Efficacy of Wound Cleansers on Wound-Specific Organisms Using In Vitro and Ex Vivo Biofilm Models.

Biofilms are believed to be a source of chronic inflammation in non-healing wounds. PURPOSE: In this study, the pre-clinical anti-biofilm efficacy of several wound cleansers was examined using the Calgary minimum biofilm eradication concentration (MBEC) and ex vivo porcine dermal explant (PDE) models on Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), and Candida albicans biofilms. METHODS: A surfactant-based cleanser and antimicrobial-based cleansers containing ionic silver, hypochlorous acid (HOCl), sodium hypochlorite (NaOCl), and polyhexamethylene biguanide (PHMB) were tested on the MBEC model biofilms with a 10-minute application time. Select cleansers were then tested on the mature PDE biofilms with 10-minute applications followed by the application of cleanser-soaked gauze. The PDE model was further expanded to include single and daily applications of the cleansers to mimic daily and 72-hour dressing changes. RESULTS: In the MBEC model, PHMB- and HOCl-based cleansers reduced immature MRSA, C albicans, and P aeruginosa biofilm regrowth by > 3× when compared with silver, surfactant, and saline cleansers. The major differences could be elucidated in the PDE model in which, after daily application, 1 PHMB-based cleanser showed a statistically significant reduction (3-8 CFU/mL log reduction) in all mature biofilms tested, while a NaOCl-based cleanser showed significant reduction in 2 microorganisms (3-5 CFU/mL log reduction, P aeruginosa and MRSA).The other PHMB-based cleanser showed a statistically significant 3 log CFU/mL reduction in P aeruginosa. The remaining cleansers showed no statistically significant difference from the saline control. CONCLUSION: Results confirm that there are model-dependent differences in the outcomes of these studies, suggesting the importance of model selection for product screening. The results indicate that 1 PHMB-based cleanser was effective in reducing mature P aeruginosa, MRSA, and C albicans biofilms and that sustained antimicrobial presence was necessary to reduce or eliminate these mature biofilms.

Recomendaciones para la preparación de soluciones de desinfección, 15 de mayo del 2020 / Recommendations for the Preparation of Disinfectant Solutions, 11 May 2020 / Recomendações para a preparação de soluções de desinfecção, 11 de maio de 2020

Utilizar la concentración de hipoclorito de sodio disponible en el país que está indicada en la etiqueta del envase, para mezclar la concentración de solución de desinfectante según el uso destinado siguiendo las indicaciones de la tabla abajo. • Utilizar medidas de protección como guantes, mascarilla, protección de ojos y delantal para la mezcla de las soluciones. • Preparar las soluciones diariamente. Si no necesita un litro por día, hacer ajustes en las cantidades de la tabla de abajo. • Utilizar un envase exclusivo para las soluciones preparadas, y marcar (rotular) el envase con la concentración claramente. • No reutilice empaques de productos comestibles para preparar la solución desinfectante y así evitar envenenamientos. • Adicionar la cantidad de hipoclorito de sodio a la cantidad de agua según se indica en la tabla de abajo...

This technical note presents the basic recommendations for the preparation and dilution of sodium hypochlorite for domestic use to prepare disinfecting solutions for the sanitary and domestic sector, at concentrations of 0.05%, 0.1%, and 0.5% depending cleaning and prevention needs against COVID-19 and other infectious agents.

Usar a concentração de hipoclorito de sódio disponível no país, indicada no rótulo da embalagem, para misturar a concentração da solução desinfetante de acordo com o uso pretendido, seguindo as indicações da tabela abaixo. • Usar medidas de proteção, como luvas, máscara, proteção para os olhos e avental, para misturar as soluções. • Preparar as soluções diariamente. Se não for necessário um litro por dia, ajustar as quantidades da tabela abaixo. • Usar um recipiente exclusivo para as soluções preparadas e marcar (etiquetar) claramente nele a concentração. • Não reutilizar embalagens de produtos comestíveis para preparar a solução desinfetante, evitando assim envenenamentos acidentais. • Adicionar a quantidade de hipoclorito de sódio à quantidade de água indicada na tabela abaixo....

Irrigation endodontique à l'hypochlorite de sodium : Types de solutions et modalités de préparations dans 102 cabinets dentaires de la ville d'Abidjan (Côte d'Ivoire)

Introduction : L'hypochlorite de sodium (NaOCl) représente à ce jour le "gold standard" pour l'irrigation endodontique. L'objectif de cette étude était d'identifier les solutions de NaOCl utilisées comme irrigant canalaire et les modes de préparations dans les cabinets dentaires. Matériels et méthodes : Une étude prospective a été réalisée dans 102 cabinets. Par la suite, les teneurs en chlore actif (c.a.) des solutions de NaOCl ont été évaluées par titrage iodométrique. Les analyses statistiques ont été effectuées par le logiciel SPSS version 22 sous Windows (SPSS Inc., Chicago, IL, USA). Résultats : Les sources commerciales de solution de NaOCl étaient utilisées à 72,5% pour l'irrigation endodontique. Ces solutions étaient concentrées à 2,53% c.a. ou 3,80% c.a. selon l'emballage. Dans l'ensemble, les titrages iodométriques ont révélé des rétrogradations en c.a. des solutions mères. Les dilutions au 1/5ième étaient généralement réalisées, ce qui signifiait une concentration à 0,5% c.a. pour l'irrigation endodontique. Une solution de NaOCl stabilisée à 0,5% c.a. et disponible en officine était principalement utilisée dans les cabinets privés. Discussion : Les concentrations des solutions de NaOCl pour l'irrigation en endodontie se situe entre 0,5% et 6% d'après la littérature. Cependant un compromis semble être trouvé autour des valeurs situées entre 2,5% c.a. et 3% c.a. Dans ce cadre, les solutions de NaOCl issues du commerce dans cette étude peuvent être considérées comme prêtes à l'emploi. Il faut cependant tenir compte de leur instabilité qui suggère des préparations finales à teneur en c.a. inférieure à la minimale préconisée en endodontie (0,5% c.a.). Conclusion : cette étude montre l'intérêt de l'usage de solutions de NaOCl stabilisées et conçues spécifiquement pour l'irrigation endodontique. Ce sont elles qui sont considérées comme dispositif médical par les autorités sanitaires

Efeito das soluções irrigadoras sobre os instrumentos Irrisafe e XP Endo utilizados na irrigação final dos canais radiculares / Effect of irrigation solutions on the Irrisafe and XP Endo used in final irrigation two root canals

Introdução: O objetivo deste estudo foi avaliar a resistência à corrosão das pontas de irrigação ultrassônica passiva Irrisafe® (Satelec/Acteon Group, Bordeaux, França) e dos instrumentos endodônticos XP Endo® (FKG Dentaire, La Chaux-de-Fonds, Switzerland), nas soluções irrigadoras hipoclorito de sódio (NaClO) 5,25%, ácido etilenodiaminotetracético (EDTA) 17% e clorexidina (CLX) 2%. O comportamento de ligas metálicas de aço inoxidável e NiTi nestas soluções também foi avaliado. Metodologia: Trinta novas pontas Irrisafe® e trinta novos instrumentos XP Endo® foram submetidos a ensaios de imersão dinâmica nas soluções irrigadoras NaClO 5,25%, EDTA 17% e CLX 2%. Cada instrumento foi submetido a dois ensaios na mesma solução com durações de 5 e 15 minutos. Antes e após cada ensaio, todos os instrumentos foram observados por microscopia eletrônica de varredura (MEV) para análise da superfície. Curvas redox das soluções de NaClO 5,25%, EDTA 17% e CLX 2% e curvas de polarização anódica de ligas metálicas de aço inoxidável e NiTi nestas soluções foram obtidas. Resultados: Não houve sinais de corrosão em nenhuma das pontas Irrisafe® e dos instrumentos XP Endo® ensaiados, independentemente do tempo de ensaio e da solução de teste utilizada. Os ensaios de polarização anódica de ambas as ligas metálicas na solução de NaClO 5,25% mostraram baixos valores de corrente até o potencial de +500 mVECS. As curvas de polarização anódica nas soluções de EDTA 17% e CLX 2% mostraram um trajeto semelhante ao da curva redox da solução em ambas as ligas metálicas. Conclusão: Concluiu-se que as pontas ultrassônicas Irrisafe® e os instrumentos endodônticos XP Endo® não sofrem corrosão nas soluções de NaClO 5,25%, EDTA 17% e CLX 2%. As ligas metálicas de aço inoxidável podem sofrer corrosão em solução de NaClO 5,25%, mas não sofrem corrosão em soluções de EDTA 17% e CLX 2%. A liga metálica de NiTi não sofre corrosão nas soluções NaClO 5,25%, EDTA 17% e CLX 2%. (AU)

Introduction: The objective of this study was to evaluate the corrosion resistance of Irrisafe® (Satelec/Acteon Group, Bordeaux, França) passive ultrasonic irrigation tips and XP Endo® (FKG Dentaire, La Chaux-de-Fonds, Switzerland) endodontic instruments in 5,25% sodium hypochlorite (NaClO), 17% EDTA and 2% chlorhexidine (CLX) irrigating solutions. The behavior of stainless steel and NiTi alloys in these solutions was also evaluated. Methodology: Thirty new Irrisafe® tips and thirty new XP Endo® instruments were submitted to dynamic immersion tests in 5,25% NaClO, 17% EDTA and 2% CLX irrigating solutions. Each instrument was submitted to two tests using the same solution for 5 and 15 minutes. Before and after each test, the surface of all instruments was analyzed by scanning electron microscopy (SEM). Redox curves of 5,25% NaClO, 17% EDTA and 2% CLX solutions and anodic polarization curves of both metal alloys in these solutions were obtained. Results: Signs of corrosion were not observed in any of the Irrisafe® tips and XP Endo® instruments tested, regardless of test time and solution used. Anodic polarization tests of both metallic alloys in 5,25% NaClO solution showed low current values to +500 mVECS potential. Anodic polarization tests of both metallic alloys in 17% EDTA and 2% CLX showed a similar path to redox curve solutions for both metallic alloys. Conclusion: It was concluded that Irrisafe® tips and XP Endo® endodontic instruments were not corroded in 5,25% NaClO, 17% EDTA and 2% CLX irrigating solutions. The stainless steel alloy suffered corrosion in 5,25% NaClO solution, but not in 17% EDTA and 2% CLX . NiTi alloy did not suffer corrosion in 5.25% NaClO, 17% EDTA and 2% CLX irrigating solutions. (AU)

Gastro Enteritis in a military population deployed in West Africa in the UK Ebola response; was the observed lower disease burden due to handwashing?

BACKGROUND: Travellers' diarrhoea in military populations is reported ranging from 50 to 70 cases per thousand person months. The UK personnel deployed to the Ebola Outbreak in Sierra Leone during the Ebola outbreak adopted standard measures associated with disease prevention. As part of the infection control measures against transmission of Ebola, personnel also rinsed their hands frequently in 0.05% hypochlorite. This was felt to have reduced the incidence of travellers' diarrhoea in the population and an audit was carried out to test this hypothesis. METHODS: Routine data identified diarrhoea and vomiting cases. A questionnaire sought information on traveller's diarrhoea and hand hygiene in Sierra Leone and Afghanistan. RESULTS: The incidence of Gastro Intestinal Disease for the population ranged from 23.9 Per thousand personnel per month to 74.4 per thousand personnel per month (mean 55.1 cases per thousand personnel per month). This included 4 headline outbreaks which accounted for 156 of the total number of 243 cases in the period of the deployment. The mean daily number of hand washes in Sierra Leone as reported in a survey was 17.02 (SD 8.2) and for Afghanistan was 9.06 (6.88). The mean difference was 7.94 (t 0.64 p < 0.0001.) CONCLUSION: The gastro intestinal disease incidence appeared to be at the lower end of the range reported by other groups in an environment with, arguably, a greater risk of infection. Force health protection policies were similar between Sierra Leone and Afghanistan excepting the frequency with which hands were rinsed or washed. We recommend that hand washing stations are placed at every office and communal area and not just at the dining facility in order to minimise the incidence of travellers' diarrhoea on future operations.

An evaluation of the accuracy of labeling of percent sodium hypochlorite on various commercial and professional sources: is sodium hypochlorite from these sources equally suitable for endodontic irrigation?

INTRODUCTION: The shelf life of sodium hypochlorite (NaOCl) is limited, and a previous article showed that there can be a discrepancy between the expected concentration of free available chlorine (FAC) and the actual FAC concentration in NaOCl solutions intended for endodontic irrigation. The current study investigates the FAC content of domestic and professional NaOCls and evaluates the influences of dilution and storage on FAC concentration. METHODS: First, domestic and professional NaOCls not obtained from manufacturers were iodometrically titrated. Then, NaOCls were diluted with demineralized water or tap water and stored at 4°C or 18°C and analyzed at baseline and 2 and 22 weeks. Statistical analyses included paired samples, independent samples t tests and repeated multivariate analysis of variance. Correlations were calculated with the Pearson or Spearman rank correlation test. A P < .05 was considered significant. RESULTS: Label specifications of domestic NaOCl were very imprecise (ie, <5% NaOCl). Domestic NaOCl contained 1.8%-3.5% NaOCl (w/v). Professional NaOCl varied from 14.3% relative less FAC than specified on the label to 23.5% relative more FAC than specified. After 22 weeks, the relative average loss of FAC in all conditions was 5.4% FAC (P = .002). Dilution, diluents, or storage temperature had no effect on the decline of FAC caused by aging. CONCLUSIONS: There is a great variation in NaOCl concentrations, with domestic NaOCl being the least accurate. NaOCl can be stored up to 5 months. The FAC concentration of domestic NaOCl is unpredictable, and, therefore, it appears less suitable for clinical application as root canal irrigant.

Viability of commercially available bleach for water treatment in developing countries.

Treating household water with low-cost, widely available commercial bleach is recommended by some organizations to improve water quality and reduce disease in developing countries. I analyzed the chlorine concentration of 32 bleaches from 12 developing countries; the average error between advertised and measured concentration was 35% (range = -45%-100%; standard deviation = 40%). Because of disparities between advertised and actual concentration, the use of commercial bleach for water treatment in developing countries is not recommended without ongoing quality control testing.

Assessment of disinfectants cleaning against bacterial biofilm of house hold water tanks.

UNLABELLED: The purpose of this study was to compare the efficacy, in terms of bacterial biofilm penetration and killing, of some chemical disinfectants against E. coli and P. aeruginosa. This study was undertaken to examine the efficacy of some disinfectants including sodium hypochlorite, povidine and tryad detergent against E. coli biofilms and the efficacy of sodium hypochlorite and tryad detergents against P. aeruginosa. Two species biofilm of E. coli and P. aeruginosa were grown by flowing a dilute tryptic soy broth medium over an inclined cement, polyethylene, fiberglass and galvanized steel slides, 2.25 x 2.25 cm2 for 15 days. Biofilm formation was evaluated by scanning electron microscopy (SEM) and standard plate counts procedures through selective media for both E. coli and P. aeruginosa. In addition, some disinfectants were selected through disk diffusion susceptibility test. The disinfectants which gave higher zone of inhibitions, were applied to remove of E. coli and P. aeruginosa biofilms from cement, fiberglass, polyethylene and galvanized steel slide surfaces. Results showed that all disinfectants tested gave high inhibition of biofilm adhesion to tank surfaces with some being significant. CONCLUSION: polyethylene and galvanized steel are strongly recommended as alternative drinking house holds water tanks in Saudi Arabia. The choice of disinfectants or cleaning agents along with optimum concentrations and the time of action is very important when destroying microbes. It is also important that resistance of microbes to some disinfectants and cleaning agents is take into consideration when planning the cleaning process.

A scanning electron microscopic evaluation of different root canal irrigation regimens / Avaliação por microscopia eletrônica de varredura de diferentes regimes irrigantes no canal radicular

The purpose of this study was to assess the effectiveness of endodontic irrigants in removing the smear layer from instrumented root canal walls using Scanning Electron Microscopy (SEM). The endodontic irrigants used were: 1 percent sodium hypochlorite (NaOCl); 1 percent NaOCl mixed to 17 percent EDTAC; 2 percent chlorhexidine gel; and Ricinus communis gel. Photomicrographs of the middle and apical thirds were evaluated with the aid of the Fotoscore - v. 2.0 software. The results indicated that the mixture of sodium hypochlorite and EDTAC completely removed the smear layer from dentinal walls. The other endodontic irrigants were not as efficient in cleansing the root canals.

A proposta deste estudo foi avaliar, por meio de microscopia eletrônica de varredura (MEV), a efetividade dos irrigantes endodônticos na remoção da "smear layer" das paredes dos canais radiculares instrumentados. Os irrigantes endodônticos utilizados foram: solução de hipoclorito de sódio a 1 por cento; solução de hipoclorito de sódio a 1 por cento misturado ao EDTAC a 17 por cento, gel de clorexidina a 2 por cento e gel de Ricinus communis. Fotomicrografias dos terços médio e apical foram avaliadas com o auxílio do software Fotoscore - versão 2.0. Os resultados indicaram que a mistura da solução de hipoclorito de sódio e EDTAC removeu eficientemente a "smear layer" das paredes dentinárias. Os demais irrigantes endodônticos não foram tão eficientes na limpeza dos canais.

Contamination levels of in-use disinfectants in a teaching hospital in Lagos, Nigeria.

In-use testing of the disinfectants; Hibitane (5% w/v Chlorhexidinegluconate), Hibiscrub (4% w/v Chlorhexidinegluconate), Savlon (3% w/v Chlorhexidine/Cetrimide), hydrogen peroxide (6% w/v hydrogen peroxide with stabilizer) and a common household bleach Jik (3.5% w/v sodium hypochlorite), was carried out over a two-month period at a university teaching hospital in Nigeria. Contamination levels were high with 82 (63.1%) of the 130 in-use disinfectants contaminated. However, a few of the stock solutions remained sterile. One hundred and thirty-four isolates were obtained of which 120 (91%) were gram-negative with Pseudomonas species being the commonest, constituting 67.2% of all the isolates. Gram-positive organisms made up the remaining 12 (9.0%) isolates. All the Pseudomonas spp. were resistant to gentamicin, ceftazidime, nalidixic acid and perfloxacin. Contributory factors for the high contamination levels were dilution of disinfectants with tap water, inadequate care of stock solution bottles and long storage of the diluted disinfectants in the wards.

Comparative sensitivity of 13 species of pathogenic bacteria to seven chemical germicides.

BACKGROUND: The relative resistance of diverse human bacterial pathogens to commonly used germicidal agents has not been established. METHODS: We measured by titration the survival of thirteen different bacteria after exposure to glutaraldehyde, formaldehyde, hydrogen peroxide, peracetic acid, cupric ascorbate, sodium hypochlorite, or phenol. RESULTS: Our comparative experiments allowed classification of the organisms' survival into four groups: (a) Pseudomonas aeruginosa and Staphylococcus aureus showed the most resistance, (b) Clostridium perfringens, Salmonella typhimurium, Staphylococcus epidermidis, and Escherichia coli O157:H7 showed intermediate resistance, (c) Listeria monocytogenes, Shigella sonnei, and Vibrio parahaemolyticus survived some treatments with chemical agents only in the presence of protecting protein (serum albumin), and (d) Vibrio cholerae, Vibrio vulnificus, Bacillus cereus, and Yersinia enterocolitica did not survive any of the treatments applied. CONCLUSION: We found species that more frequently survived exposure to germicidal agents were also those most commonly reported in association with hospital infections. Our findings suggest that resistance to disinfectants may be more important than pathogenicity in determining the relative prominence of an organism as an agent responsible for nosocomial infections.

Chemical degradation of wastes of antineoplastic agents. 2: Six anthracyclines: idarubicin, doxorubicin, epirubicin, pirarubicin, aclarubicin, and daunorubicin.

OBJECT: Handling of genotoxic compounds commonly used in cancer chemotherapy generates contaminated wastes that require decontamination before disposal. Chemical methods are an alternative and/or a complement to incineration for the treatment of wastes and spills. METHODS: As part of a program initiated by the International Agency for Research on Cancer (IARC), 3 chemical methods readily available in the hospital environment--sodium hypochlorite (NaOCl, 5.25%), hydrogen peroxide (H2O2, < or = 30%) and Fenton reagent (FeCl2, 2H2O; 0.3 g in 10 ml H2O2, 30%)--are being tested for the degradation of a total of 32 antineoplastic agents. The efficiency of degradation was monitored by high-pressure liquid chromatography. The mutagenicity of the degradation residues were tested by the Ames test using tester strains Salmonella typhimurium TA 97a, TA 98, TA 100, and TA 102 with and without an exogenous metabolic activation system. RESULTS: The first results obtained for the degradation of cyclophosphamide, ifosfamide, and melphalan have been published in this journal. The present manuscript reports the results of the investigation of a series of six anthracyclines (aclarubicin, daunorubicin, doxorubicin, epirubicin, idarubicin, and pirarubicin) commonly used in chemotherapy treatment. Pharmaceutical preparations corresponding to the most concentrated administration solutions in either NaCl (0.9%) or dextrose (5%) were inactivated by oxidation volume/volume with each of the methods for at least 1 h. Complete degradation into nonmutagenic residues of all the tested compounds was observed after 1 h for the NaOCl (5.25%) treatment as previously reported for the first study. CONCLUSION: Sodium hypochlorite (5.25%) is an efficient reagent for the chemical degradation of the nine drugs tested thus far.