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1.
BMC Infect Dis ; 20(1): 88, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000698

RESUMO

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) infections have become a global health threat. Controlling CRE transmission in hospitals is increasingly dependent on the use of disinfectants to restrict the risk of infection. Here, the susceptibility of patient-derived carbapenem resistant Klebsiella pneumoniae (CRKP) and Escherichia coli (CREC) strains against three common disinfectants and the determinants of resistance to disinfectants were investigated. METHODS: The minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs) of three common chemical disinfectants: chlorhexidine, trichloroisocyanuric (TCCA) acid and Povidone iodine (PVP-I) against 50 CRE strains were measured. The drug-resistance genes -qacEΔ1, qacA/B and cepA-were determined using polymerase chain reaction. RESULTS: A total of 36 CRKP and 14 CREC strains were collected in our hospital from 2016 to 2018. The MIC ranges of 36 CRKP strains against chlorhexidine, TCCA and PVP-I were 8~512 mg/L, 64~128 mg/L and 8~128 mg/L, respectively. For 14 CREC strains, the MIC ranges against chlorhexidine, TCCA and PVP-I were 4~128 mg/L, 64~128 mg/L and 4~128 mg/L, respectively. Moreover, against chlorhexidine and PVP-I, the MIC90 of 36 CRKP strains was higher than that of 50 CSKP strains. The qacE△1 gene was detected in 15 isolates among 36 CRKP strains (41.7%), and 8 isolates among 14 CREC strains (57.1%); while the qacA/B gene was not detected. Specifically, the cepA gene was much more prevalent than the qacEΔ1; it reached over 80% among CRKP strains. Compared to the CSKP strains, the presence of the qacEΔ1 and cepA genes was significantly higher among the CRKP strains (p < 0.05). CONCLUSION: CRE strains collected from patients in our hospital exhibit various degree of resistance to the commonly used chemical disinfectants. It is of great help to keep monitoring the tendency of the reduced susceptibility of the pan-resistant strains against disinfectants, in order to effectively control and prevent the spread of the super resistant bacteria.


Assuntos
Enterobacteriáceas Resistentes a Carbapenêmicos/efeitos dos fármacos , Desinfetantes/farmacologia , Farmacorresistência Bacteriana/genética , Escherichia coli/efeitos dos fármacos , Klebsiella pneumoniae/efeitos dos fármacos , Antibacterianos/farmacologia , Enterobacteriáceas Resistentes a Carbapenêmicos/genética , Enterobacteriáceas Resistentes a Carbapenêmicos/isolamento & purificação , China , Clorexidina/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Humanos , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Povidona-Iodo/farmacologia , Centros de Atenção Terciária , Triazinas/farmacologia
2.
J Med Microbiol ; 69(2): 298-308, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31976854

RESUMO

Introduction. Periodontitis is among the most widespread oral bacterial diseases affecting 15-20% of the world population.Aim. This study aimed to develop dental floss impregnated with povidone-iodine (PVP-I) as an antimicrobial delivery system against periodontopathogenic bacteria in a planktonic form and within biofilms.Methods. Identical lengths of dental floss impregnated with PVP-I formulations were placed on agar along with previously grown periodontal pathogens. The bioactivity of the dental floss was investigated by response-surface methodology. In order to explore the antibacterial activity of the selected formulation and the potential application in the prevention and treatment of plaque-caused diseases such as periodontitis and caries, the antibacterial and anti-biofilm activity of the selected PVP-I formulation against pathogenic bacteria were investigated.Results. The results indicated that the coating formulation containing Eudragit L-100 2.90 %, PVP-I 24.58 % and PEG 400 3.73 % had antimicrobial activity for all pathogens. The mechanism of this formulation involved disruption of bacterial cell membranes. Moreover, this formulation inhibited the formation of oral pathogenic biofilms.Conclusion. It was concluded that Eudragit L-100 and PVP-I-coated dental floss represented a potential therapeutic agent to prevent periodontal diseases and dental caries and exhibited non-toxicity to periodontal ligament cells.


Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Periodontite/prevenção & controle , Ácidos Polimetacrílicos/química , Povidona-Iodo/farmacologia , Antibacterianos/química , Bactérias/crescimento & desenvolvimento , Dispositivos para o Cuidado Bucal Domiciliar , Sistemas de Liberação de Medicamentos , Humanos , Periodontite/microbiologia , Povidona-Iodo/química
3.
J Hosp Infect ; 104(3): 302-304, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31743692

RESUMO

BACKGROUND: Alcoholic povidone-iodine (API) used as skin disinfection reduces the risk of postoperative infection but there is no evidence for its use on mucous membranes. We therefore conducted a tolerance study on the glans of men operated in urology. AIM: To confirm the safety of using API on mucous membranes. METHODS: The impact of applying API on the glans mucosa was measured using a chromameter. Caucasian men, without any dermatological lesion of the glans, operated by endoscopic transurethral route, were included. Measurements (L*a*b*) were made preoperatively and postoperatively by an independent person. Parameters were compared using the recognized formula ΔE = √(ΔL2 + Δa2 + Δb2). FINDINGS: Ninety-six patients, average age 68.9 ± 10.4 years, were included. For L*, the mean pre- and postoperative difference was +2.36 (P = 0.168). For a* and b*, the mean pre- and postoperative differences were +0.13 (P = 0.9085) and -0.12 (P = 0.17089), respectively. ΔE was equal to 13.92 ± 17.49 (non-significant difference). CONCLUSION: Our study is the first to analyse the impact of API on genital mucous membranes. In our study conditions, API had no impact on the mucous membranes, suggesting that it can be used safely.


Assuntos
Anti-Infecciosos Locais/farmacologia , Povidona-Iodo/farmacologia , Cuidados Pré-Operatórios , Infecção da Ferida Cirúrgica/prevenção & controle , Idoso , Humanos , Masculino , Membrana Mucosa/efeitos dos fármacos , Membrana Mucosa/microbiologia , Complicações Pós-Operatórias/prevenção & controle
4.
Ophthalmic Physiol Opt ; 39(5): 337-349, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31435968

RESUMO

PURPOSE: The presence of biofilm in the lens case has been shown to be a risk factor for contamination of lenses and consequently microbial keratitis. This study aimed to evaluate effectiveness of solutions for rigid contact lenses in prevention and disruption of biofilm in lens cases and methods for biofilm detection. METHOD: This study adopted a stepwise approach to evaluate effectiveness of four rigid lens disinfecting solutions against biofilm. These included two polyhexamethylene bigiuanide (PHMB) solutions and a chlorhexidine/PHMB-based solution, as well as a novel povidone-iodine formulation. The presence of biofilm following exposure to the solutions was assessed using both crystal violet (CV) staining and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) viability assay, taking into account the effect of lens case design. Three lens case designs, conventional flat, large bucket type, and cylindrical cases, were investigated for the ability to trap stain and allow biofilm formation. RESULTS: Considerable differences were noted between solutions in their ability to prevent and disrupt biofilm (p < 0.001). Lens case design greatly influenced optical density (OD) measurements even in negative controls, as cylindrical cases trapped more stain, increasing OD readings. Correcting for this factor reduced variations, but could not differentiate between residues and biofilm. MTT assay revealed that both povidone-iodine and chlorhexidine-containing solutions could effectively kill > 95% of organisms, whilst PHMB-based solutions were less effective with up to 55% of staphylococci and 41% of Pseudomonas surviving at 24 h. CONCLUSION: Biofilm can rapidly form in lens cases and may not be killed by disinfecting solutions. Of the solutions tested, none were able to prevent biofilm formation or disrupt established biofilm, but those containing chlorhexidine or povidone iodine were able to penetrate the biofilm and kill organisms. Assessment of biofilm by CV assay may be confounded by lens case design. Whilst CV assay can demonstrate presence of biofilm, this technique should be accompanied by viability assay to determine bactericidal activity.


Assuntos
Biofilmes/efeitos dos fármacos , Soluções para Lentes de Contato/farmacologia , Lentes de Contato Hidrofílicas/microbiologia , Desinfetantes/farmacologia , Biguanidas/farmacologia , Clorexidina/farmacologia , Humanos , Povidona-Iodo/farmacologia , Pseudomonas aeruginosa/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacos
5.
Biomater Sci ; 7(8): 3334-3347, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31215915

RESUMO

Biomaterial-associated infections caused by bacterial contamination and the subsequent formation of biofilms on the surfaces are challenges faced by our healthcare system. In this work, povidone-iodine-functionalized fluorinated copolymers with stable antibacterial, antibiofilm, and antifouling activities were designed and prepared by a two-step synthesis. First, a series of poly(hexafluorobutyl methacrylate-co-N-vinyl-2-pyrrolidone), i.e., P(HFBMA-NVP), were synthesized by radical copolymerization at different feed ratios to acquire water insoluble and antifouling copolymers. At the second step, the NVP segments in the copolymer were complexed with iodine to obtain the objective antibacterial and antifouling copolymer P(HFBMA-NVP)-I. The chemical and physical characteristics of the copolymers were investigated using 1H NMR, FTIR, XPS, EDX, UV-Vis, SEM, TEM, elemental analysis, and contact angle measurement. P(HFBMA-NVP)-I exhibited excellent antibacterial activity against both Gram-negative bacteria (Escherichia coli) and Gram-positive bacteria (Staphylococcus aureus), as well as good biocompatibility towards human hepatocyte cells (L02) and Caenorhabditis elegans. Using the electrospinning or spraying technique, P(HFBMA-NVP)-I was coated on polystyrene slides, medical stainless steel sheets, and cotton fabric, allowing the surfaces to have stable antibacterial and antibiofilm activities against pathogenic bacteria and antifouling capability against foulants and blood, and exhibit excellent self-cleaning properties.


Assuntos
Antibacterianos/química , Antibacterianos/farmacologia , Incrustação Biológica/prevenção & controle , Halogenação , Povidona-Iodo/química , Povidona-Iodo/farmacologia , Aderência Bacteriana/efeitos dos fármacos , Biofilmes/efeitos dos fármacos , Linhagem Celular , Escherichia coli/efeitos dos fármacos , Escherichia coli/fisiologia , Humanos , Interações Hidrofóbicas e Hidrofílicas , Teste de Materiais , Staphylococcus aureus/efeitos dos fármacos
6.
Turk J Med Sci ; 49(3): 795-801, 2019 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-31072075

RESUMO

Background/aim: The purpose of this study was toinvestigate the effects of 10% povidone­iodine (PI) sclerotherapyon ovarian cyst diameter through an experimental study. Materials and methods: To be able to create ovarian cysts, right unilateral salpingectomy was performed on 20 Wistar albino rats. One month after the operation, the abdomens of all rats were reopened. Sixteen rats with macroscopic ovarian cysts were divided randomly into 2 groups consisting of 8 rats. Group 1 (G1): the cyst content was only aspirated. Group 2 (G2): the ovarian cyst was aspirated and then the cystic cavity was irrigated with PI. Abdomens of all rats were closed and 1 month later they were reopened. Tissues of the right ovaries of the rats were embedded in paraffin blocks for histopathological examination. Follicle count, fibrosis, and congestion were evaluated under a light microscope. Results: For G1, there was no difference in cyst diameters before and after aspiration. In G2, a decrease was observed in cyst diameter. There was no difference in ovarian reserve between the 2 groups. When compared with G1, an increase in fibrosis and congestion was determined in G2. Conclusion: Sclerotherapyinto the ovarian cyst for a 5-min period using 10% PI reduces cyst diameter without any change in ovarian reserve.


Assuntos
Cistos Ovarianos/patologia , Ovário/efeitos dos fármacos , Povidona-Iodo/farmacologia , Escleroterapia/métodos , Animais , Feminino , Reserva Ovariana/efeitos dos fármacos , Ovário/patologia , Povidona-Iodo/administração & dosagem , Ratos , Ratos Wistar
7.
Ann Agric Environ Med ; 26(1): 39-45, 2019 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-30922027

RESUMO

INTRODUCTION: Mastitis may result in physical, chemical and microbiological changes in milk and pathological lesions in the glandular tissue. Milk derived from cows with mastitis may become a cause of infections in humansw and animals. OBJECTIVES: The aim of this study was to assess the effectiveness of selected dipping agents in the inactivation of several bacteria that may cause mastitis in cattle. MATERIAL AND METHODS: Three strains of each of the following species: Escherichia coli, Klebsiella pneumoniae, Serratia marcescens, Staphylococcus aureus and Listeria monocytogenes, isolated from milk, were used in the study. Identification of isolates was carried out using the automatic system VITEK2 Compact. Evaluation of the genetic similarity between the tested strains was made using the RAPD technique. Drug susceptibility of strains was evaluated with the disc diffusion method. Assessment of the effectiveness of iodine, stabilized iodine, povidone iodine and chlorhexidine was performed using fragments of skin from cow teats. RESULTS: All the tested strains were genetically different. Most of them were susceptible to the studied antibiotics. Only two strains of L. monocytogenes were resistant to all the studied antibiotics. The percentage rate of reduction in the number of bacteria after using of dipping agents was very high (>90%). The most susceptible to the dipping preparations used were L. monocytogenes (99.6 - 99.9%). Stabilized iodine was the most effective dipping agent for all tested bacteria, causing a reduction rate in the number of bacteria from 99.80% (E. coli) - 99.99% (S. aureus, L. monocytogenes). CONCLUSIONS: The results obtained may contribute to a reduction in udder infections in cows, especially mastitis, and improve the quality of the milk.


Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Glândulas Mamárias Animais/microbiologia , Mastite Bovina/prevenção & controle , Animais , Anti-Infecciosos Locais/farmacologia , Bactérias/genética , Bovinos , Clorexidina/farmacologia , Indústria de Laticínios/métodos , Feminino , Iodo/farmacologia , Mastite Bovina/microbiologia , Povidona-Iodo/farmacologia
8.
J Emerg Med ; 56(4): 405-412, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30826080

RESUMO

BACKGROUND: Povidone-iodine (PVP-I) antiseptic solutions have been shown to be effective against methicillin-resistant Staphylococcal aureus, a common cause of superficial skin abscesses. OBJECTIVES: Our objective was to study the feasibility of using PVP-I as a treatment adjunct in patients with superficial skin abscesses and determine if it confers any benefit over incision and drainage (I&D) alone. METHODS: This was a randomized controlled pilot study of adult patients with an uncomplicated skin abscess. Patients were randomized to PVP-I or standard treatment. All patients had I&D and abscess packing. Patients randomized to PVP-I were instructed on daily application of the agent to hands, wound, and surrounding skin with dressing changes. Subjects returned at 48-72 h and 7-10 days and followed-up by phone at 30 days. The primary outcome was clinical cure 7-10 days after I&D. The secondary outcomes were rate of development of new skin lesions and spread in household contacts within 30 days. RESULTS: Clinical cure occurred in 91.3% of patients in the standard group vs. 88.2% of patients in the PVP-I group (difference, 3.1%; 95% confidence interval [CI] -10.7 to 16.8; p = 0.53). There was a significantly higher adverse event rate in the group who received PVP-I (59.6%) vs. standard care (26.5%) (difference 33.1%, 95% CI 13.2-50.2; p < 0.001). CONCLUSIONS: There was no difference in clinical cure rates among patients using PVP-I (88.2%) vs. standard care (91.3%) after I&D. There were no major adverse events, but the addition of PVP-I was commonly associated with local skin irritation.


Assuntos
Povidona-Iodo/farmacologia , Infecções dos Tecidos Moles/tratamento farmacológico , Adulto , Anti-Infecciosos Locais/farmacologia , Anti-Infecciosos Locais/uso terapêutico , Drenagem , Feminino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Pessoa de Meia-Idade , Povidona-Iodo/uso terapêutico , Resultado do Tratamento , Cicatrização/efeitos dos fármacos
9.
J Med Microbiol ; 68(3): 432-439, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30735113

RESUMO

PURPOSE: To develop a new in vitro model of prosthetic vascular graft infection (PVGI) and evaluate antimicrobial and biofilm-disrupting efficacy of 0.1% octenidine dihydrochloride, 10% povidone-iodine and 0.02% chlorhexidine digluconate against biofilm-producing Staphylococcus aureus (S. aureus). METHODOLOGY: The effect of antiseptics on the microscopic integrity and antimicrobial effect on S. aureus biofilms was tested by growing biofilms on glass coverslips, in the modified Lubbock chronic wound pathogenic biofilm (LCWPB) model and on the surface of vascular grafts using qualitive and quantitative methods as well as by scanning electron microscopy (SEM). RESULTS: Chlorhexidine worked best on destroying the integrity of S. aureus biofilms (P=0.002). In the LCWPB model, octenidine and povidone-iodine eradicated all S. aureus colonies (from 1.79 × 109 c.f.u. ml-1 to 0). In the newly developed PVGI model, the grafts were successfully colonized with biofilms as seen in SEM images. All antiseptics demonstrated significant antimicrobial efficacy, decreasing colony counts by seven orders of magnitude (P=0.002). Octenidine was superior to povidone-iodine (P=0.009) and chlorhexidine (P=0.041). CONCLUSION: We implemented an innovative in vitro model on S. aureus biofilms grown in different settings, including a clinically challenging situation of PVGI. The strongest antimicrobial activity against S. aureus biofilms, grown on prosthetic vascular grafts, was showed by 0.1% octenidine dihydrochloride. We suggest that combinational therapy of antiseptics between chlorhexidine with either povidone-iodine or octenidine dihydrochloride should be tested in further experiments. Despite the need of further studies, our findings of these in vitro experiments will assist the management of vascular graft infection in clinical cases.


Assuntos
Anti-Infecciosos Locais/farmacologia , Biofilmes/efeitos dos fármacos , Próteses e Implantes/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Clorexidina/análogos & derivados , Clorexidina/farmacologia , Humanos , Povidona-Iodo/farmacologia , Infecções Relacionadas à Prótese/prevenção & controle , Piridinas/farmacologia , Infecções Estafilocócicas/prevenção & controle
10.
BMC Ophthalmol ; 19(1): 62, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30808316

RESUMO

BACKGROUND: Povidone-Iodine (PI) may be diluted when used as an antiseptic prior to an intravitreal injection in an attempt to decrease patient discomfort. This study aims to investigate the effect of diluting povidone-iodine (PI) on bacterial growth from bacterial droplet dispersal associated with speech. METHODS: Participants read a standardised script for 5 min over a blood agar plate positioned at 20 cm in a simulated position of an intravitreal injection procedure. The blood agar plates were subject to a randomised pre-application of 1% PI; 2.5% PI; 5% PI and no pre-application (control). The plates were incubated at 37 °C for 72 h and the number of Colony Forming Units (CFUs) was determined. CFUs were summarised as median and interquartile range (IQR). Wilcoxon rank sum test was used to assess pairwise comparisons of the various PI concentrations to the control group. Any trend across PI concentration was assessed using Kendall's tau rank correlation. RESULTS: Twenty-one subjects participated. Control plates had a median growth of 25 CFUs (interquartile range [IQR]:15-40), 1% PI plates had a median growth of 30 CFUs (IQR:15-82), 2.5% PI had a median growth of 18 CFUs (IQR:10-32) and 5% PI had a median growth of 2 CFUs (IQR:0-5). There was significantly less bacterial growth with 5% PI compared to control (P < 0.001). Bacterial growth at 2.5% PI and 1% PI did not differ significantly from control. There was a statistically significant trend for decreasing colony count as PI concentration increased (P < 0.001). CONCLUSIONS: PI concentrations less than 5% are not effective at reducing bacterial growth from bacterial droplet dispersal associated with speech. When using PI for pre-injection antisepsis, concentrations below 5% should be avoided.


Assuntos
Anti-Infecciosos Locais/farmacologia , Bactérias/efeitos dos fármacos , Infecções Oculares Bacterianas/prevenção & controle , Povidona-Iodo/farmacologia , Fala , Adulto , Anti-Infecciosos Locais/química , Contagem de Colônia Microbiana , Feminino , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Povidona-Iodo/química , Adulto Jovem
11.
Plast Reconstr Surg ; 143(5): 1371-1382, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30807498

RESUMO

BACKGROUND: This study investigated whether a hyaluronic acid-povidone-iodine compound can enhance diabetic wound healing. METHODS: A dorsal skin defect (6 × 5 cm) in a streptozotocin-induced diabetes rodent model was used. Seventy male Wistar rats were divided into seven groups: I, normal control; II, diabetic control, no treatment; III, diabetic rats, lower molecular weight (100 kDa) hyaluronic acid; IV, rats, higher molecular weight (1000 kDa) hyaluronic acid; V, rats, 0.1% povidone-iodine; VI, rats, lower molecular weight hyaluronic acid plus povidone-iodine; and VII, rats, higher molecular weight hyaluronic acid plus povidone-iodine. Histologic examination was performed with hematoxylin and eosin staining. CD45, Ki-67, prolyl 4-hydroxylase, and vascular endothelial growth factor were evaluated with immunohistochemical staining. RESULTS: Compared with the control, higher molecular weight hyaluronic acid plus povidone-iodine-treated rats had significantly reduced wound area (p < 0.001). Higher molecular weight hyaluronic acid plus povidone-iodine increased wound healing time when compared with higher molecular weight hyaluronic acid, povidone-iodine, or lower molecular weight hyaluronic acid plus povidone-iodine. Histology revealed significantly increased neovessels and suppressed inflammatory response in the higher molecular weight hyaluronic acid plus povidone-iodine group when compared with the control group. Immunohistochemical staining revealed significantly increased Ki67, prolyl 4-hydroxylase, and vascular endothelial growth factor expression, and suppressed CD45 expression in the higher molecular weight hyaluronic acid plus povidone-iodine group when compared with the other groups. CONCLUSION: Higher molecular weight hyaluronic acid plus povidone-iodine complex dressing significantly facilitated diabetic wound healing via increasing neovascularization and tissue regeneration and suppressing a proinflammatory response.


Assuntos
Anti-Infecciosos Locais/farmacologia , Diabetes Mellitus Experimental/complicações , Ácido Hialurônico/farmacologia , Povidona-Iodo/farmacologia , Cicatrização/efeitos dos fármacos , Administração Cutânea , Animais , Anti-Infecciosos Locais/química , Anti-Infecciosos Locais/uso terapêutico , Bandagens , Diabetes Mellitus Experimental/induzido quimicamente , Pé Diabético/tratamento farmacológico , Pé Diabético/etiologia , Combinação de Medicamentos , Humanos , Ácido Hialurônico/química , Ácido Hialurônico/uso terapêutico , Masculino , Peso Molecular , Povidona-Iodo/química , Povidona-Iodo/uso terapêutico , Ratos , Ratos Wistar , Pele/efeitos dos fármacos , Pele/patologia , Estreptozocina/toxicidade , Resultado do Tratamento
12.
J Hosp Infect ; 101(4): 370-379, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30500384

RESUMO

BACKGROUND: Presurgical hand washing is crucial for preventing surgical site infections (SSIs). Chlorhexidine gluconate (CHG) and povidone-iodine (PI) products have been conventionally used as hand scrubs for presurgical hand preparation. However, waterless hand rub (WHR) products have been developed for operating room staff. AIM: The aim of this study was to conduct a systematic review and meta-analysis to compare the antiseptic efficacies of WHR, CHG, and PI in surgical settings. METHODS: PubMed, Embase, and Cochrane Library databases as well as the ClinicalTrials.gov registry were searched for studies published before October 2018. Randomized controlled trials (RCTs) comparing the clinical outcomes of the use of WHRs, CHG, or PI for presurgical hand washing were included. A random effects model was used for meta-analysis. Colony-forming unit (cfu) counts, SSI rates, and preference and compliance were determined to measure efficacies. FINDINGS: Eleven RCTs involving 5135 participants were included. Residual cfu counts were significantly lower in the WHR and CHG groups than in the PI group. The differences in cfu counts between the WHR and CHG groups were non-significant. No significant differences were observed in the SSI rates between the WHR and traditional hand scrub groups. Moreover, WHRs were considered most favourable and were associated with higher compliance rates than the other products. CONCLUSION: WHRs and CHG exhibited higher antiseptic efficacies than PI. However, additional studies with consistent outcome measurements and accurate grouping are required to obtain comprehensive results. Moreover, preference, compliance, and the cost determine the selection of hand wash products.


Assuntos
Anti-Infecciosos Locais/farmacologia , Clorexidina/farmacologia , Desinfecção das Mãos/métodos , Povidona-Iodo/farmacologia , Contagem de Colônia Microbiana , Humanos , Cuidados Pré-Operatórios/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecção da Ferida Cirúrgica/prevenção & controle , Resultado do Tratamento
13.
Int J Pharm ; 554: 81-86, 2019 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-30395958

RESUMO

Staphylococcus aureus, a leading cause of serious human infections in both healthcare and community settings, is increasingly difficult to control due to expanding resistance to multiple antibiotic classes. Methicillin-resistant S. aureus (MRSA) strains have disseminated on a global scale and are associated with adverse patient outcomes, increased hospital stays, and significant economic costs to the healthcare system. A proximal step in S. aureus infection is colonization of the nasal mucosa, and effective strategies to decolonize high risk patients to reduce the risk of invasive infection and nosocomial spread represent an important clinical priority. With rising resistance to mupirocin, the most common antibiotic utilized for nasal MRSA decontamination, we are examining the use of pure molecular iodine (I2)-based formulations for this indication. Recently, an iodophor formulation of povidone-iodine (PVP-I) has shown significant promise for nasal MRSA decontamination by swabbing the anterior nares of patients in hospital settings, but the I2 concentration in this treatment is less than 0.01% of total iodine species present and like all providone-iodine formulations causes skin staining. Here we determine that a novel non-staining formulation of I2 combined with the safe organic emollient glycerin delivers high local concentrations of the active antimicrobial entity (I2) with minimal evaporative loss, exhibits activity at ∼1 part per million against MRSA and other important Gram-positive and -negative human pathogens. This formulation for I2 topical delivery produced similar reductions in mean bacterial burden and was associated with fewer treatment failures (<2-logfold reduction) than PVP-I in a murine model of MRSA nasal decontamination. Formulations of I2 in glycerin emollient merit further exploration as topical disinfectants for human medical indications.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Sistemas de Liberação de Medicamentos , Iodo/administração & dosagem , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Administração Intranasal , Animais , Anti-Infecciosos Locais/farmacologia , Modelos Animais de Doenças , Emolientes/química , Feminino , Glicerol/química , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Iodo/farmacologia , Masculino , Camundongos , Cavidade Nasal/microbiologia , Povidona-Iodo/administração & dosagem , Povidona-Iodo/farmacologia
14.
Interact Cardiovasc Thorac Surg ; 28(3): 353-359, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30165653

RESUMO

OBJECTIVES: Hyperthermic pleural lavage with povidone-iodine (PVP-I) is utilized to control micrometastatic disease following cytoreductive surgery for thymic epithelial tumours (TETs). Our objective was to investigate whether PVP-I demonstrates direct cytotoxicity against human TET cells. METHODS: Human Met-5A (immortalized mesothelial cell), IU-TAB-1 (thymoma) and Ty-82 (thymic carcinoma) cell lines were treated with serial dilutions of PVP-I (0.01-10%) for 5, 30 and 60 min at 37°C and 42°C. MTT assays and flow cytometry were used to evaluate cell death and apoptosis. Membrane permeability was assayed by intracellular staining of cleaved poly-ADP-ribose polymerase. Cellular fixation was evaluated by membrane disruption of dead cells by dimethylsulphoxide and by comparing cleaved poly-ADP-ribose polymerase staining following PVP-I with known fixatives. RESULTS: MTT assays demonstrated that PVP-I concentrations greater than 0.5% led to rapid cell death in both TET cell lines regardless of temperature. IC50 values following 5 min of exposure to PVP-I were 8.4 mM (0.3%) and 13.3 mM (0.48%) for IU-TAB-1 and Ty-82, respectively and 8.9 mM (0.32%) for MeT-5A. Flow cytometry demonstrated that 5-min exposure of either cell line to 1% PVP-I resulted in profound cell death: 74% and 58% at 5 min and 97% and 95% at 30 min, for IU-TAB-1 and Ty-82 cells, respectively. Resistance of PVP-I-treated cells to dimethylsulphoxide lysis and similar cleaved poly-ADP-ribose polymerase expression following PVP-I and known fixatives revealed cellular fixation as the mechanism of death following PVP-I exposure. CONCLUSIONS: PVP-I results in rapid death of human TET cells and normal mesothelial cells through a cellular fixation mechanism and may, therefore, favourably impact the control of micrometastatic disease following resection of TETs with pleural dissemination.


Assuntos
Neoplasias Epiteliais e Glandulares/tratamento farmacológico , Povidona-Iodo/farmacologia , Neoplasias do Timo/tratamento farmacológico , Anti-Infecciosos Locais/farmacologia , Apoptose , Linhagem Celular Tumoral , Humanos , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias do Timo/patologia
15.
J Pharm Biomed Anal ; 165: 90-93, 2019 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-30513509

RESUMO

A potentiometric method is presented that allows to characterize aqueous iodine-based disinfecting solutions and preparations, respectively. By means of three electrodes (iodide-sensitive, platinum redox, and reference electrode), the concentrations of free iodine, iodide, and triiodide were determined. The apposition "free" means iodine not complexed with ligands originating from the organic matrix of the iodophoric iodine source (e.g. povidone iodine). Based on the gained values ([I2], [I-], and[I3-]), it is possible to assess features concerning kinetics of disinfection, disinfecting capacity, and tolerability. The method distinguishes by simplicity and modest time expenditure of 10-15 min for a complete investigation comprising two potentiometric measurements.


Assuntos
Desinfetantes/química , Iodo/química , Potenciometria/métodos , Povidona-Iodo/química , Desinfetantes/farmacologia , Eletrodos , Oxirredução , Povidona-Iodo/farmacologia , Fatores de Tempo
16.
Ann Agric Environ Med ; 25(4): 725-731, 2018 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-30586959

RESUMO

INTRODUCTION: Free-living amoebae, ubiquitous in outer environments, in predisposing circumstances may exist as parasites, infectious agents of Acanthamoeba keratitis. In recent decades, the vision-threatening corneal infection is a growing human health threat worldwide, including Poland. The applied therapy is often ineffective due to diagnostic mistakes, various pathogenicity of Acanthamoeba strains and high resistance of cysts to drugs; many agents with possible anti-amoebic activity are still being tested. In the presented study, selected chemicals are investigated in terms of their in vitro effect on corneal and environmental Acanthamoeba strains. MATERIAL AND METHODS: Samples of a corneal isolate from a patient with severe Acanthamoeba keratitis,of assessed on the basis of genotype associations of 18S rRNA and the type strain, Acanthamoeba castellanii Neff cultivated in bacteria-free condition, were exposed to povidone iodine, chlorhexidine digluconate or toyocamycin. In vitro population dynamics of the strains were monitored and compared to those of control cultures. RESULTS: All chemicals showed anti-amoebic effects with different degrees of effectiveness. Significant differences were observed in the in vitro population dynamics, and the morpho-physiological status of A. castellanii Neff T4 and corneal strains determined as A. polyphaga T4 genotype, exposed to povidone iodine or toyocamycin, in comparison with chlorhexidine taken as reference. CONCLUSIONS: Time-dependent amoebstatic in vitro effects were demonstrated for all agents, in particular, the results of assays with povidone iodine are promising. No significant stimulation of encystation appeared; however, as cysticidal efficacy of chemicals is expected, complementary research is needed on different Acanthamoeba strains with modified agent concentrations and method application.


Assuntos
Ceratite por Acanthamoeba/parasitologia , Acanthamoeba/efeitos dos fármacos , Antiprotozoários/farmacologia , Clorexidina/análogos & derivados , Povidona-Iodo/farmacologia , Toiocamicina/farmacologia , Acanthamoeba/classificação , Acanthamoeba/genética , Acanthamoeba/isolamento & purificação , Ceratite por Acanthamoeba/tratamento farmacológico , Ceratite por Acanthamoeba/epidemiologia , Clorexidina/farmacologia , Genótipo , Humanos , Polônia/epidemiologia
17.
PLoS One ; 13(10): e0205526, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30304066

RESUMO

Staphylococcal extracellular polymeric substances (EPS) such as extracellular DNA (eDNA) and poly-N-acetylglucosamine surface polysaccharide (PNAG) mediate numerous virulence traits including host colonization and antimicrobial resistance. Previous studies showed that EPS-degrading enzymes increase staphylococcal biocide susceptibility in vitro and in vivo, and decrease virulence in animal models. In the present study we tested the effect of EPS-degrading enzymes on staphylococcal skin colonization and povidone iodine susceptibility using a novel in vivo pig model that enabled us to colonize and treat 96 isolated areas of skin on a single animal in vivo. To quantitate skin colonization, punch biopsies of colonized areas were homogenized, diluted, and plated on agar for colony forming unit enumeration. Skin was colonized with either Staphylococcus epidermidis or Staphylococcus aureus. Two EPS-degrading enzymes, DNase I and the PNAG-degrading enzyme dispersin B, were employed. Enzymes were tested for their ability to inhibit skin colonization and detach preattached bacteria. The effect of enzymes on the susceptibility of preattached S. aureus to killing by povidone iodine was also measured. We found that dispersin B significantly inhibited skin colonization by S. epidermidis and detached preattached S. epidermidis cells from skin. A cocktail of dispersin B and DNase I detached preattached S. aureus cells from skin and increased their susceptibility to killing by povidone iodine. These findings suggest that staphylococcal EPS components such as eDNA and PNAG contribute to skin colonization and biocide resistance in vivo. EPS-degrading enzymes may be a useful adjunct to conventional skin antisepsis procedures in order to further reduce skin bioburden.


Assuntos
Antibacterianos/farmacologia , Matriz Extracelular de Substâncias Poliméricas/efeitos dos fármacos , Povidona-Iodo/farmacologia , Infecções Cutâneas Estafilocócicas/tratamento farmacológico , Staphylococcus aureus , Staphylococcus epidermidis , Animais , Aderência Bacteriana/efeitos dos fármacos , Aderência Bacteriana/fisiologia , Desoxirribonuclease I/farmacologia , Modelos Animais de Doenças , Farmacorresistência Bacteriana/efeitos dos fármacos , Farmacorresistência Bacteriana/fisiologia , Matriz Extracelular de Substâncias Poliméricas/enzimologia , Feminino , Humanos , Proteínas Recombinantes/farmacologia , Infecções Cutâneas Estafilocócicas/enzimologia , Infecções Cutâneas Estafilocócicas/patologia , Sus scrofa
18.
Vet J ; 241: 38-41, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30340658

RESUMO

Infectious ocular disease, such as conjunctivitis, is common in cats and can be caused by several viruses and bacteria, either as a single infection or as co-infections. In this study, povidone-iodine (PVP-I), alone or compounded with hydroxyethyl cellulose (HEC), was investigated for its efficacy against these pathogens in vitro. Whilst PVP-I alone was effective at inhibiting feline herpesvirus type 1 (FHV-1), Chlamydia felis, and Mycoplasma felis, PVP-I with HEC exerted a synergistic inhibitory effect against FHV-1 and C. felis. In contrast, only minimal inhibition of feline calicivirus was observed. These results demonstrate that PVP-I, alone and in combination with HEC, is effective against some feline ocular pathogens when tested in cell lines in vitro. In vivo studies investigating the systemic safety, ocular tolerance, and clinical efficacy of this combination in cats would be necessary before it could be recommended as a therapy in affected cats.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Doenças do Gato/tratamento farmacológico , Celulose/análogos & derivados , Conjuntivite/veterinária , Soluções Oftálmicas/uso terapêutico , Povidona-Iodo/uso terapêutico , Animais , Anti-Infecciosos Locais/administração & dosagem , Anti-Infecciosos Locais/farmacologia , Calicivirus Felino/efeitos dos fármacos , Doenças do Gato/microbiologia , Gatos , Celulose/administração & dosagem , Celulose/uso terapêutico , Chlamydia/efeitos dos fármacos , Infecções por Chlamydophila/tratamento farmacológico , Infecções por Chlamydophila/veterinária , Conjuntivite/tratamento farmacológico , Quimioterapia Combinada , Feminino , Infecções por Herpesviridae/tratamento farmacológico , Infecções por Herpesviridae/veterinária , Masculino , Testes de Sensibilidade Microbiana/veterinária , Mycoplasma/efeitos dos fármacos , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/veterinária , Soluções Oftálmicas/administração & dosagem , Povidona-Iodo/administração & dosagem , Povidona-Iodo/farmacologia , Resultado do Tratamento
19.
Cont Lens Anterior Eye ; 41(6): 542-546, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30100388

RESUMO

This study investigated the efficacy of a novel povidone-iodine based disinfection solution for rigid gas permeable (RGP) lenses compared to three other currently available multipurpose and hydrogen peroxide solutions. Bactericidal and fungicidal activities were assessed using ISO 14729 reference methods, whilst amoebicidal properties were evaluated using an automated viability counter. All solutions were also assessed for long term storage stability over a 3-month period. The FDA guidelines were adequately achieved by all solutions tested and 3-month storage did not affect their activity against bacterial and fungal agents. Activity against Acanthamoeba castellani trophozoites reached 1-log reduction for the povidone-iodine solution and approached this level for the remaining solutions. Activity against cysts was somewhat reduced and ranged from 78 to 86% reduction in viability. A povidone-iodine based solution, which may offer advantages as resistance to this agent has not been demonstrated and it lacks toxicity, provided equivalent antimicrobial activity to other RGP solutions.


Assuntos
Bactérias/isolamento & purificação , Soluções para Lentes de Contato/farmacologia , Desinfecção/métodos , Infecções Oculares Bacterianas/prevenção & controle , Infecções Oculares Fúngicas/prevenção & controle , Fungos/isolamento & purificação , Povidona-Iodo/farmacologia , Anti-Infecciosos Locais/farmacologia , Bactérias/efeitos dos fármacos , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Fúngicas/microbiologia , Fungos/efeitos dos fármacos , Humanos
20.
Mol Pharm ; 15(8): 3527-3534, 2018 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-30047266

RESUMO

The aim of this study was to synthesize iodine containing polymeric excipients for mucosal treatment of microbial infection exhibiting a prolonged mucosal residence time by forming an adhesive gel on the mucosal surface. In order to achieve this aim, 2-(2 acryloylamino-ethyldisulfanyl)-nicotinic acid (ACENA) was copolymerized with N-vinylpyrrolidone (NVP) to obtain thiolated polyvinylpyrrolidone (PVP) for complexation with iodine. The average molecular mass of different thiolated PVP variants was determined by size exclusion chromatography. The structure of thiolated PVP was confirmed by 1H NMR. Thiolated PVP variants were characterized for thiol content, cytotoxicity, iodine loading capacity, rheological behavior, and adhesion time on mucosa. The highest achieved degree of thiolation was 610 ± 43 µmol/g, and the maximum recorded iodine loading was 949 ± 31 µmol/g of polymer. Thiolated PVP variants (0.5% m/v) showed no toxicity after incubation on Caco-2 cells for the period of 3 and 24 h, respectively. Thiolated PVP and thiolated PVP-iodine complexes exhibited a 5.4- and 4.4-fold increased dynamic viscosity in porcine mucus in comparison to PVP and PVP-iodine complex, respectively. Compared to PVP and PVP-iodine complex thiol-functionalized PVP and PVP-iodine complexes demonstrated significantly prolonged attachment to mucosal surface over a period of 3 h. Thiol functionalized PVP proved to be a promising novel excipient for complexation with iodine and to exhibit strongly improved mucoadhesive properties.


Assuntos
Adesivos/farmacologia , Anti-Infecciosos Locais/farmacologia , Excipientes/farmacologia , Povidona-Iodo/farmacologia , Compostos de Sulfidrila/farmacologia , Adesivos/síntese química , Animais , Anti-Infecciosos Locais/síntese química , Células CACO-2 , Composição de Medicamentos/métodos , Excipientes/síntese química , Glicoproteínas/metabolismo , Humanos , Mucosa Intestinal/metabolismo , Povidona-Iodo/síntese química , Compostos de Sulfidrila/síntese química , Suínos
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