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Chlorhexidine gluconate (CHG) is a cationic disinfectant. The positive charge of CHG molecules binds to phospholipid's negative charge in bacterial cell walls, causing membrane disruption. The in vitro kinetic physical, chemical and biological incompatibilities of nine lubricating gels with 1% w/v CHG were investigated. Five containing anionic thickener, two containing nonionic thickener, and two containing cationic thickener were collected from hospitals in northern Thailand. All the anionic and nonionic lubricating gels significantly reduced (p < 0.05) the CHG amount after 5 min of exposure time from 12.54% to 54.99%, respectively. In contrast, the amount of CHG exposed with cationic lubricating gels was maintained. Antibacterial activity was significantly reduced to a 1.17-4.33 log10 reduction for Staphylococcus aureus ATCC25923 and a 1.07-3.52 log10 reduction for Escherichia coli ATCC25922 after 5 min exposure to all anionic and nonionic lubricating gels. In contrast, the two cationic lubricating gels maintained the antibacterial activity of the CHG solution (5.69 ± 0.14 and 5.45 ± 0.17 log10 reduction). The results suggest that anionic and nonionic thickeners in lubricating gel formulations may neutralize the positive charge and reduce the antibacterial activity of CHG, reducing its effectiveness as a disinfectant.
Asunto(s)
Antiinfecciosos Locales , Desinfectantes , Antibacterianos/farmacología , Antiinfecciosos Locales/farmacología , Clorhexidina/análogos & derivados , Clorhexidina/farmacología , Escherichia coli , Geles , Fosfolípidos , TailandiaRESUMEN
Pyomyositis is a purulent infection of striated muscle and postoperative management remains the mainstay. If delayed primary wound closure is not managed in a timely manner, it often results in recurrent infection and sinus tract creation. Cavity wounds with sinus formation are known to complicate treatment, are problematic to manage and persist for long periods of time. The aim of this case report is to present the challenges in the assessment and management of a sinus tract with deep cavity wound, between the vastus lateralis and biceps femoris muscles, originating from liquefaction of a haematoma. Our review of the literature revealed limited research evidence in the management of deep cavity wounds. This is a rare case where the sinus tract route which leads to the rim-shaped cavity is embedded deep between the muscles, posing a high risk of recurrent infection from the premature closure of the wound tract. Successful management was attributed to: the accuracy in the initial wound assessment; appropriate dressing plans; the rationale for each action; and an outcome goal as each treatment progressed. Daily dressing change and reassessment of the wound was required to ensure progress and to address any complications in a timely manner. Finally, concerns of the patient and their family and regular discussions on the treatment plans are important to encourage adherence with management goals.
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Piomiositis , Adolescente , Celulitis (Flemón) , Humanos , Masculino , Meticilina , Piomiositis/diagnóstico , Piomiositis/terapia , Reinfección , Staphylococcus aureus , MusloRESUMEN
OBJECTIVES: Isopropyl alcohol 70% as a rinse agent for chlorhexidine scrub has been shown to decrease body temperature more quickly than chlorhexidine solution in mice prepared aseptically prior to surgery. For this reason, some high-quality, high-volume (HQHV) surgical sterilization clinics use chlorhexidine solution rather than alcohol. We sought to determine if temperature upon entry to recovery, heat loss per kg and rate of temperature decline during surgery were different between cats rinsed with chlorhexidine solution vs 70% isopropyl alcohol following surgical scrub, and if there were significant predictors of recovery temperature. METHODS: Female cats admitted for surgery to trap-neuter-return (TNR) clinics at a veterinary college were assigned chlorhexidine solution or alcohol rinse agents via block randomization. Veterinary students and veterinarians performed spay surgeries using HQHV techniques. In recovery, heat support and reversal agents were available for cats with a low body temperature or that were slow to recover. Baseline values, outcome variables and duration of each stage (preparation, surgery, recovery) were assessed using Wilcoxon rank-sum and t-tests. Recovery temperature was evaluated using random effects multiple linear regression. RESULTS: The recovery temperature, heat loss per kg, heat loss per min, need for reversal and need for heat support in recovery were not significantly different between rinse groups. Weight <2.3 kg, body condition score <4, duration of surgery and postinduction temperature were predictors of recovery temperature. The rate of heat loss in the first 30 mins of surgery was slightly lower for cats in the alcohol rinse group and the recovery duration was shorter for cats weighing less <2.3 kg in the alcohol rinse group. CONCLUSIONS AND RELEVANCE: There were no clinically meaningful differences in body temperature between chlorhexidine and alcohol rinses. Both chlorhexidine solution and isopropyl alcohol 70% are appropriate rinse agents for aseptic preparation of feline spay surgeries.
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Antiinfecciosos Locales , Temperatura Corporal/efectos de los fármacos , Clorhexidina , 2-Propanol/farmacología , Animales , Antiinfecciosos Locales/farmacología , Gatos , Clorhexidina/farmacología , Femenino , Ratones , Cuidados Preoperatorios/veterinaria , Esterilización , TemperaturaRESUMEN
INTRODUCTION: The root canal is a hub of numerous microorganisms. Routine endodontic procedures fail to remove the resistant microorganisms such as Enterococcus faecalis. AIM: The aim of the present study was to evaluate the influence of different vehicles on the antimicrobial efficacy of triple antibiotic paste (TAP) on E. faecalis infected root canals. MATERIALS AND METHODS: Eighty single-rooted and freshly extracted human teeth were prepared in radicular portion, and pure culture of E. faecalis (ATCC® 29212™) inoculum was injected into canals of tooth blocks and incubated for 21 days. Tooth blocks were divided into five groups. Each experimental group was then medicated with 0.1 ml of TAP and no medication was added for control groups. After 21 days of incubation at 37°C, colony-forming units per milliliter (CFU/ml) were counted for each group. RESULTS: Group II treated with TAP mixed with propylene glycol revealed a maximum reduction in CFU/ml, and that was followed by Group I and Group III, where TAP was mixed with 2% chlorhexidine (CHX) and 0.9% normal saline, respectively. Data were compared and analyzed using statistics software. The results were considered statistically significant for P < 0.05. There was a statistically significant difference in CFU/ml between propylene glycol and positive control group, between CHX and positive control group, between saline and positive control group. CONCLUSIONS: The propylene glycol group with TAP was the most effective vehicle for the elimination of E. faecalis from canals of tooth blocks, followed by 2% CHX solution as the second vehicle of choice over 0.9% normal saline.
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BACKGROUND: Bacteria in the conjunctiva present a potential risk of vitreous cavity infection during 23-gauge pars plana vitrectomy (PPV). Current preoperative procedures used in Sweden include irrigation with chlorhexidine solution (CHX) 0.05% only and no iodine solutions. We evaluated the bacterial diversity and load before and after this single antibacterial measure. METHODS: In a prospective, consecutive cohort we investigated bacterial growth in samples from 40 eyes in 39 consecutive individuals subjected to vitrectomy. A conjunctival specimen was collected from each preoperative patient before and after irrigating of eye with CHX, 0.05% solution. Iodine was not used during any part of the surgery. One drop of chloramphenicol was administered prior to surgery. Samples from vitreous cavity were collected at the beginning and end of vitrectomy. All conjunctival specimens were cultured for different species and quantified using colony forming units (CFU). RESULTS: There was a significant 82% reduction in the total number of CFUs for all bacteria in all eyes (P < 0.0001), and 90% reduction for coagulase negative staphylococci (CoNS) alone (P = 0.0002). The number of eyes with positive bacterial growth in conjunctival samples decreased from 33 to 18 after irrigation with CHX (P = 0.0023). The most common bacteria prior to surgery were CoNS (70%), Propionibacterium acnes (55%) and Corynebacterium species (36%). No case of post-vitrectomy endophthalmitis was reported during mean follow-up time, which was 4.6 ± 2.3 (range; 1.5 to 9) months. CONCLUSIONS: Patients undergoing PPV harbored bacteria in conjunctiva capable of causing post-vitrectomy endophthalmitis. Preoperative preparation with CHX significantly reduced the bacterial load in the conjunctival samples subsequently leading to very low inoculation rates in recovered vitreous samples. Thus, CHX used as a single disinfectant agent might be an effective preoperative procedure for eye surgery in Sweden. This is a relatively small study but the results could be a reference for other intraocular surgeries.
Asunto(s)
Carga Bacteriana , Clorhexidina/administración & dosificación , Infecciones Bacterianas del Ojo/prevención & control , Cuidados Preoperatorios/métodos , Infecciones Estafilocócicas/prevención & control , Infección de la Herida Quirúrgica/prevención & control , Anciano , Anciano de 80 o más Años , Antiinfecciosos Locales/administración & dosificación , Conjuntiva/microbiología , Endoftalmitis/epidemiología , Endoftalmitis/microbiología , Endoftalmitis/prevención & control , Infecciones Bacterianas del Ojo/epidemiología , Infecciones Bacterianas del Ojo/microbiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Infecciones Estafilocócicas/microbiología , Staphylococcus/aislamiento & purificación , Infección de la Herida Quirúrgica/microbiología , Suecia/epidemiología , Irrigación Terapéutica/métodos , Cuerpo Vítreo/microbiologíaRESUMEN
INTRODUCTION: Bacteria and their products play a primary etiological role in the initiation and perpetuation of pulpoperiapical pathosis. Intracanal medication is important for endodontic success as it eliminates microorganisms that persist after chemomechanical preparation. AIM: To compare antimicrobial efficacy of calcium hydroxide powder, triple antibiotic paste, calcium hydroxide with 2% chlorhexidine solution, and triple antibiotic paste with 2% chlorhexidine solution. MATERIALS AND METHODS: A total of 48 nonvital primary teeth were included in this study. After access opening first microbiological sample (s1) was collected by using absorbent paper point introducing into canal. Second microbilogical sample (s2) was taken following chemomechanical preparation and the teeth were divided into four groups: Group I: calcium hydroxide (CH) powder with distilled water; group II: CH with 2% chlorhexidine solution; group III: triple antibiotic powder with distilled water; group IV: triple antibiotic paste with 2% chlorhexidine solution. Then the canals were filled with any one group of the medicament and cavity was temporarily sealed with zinc oxide eugenol. After 1 week, a postmedication sample (s3) was collected. Then the canal was filled with Metapex, restored with glass ionomer cement. CONCLUSION: From the experiments carried out in this study, with the limitations, an inference can be drawn that a combination of antimicrobial agent used as intracanal medicament is definitely better than single agent like Ca(OH)2. HOW TO CITE THIS ARTICLE: Dutta B, Dhull KS, Das D, Samir PV, Verma RK, Singh N. Evaluation of Antimicrobial Efficacy of various Intracanal Medicaments in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017;10(3):267-271.
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BACKGROUND: Several studies have shown that rubbing hands with an alcohol/chlorhexidine solution provides equivalent microbial decontamination to a conventional surgical scrub using aqueous chlorhexidine. However, the authors believe that these studies have methodological flaws that limit their applicability to the operating theatre environment. As such, a method was developed to compare products in an everyday operating theatre environment using working operating theatre personnel. AIM: To determine whether or not an alcohol/chlorhexidine rub is as efficacious as a traditional surgical scrub using a novel method. METHODS: Bacterial counts at baseline were collected from 20 anaesthetists using the glove juice method. Subsequently, with sequential exchange of sterile gloves, one hand underwent a 3-min scrub using 4% aqueous chlorhexidine, and the other hand underwent a 60-s rub with a 70% isopropyl alcohol/0.5% chlorhexidine solution. The residual bacterial count was collected for each hand after 30 min using the glove juice method. These counts were converted to log10 values to compare the baseline counts of right and left hands, and efficacy between the treatment groups. FINDINGS: Mean [± standard deviation (SD)] bacterial counts at baseline were (log10) 4.42 ± 0.81 for left hands and 4.64 ± 0.60 for right hands (P > 0.05). The mean (± SD) reduction from baseline was (log10) 1.45 ± 0.50 for 4% chlorhexidine and 2.01 ± 0.98 for alcohol/chlorhexidine (P > 0.05). CONCLUSION: An alcohol/chlorhexidine hand rub was found to be as efficacious as a traditional scrub after 30 min; this study differs from previous work as it was undertaken in a population of practising anaesthetists in their working environment. The McKenzie method allows baseline and study evaluations to be performed contemporaneously on the same individual. Each subject was his/her own control. This method offers a more clinically relevant way to compare disinfectant solutions than standard methods.