant activity against vegetative bacteria. Sporicidal action required higher concentrations of both agents, and NaOCl at pH 7.2 showed most activity. In the presence of organic matter NaDCC offers significant advantages over NaOCl, a 3000 mg l-1 solution of NaDCC giving satisfactory activity in the presence of plasma concentrations up to 20% v/v compared with NaOCl solutions at pH 7.2, 9.0 and 10.6 which were inactivated at chlorine concentrations up to 5000 mg l-1. Although NaOCl pH 10.6 showed satisfactory disinfectant activity under clean conditions, our results indicate that formulations at this pH should not be used where sporicidal action is required or where substantial organic soiling is anticipated.

Bacillus subtilis↗

Effects of sodium hypochlorite gel and sodium hypochlorite solution on dentin bond strength.

The aim of this study was to determine the effect of 10% NaOCl gel and 10% NaOCl solution on dentin bond strengths of four adhesive systems. One hundred eighty bovine incisors were ground to achieve a flat polished surface, then divided into 12 groups: Gluma One Bond [G1-control; G2-NaOCl solution; G3-NaOCl gel]; Prime & Bond 2.1 [G4-control; G5-NaOCl solution; G6-NaOCl gel]; Single Bond [G7-control; G8-NaOCl solution; G9-NaOCl gel]; Prime & Bond NT [G10-control; G11-NaOCl solution; G12-NaOCl gel]. Dentin was etched, rinsed, and blot dried. For the experimental groups, after acid etching, 10% NaOCl solution or 10% NaOCl gel was applied for 60 s, rinsed, and blot dried. Composite resin was inserted and light cured. Shear bond strengths were tested with a crosshead speed of 0.5 mm/min. The mean values MPa (SD) were analyzed with two-way ANOVA and Tukey's tests (alpha < 0.01). Ten percent NaOCl solution significantly increased Gluma One Bond strength. No effect was observed for the other adhesives. The 10% NaOCl gel did not affect bond strengths. Ten percent NaOCl gel was less effective on collagen removal as compared to 10% NaOCl solution. The influence of collagen removal on bond strength is dependent on adhesive system, where both the solvent and the monomer can influence the results.

Adhesives↗

Immunological and biophysical alteration of hepatitis B virus antigens by sodium hypochlorite disinfection.

Sodium hypochlorite (NaOCl) was examined as an effective disinfectant in hepatitis laboratories. Concentrations of NaOCl containing 5,600 ppm (5,600 microgram/ml) of available chlorine were found to be effective in destroying the antigenicity of hepatitis B surface antigen (HBsAg) in virion-rich plasma after an exposure time of 1 min or more. In the treatment of protein-deficient solutions containing HBsAg, smaller concentrations of available chlorine (less than 500 pm) are equally effective. Neither 17-to 25-nm HBsAg particles nor 45-nm virion particles could be detected by electron microscopy after treatment. chemical interaction of protein and NaOCl was confirmed by isoelectrofocusing of 125I-labeled HBsAg. More than 90% of the labeled material was found at pH 3.0 or lower, indicating complete antigen oxidation. Labeled HBsAg was reduced in density from 1.21 g/cm3 in CsCl to approximately 1.07 g/cm3 after treatment with NaOCl. Both hepatitis B core antigen and deoxyribonucleic acid polymerase activity were significantly reduced after interaction with hypochlorite solutions. These results show that NaOCl destroys hepatitis B antigenicity and virus structures and therefore may be utilized as a disinfectant for the virus.

Centrifugation, Density Gradient↗

Destruction of the S antigen by sodium hypochlorite.

Low concentrations of sodium hypochlorite (chlorine bleach) destroyed S antigen on intact fresh red cells (RBCs). At levels of 0.0005 percent sodium hypochlorite in a 3 percent RBC suspension, S+s+ cells immediately became nonreactive with anti-S. S+s- cells required approximately 1.5 times this level of sodium hypochlorite to destroy S antigen reactivity. Anti-S absorbed three times with treated S+RBCs demonstrated no significant reduction in titer. In addition to its effect on S, the Rh antigens D, C, E, and e appeared slightly reduced in strength after treatment with sodium hypochlorite. However, the c antigen, as well as 20 other red cell antigens tested, appeared unaffected. Osmolality and pH determinations of supernatants from treated and untreated RBCs showed no significant differences. The proposed mechanism of S antigen destruction is an oxidation of the methionine residue in the S determinant. When sodium hypochlorite is used as a disinfectant, it should be rinsed thoroughly from all surfaces that might contaminate solutions that contact test RBCs. The destruction of the S antigen by sodium hypochlorite may be useful in testing complex antibody mixtures when a limited cell selection is available.

Epitopes↗

Immersion disinfection of irreversible hydrocolloid impression in pH-adjusted sodium hypochlorite. Part 1: Microbiology.

Sodium hypochlorite is one of the disinfectants recommended for impressions, usually in a 1:10 dilution to minimize the negative effects on the impression material and poured gypsum cast. Dilution causes a loss of antimicrobial properties, however. Sodium hypochlorite is known to have enhanced antimicrobial properties at lower pH levels. This study evaluated the antimicrobial activity of sodium hypochlorite at progressively lower pH levels. A metal model of a dental arch was contaminated, and irreversible hydrocolloid impressions were made, cultured, disinfected (by immersion), and cultured again. Predisinfection and postdisinfection bacterial counts were compared. It was found that a 10-minute immersion in solutions reduced to pHs 7 to 11 consistently produced a 4-log (99.99%) or greater reduction in viable organisms. A pH of 10 was the only level that was consistently effective at decreased immersion times. It was effective in times of 3 minutes or greater.

Bacillus subtilis↗

Immersion disinfection of irreversible hydrocolloid impressions with sodium hypochlorite. Part I: Microbiology.

Current American Dental Association infection control guidelines recommend immersion disinfection of irreversible hydrocolloid impressions, and this study further defines the parameters for use of sodium hypochlorite. Sodium hypochlorite has been shown to be an effective disinfectant for impressions; however, it has not been fully evaluated for optimum immersion time and concentration. In this study, irreversible hydrocolloid impressions contaminated with different bacteria were immersed in varying concentrations of sodium hypochlorite for 1, 5, or 10 minutes. Dilute solutions of sodium hypochlorite (0.525% or 0.0525%) produced a 4-log10 (99.99%) reduction in colony-forming units of Staphylococcus aureus, Salmonella choleraesuis, or Pseudomonas aeruginosa after 1 to 5 minutes' immersion. Full-strength sodium hypochlorite (5.25%) required 5 minutes to produce a 4-log10 reduction of Bacillus subtilis. A 4-log10 reduction of Mycobacterium bovis was not obtained under any conditions examined.

Alginates↗