Antimicrobial activity of Er, Cr: YSGG and Ultrasonic on E. faecalisbiofilm in the mesial root canal systems of lower molars / Atividade antimicrobiana de Er, Cr: YSGG e Ultrassônico no biofilme de E. faecalis nos sistemas de canais radiculares mesiais de molares inferiores

The internal topography of the root canal is complex, especially for the permanent molar's mesial root. In response to such issues, improved irrigation techniques have been created, which use laser pulses to agitate fluids and improve microbial deposit removal. Objective: To assess the effectiveness of the Er,Cr:YSGG laser with a wavelength of 2,780 nm via photon-induced photoacoustic streaming (PIPS) protocol which agitated of 2% chlorohexidine (CHX) in removing mature Enterococcus faecalis (E. faecalis) biofilm in root canal systems of lower molars. Material and Methods: The mesial roots of lower first and second molars were separated and inoculated with E. faecalis bacterial suspension for 30 days. The roots were irrigated with CHX, some of them were agitated with a passive ultrasonic device (PUI), while the other roots were agitated by an Er,Cr:YSGG laser in PIPS at 60 µs/pulse, 5 Hz, (0.25, 0.5, 0.75, and 1) W. An atomic force microscope (AFM) was used as a new method to get the results in the isthmus area; the obtained results from each group were compared with each other. Results: Based on the AFM and SEM analyses, laser and ultrasonic activation groups showed higher antimicrobial efficacy than the conventional syringe irrigation group (P<0.05). Conclusion: Based on the investigation's findings, the activation of 2% CHX solution by Er,Cr:YSGG laser in PIPS and PUI offers better mature bacterial biofilm removal in the mesial root of lower human molars than the same irrigant with the SI technique (AU)

A topografia interna do canal radicular é complexa, especialmente para a raiz mesial do molar permanente. Em resposta a esses problemas, foram criadas técnicas aprimoradas de irrigação, que utilizam pulsos de laser para agitar fluidos e melhorar a remoção de depósitos microbianos. Objetivo: Avaliar a eficácia do laser Er,Cr:YSGG com comprimento de onda de 2.780 nm via protocolo de streaming fotoacústico induzido por fótons (PIPS) que agitou clorohexidina a 2% (CHX) na remoção de Enterococcus faecalis maduro (E. faecalis) biofilme em sistemas de canais radiculares de molares inferiores. Material e Métodos: As raízes mesiais de 28 primeiros e segundos molares inferiores foram separadas e inoculadas com suspensão bacteriana de E. faecalis por 30 dias. As raízes foram irrigadas com CHX, sendo algumas delas agitadas com aparelho ultrassônico passivo (PUI), enquanto as demais raízes foram agitadas com laser Er,Cr:YSGG em PIPS a 60 µs/pulso, 5 Hz (0,25, 0,5, 0,75 e 1) W. Um microscópio de força atômica (AFM) foi utilizado como um novo método para obter os resultados na área do istmo; os resultados obtidos de cada grupo foram comparados entre si. Resultados: Com base nas análises de AFM e SEM, os grupos de ativação por laser e ultrassom apresentaram maior eficácia antimicrobiana do que o grupo de irrigação com seringa convencional (P<0.05). Conclusão: Com base nos achados da investigação, a ativação da solução de CHX a 2% pelo laser Er,Cr:YSGG em PIPS a (60 µs/pulso, 5 Hz, 0,75 W) oferece melhor remoção de biofilme (AU)

Antibacterial Effect of Commercial Mouthwashes on Streptococcus mutans: An in vitro study

ABSTRACT: The aim of this study was to compare the antibacterial effect of eight different commercial (MWs) on two Streptococcus mutans (SM) strains by using the agar well diffusion method. Eight commercial MWs were selected, all of them combined several ingredients in different concentrations, the main active ingredients were: Chlorhexidine gluconate, cetylpyridinium chloride, sodium fluoride, zinc lactate, vitamin B5 and super-oxidized water. The SM strains were extracted from Cultiloops® and incubated for 24 hours at 37 °C. The antimicrobial activity was evaluated using the agar well diffusion method. The inhibition zones were measured using an electronic digital caliper. The R© software was used to perform the statistical analysis using Kruskall-Wallis test and Dunn's multiple comparisons test. Seven commercial formulas demonstrated inhibitory effect over both SM strains. Only the MW containing super-oxidized water did not exhibit antibacterial activity. Higher inhibitory effect was observed in the chlorhexidine gluconate formula (27.38 ± 0.98 mm and 31.52 ± 0.64 mm). No statistically significant differences were observed when comparing formulas containing chlorhexidine gluconate in combination with other active ingredients. Seven MWs showed antibacterial activity except super-oxidized water formula. MWs containing chlorhexidine gluconate demonstrated the best effect against SM. However, no statistically significant differences were found when comparing formulas using exclusively chlorhexidine gluconate or combined with other antiseptics. Future research must be performed, focused on developing new MWs with similar antibacterial effects to chlorhexidine, but free of side effects, particularly in long-term treatments.

RESUMEN: El objetivo de este estudio fue comparar el efecto antibacteriano de ocho colutorios comerciales en la proliferación de dos cepas de Streptococcus mutans (SM) mediante el método de difusión de pozos de agar. Se seleccionaron ocho colutorios comerciales, todos ellos combinados con varios ingredientes en diferentes concentraciones, los principales ingredientes activos fueron: gluconato de clorhexidina, cloruro de cetilpiridinio, fluoruro de sodio, lactato de zinc, vitamina B5 y agua superoxidada. Las cepas SM se extrajeron de Cultiloops® y se incubaron durante 24 horas a 37 °C. La actividad antimicrobiana se evaluó mediante el método de difusión de placa de agar. Las zonas de inhibición se midieron utilizando un calibre digital electrónico. Se utilizó el software R © para realizar el análisis estadístico mediante la prueba de Kruskall-Wallis y la prueba de comparaciones múltiples de Dunn. Siete fórmulas comerciales demostraron efecto inhibidor sobre ambas cepas SM. Solo el colutorio que contenía agua superoxidada no mostró actividad antibacteriana. Se observó un mayor efecto inhibidor en las fórmulas congluconato de clorhexidina (27,38 ± 0,98 mm y 31,52 ± 0,64 mm). No se observaron diferencias estadísticamente significativas al comparar fórmulas que contienen gluconato de clorhexidina en combinación con otros ingredientes activos. Siete MW mostraron actividad antibacteriana excepto la fórmula de agua superoxidada. Los colutorios que contienen gluconato de clorhexidina mostraron el mejor efecto contra SM. Sin embargo, no se encontraron diferencias estadísticamente significativas al comparar fórmulas que combinaron con otros principios activos. Se deben realizar investigaciones, enfocadas en el desarrollo de nuevos colutorios con efectos antibacterianos similares a la clorhexidina, pero libres de efectos secundarios, particularmente en tratamientos a largo plazo.

Resistance profiles of clinical isolates to chlorhexidine gluconate and clinical characteristics of the infected patients / 中华传染病杂志

Objective:To explore the resistance of common clinical isolates to chlorhexidine gluconate (CHG) and the clinical characteristics of patients with the infections.Methods:A total of 1 000 isolates from the First Affiliated Hospital of Wenzhou Medical University in 2018 (from January to May) were collected, which included 200 strains each of Escherichia coli ( E. coli), Acinetobacter baumanii ( A. baumanii), Pseudomonas aeruginosa ( P. aeruginosa), Staphylococcus aureus ( S. aureus), and Enterococcus spp.. Minimum inhibitory concentration (MIC) of CHG against 1 000 isolates were determined by the agar dilution method. The correlation between the resistance of isolates and clinical characteristics of infected patients was analyzed. Chi-square test or Fisher exact probability test were used for statistical analysis. Results:A total of 57 CHG resistant strains were detected in 1 000 clinical isolates. These CHG-resistant strains were mainly isolated from sputum and intensive care unit ward, accounting for 49.1%(28/57)and 38.6%(22/57), respectively. The resistance rates of P. aeruginosa, A. baumanii, Enterococcus spp., S. aureus, and E. coli to CHG were 16.0%(32/200), 7.0%(14/200), 3.0%(6/200), 1.5%(3/200) and 1.0%(2/200), respectively. The CHG-resistant rates of P. aeruginosa to ceftazidime, ciprofloxacin, levofloxacin and gentamicin were 53.1%(17/32), 78.1%(25/32), 65.6%(21/32) and 50.0%(16/32), respectively, which were all higher than those of CHG-sensitive P. aeruginosa (25.0%(8/32), 25.0%(8/32), 21.9%(7/32) and 15.6%(5/32), respectively), with statistical significance ( χ2=5.317, 18.080, 12.444 and 8.576, respectively, all P<0.05). The hospital mortality was 22.8%(13/57) in patients infected with CHG-resistant bacteria, which was higher than that in patients infected with CHG-sensitive bacteria ((7.0%(4/57); Fisher exact probability test, P=0.018)). CHG-resistant group had a higher history of CHG exposure and antimicrobial treatment (61.4%(35/57) and 70.2%(40/57), respectively), which were both higher than those with CHG-susceptible isolates (17.5%(10/57) and 47.4%(27/57), respectively), the differences were both statistically significant ( χ2=22.947 and 6.118, respectively, both P<0.05). In addition, the multi-drug resistance rate of CHG-resistant strains was 54.4%(31/57), which was higher than that of CHG-susceptible strains (35.1%(20/57)), the difference was statistically significant ( χ2=4.293, P=0.039). Conclusions:CHG resistant strains have higher antimicrobial resistance. Hospital mortality in patients infected with CHG-resistant bacteria is higher than patients infected with CHG-sensitive bacteria. The important risk factors are CHG exposure and antimicrobial therapy.

Antisepsys and profilatic antimicrobial therapy in prevention of surgical site infection of horses / [Antissepsia e terapia antimicrobiana profilática no controle infeccioso do foco cirúrgico em equinos

The efficacy of an antisepsis protocol comprising chlorhexidine gluconate and ethyl alcohol in combination with prophylactic antimicrobial therapy in controlling surgical site infection in horses was studied. To that purpose, seven mixed breed horses received potassium penicillin and gentamicin at least 30 minutes prior to surgery. The surgical site was scrubbed with chlorhexidine gluconate and rinsed with ethyl alcohol. Samples were collected at four time points: (A) - before and (B) - immediately following shaving of the hair coat, (C) - at the end of antisepsis procedures, and (D) - at the end of the surgical procedure. Duration of surgery was recorded. Samples were cultured in three different culture mediums: Mitis Salivarus (Streptococcus sp.), Staphylococcus 110 (Staphylococcus sp.), and Mac Conkey (Enterobacteria). A high level of bacterial growth was observed in all culture mediums at (A) and (B), with no bacterial growth in (C). Staphylococcus sp. growth was observed in (D) in a single patient whose surgical procedure lasted for 120 minutes. Shaving of the hair coat reduced microbial flora on the surface of the skin. Antisepsis in combination with prophylactic antimicrobial therapy was effective in controlling surgical site infection in elective procedures with an average duration of 90 minutes.(AU)

Objetivou-se averiguar a eficácia do protocolo de antissepsia com clorexidina degermante e álcool etílico hidratado 70%, em associação com terapia antimicrobiana profilática, no controle microbiano do foco cirúrgico de equinos submetidos a procedimentos cirúrgicos. Foram utilizados 07 cavalos adultos de raças variadas, onde ambos receberam o mesmo tratamento (terapia antimicrobiana profilática e antissepsia com clorexidina degermante 2% e álcool etílico hidratado 70%), coletando-se amostras em quatro tempos distintos [(A - antes da tricotomia), (B - imediatamente após tricotomia), (C - ao término da antissepsia), (D - ao término do procedimento cirúrgico)]. O tempo de cada procedimento cirúrgico foi contabilizado. Foram utilizados três meios de cultura diferentes, cada um com especificidade para um tipo de crescimento bacteriano. Constatou-se alta incidência de crescimento bacteriano nos três meios utilizados nos tempos de coleta A e B. Para o tempo C, não foi observado crescimento bacteriano. No tempo D averiguou-se crescimento bacteriano do tipo Staphylococcus sp. em um único paciente, cujo tempo cirúrgico foi de 120 minutos de duração. Desta forma, a tricotomia reduziu a carga microbiana na superfície da pele. A antissepsia associada à terapia antimicrobiana profilática mostrou-se eficaz no controle microbiano do foco cirúrgico em procedimentos eletivos, com duração média de 90 minutos.(AU)

Analytical Method Development And Its Validation For Estimation Of Chlorhexidine Gluconate

In the present work, Independent method was developed for estimation of Chlorhexidine Gluconate, Metronidazole benzoate,Lignocaine Hydrochloride, and Salicylic Acid in bulk and dosage form by UV-Visible Spectrophotometry. In this method the determination ofmaximum absorbance (λmax) of the drugs were found to be 259 nm, 285.8 nm, 263 nm and 304 nm. The validation parameters were studiedaccording to ICH guidelines. On the basis of % agreement criteria, therefore Average % agreement found to be 100.05 at 259 nm, 99.32 at285.8 nm, 100.001 at 304 nm and 99.70 at 263 nm. Specificity study shows the good agreement with results, indicating that excipients did notinterfere with the analyte. Repeatability study showed a % R.S.D of 0.2486 at 259 nm, 0.2605 at 285.8 nm, 0.403174 at 304 nm and 0.880817at 263 nm for Chlorhexidine Gluconate, Metronidazole benzoate, Lignocaine Hydrochloride, and Salicylic Acid. Thus it is concluded that theanalytical technique has a good repeatability precision as R.S.D are less than 5.3% (Specified) and less than 2% (desired). So it can be said thatthe proposed method is precise. Intraday study were showed a % R.S.D of 1.246918, 0.984763, 0.775939 and 1.022045 respectively forChlorhexidine Gluconate, Metronidazole benzoate, Lignocaine Hydrochloride, and Salicylic Acid. So it can be said that the proposed method isprecise. Interday study were showed a % R.S.D of 1.358486, 0.829325, 1.273356 and 0.968196 respectively for Chlorhexidine Gluconate,Metronidazole benzoate, Lignocaine Hydrochloride, and Salicylic Acid. So it can be said that the proposed method is precise. Limit of detectionwere found to be 0.097, 0.117, 0.010 and 0.074 g/ml at 259, 285.8, 304and 263 nm. Limit of quantification were found to be 0.29, 0.35, 0.030and 0.418 g/ml at 259, 285.5 304, and 263nm. The accuracy of the methods was proved by performing recovery studies in availableformulations. Since the % recovery 98.07 to 101.28 at 259 nm, 98.29 to 101.02 at 285.8 nm, 99.99 to 101.25 at 304nm and 99.10 to 101.78 at263nm are within the desirable confidence interval of 98-102%. So it can be said that the proposed method is accurate. The percent meanrecovery is 98.46, 101.42 (1:3), 98.20 and 99.78% of labeled amount, which is within specified limits of 98-102%. It can be said that proposedmethod can satisfactory be applied for analysis of Chlorhexidine Gluconate, Metronidazole benzoate, Lignocaine Hydrochloride, and SalicylicAcid in dosage form. The developed method is precise, accurate and do not suffer from any interference due to common excipients. It isevident from this study that the developed method is simple, sensitive, specific, precise and accurate and economic. Hence it can be employedfor routine analysis in quality control laboratories.

Effect of DAPC on Adhesion of Streptococcus Mutans / 昆明医科大学学报

Objective To analyze the property of the new antibacterial agent (N, N-di-n-decyl-N, N-dimethyl-ammonium 5-oxopyrrolidine-2-carboxylate, DAPC) to prevent Streptococcus mutans' adhesion on tooth surface.Method determine the minimal inhibitory concentration and minimal bactericidal concentration of DAPC and Chlorhexidine gluconate by liquid dilution method.Set the Chlorhexidine gluconate as the positive control, while PBS as the negative control.Use the crystal violet staining to measure the quantity of biofilm.Re s ult The MIC of DAPC on Streptococcus mutans was 0.0031250％ and MBC was 0.0062500％. The MIC of Chlorhexidine gluconate was 0.0015625％, while the MBC was 0.0031250％.When concentration of the two antibacterial agents was MIC, the quantity of biofilm have no significance among three groups.However, when concentration of Chlorhexidine gluconate and DAPC were 0.12％ and 0.24％ respectively, biofilm of experimental group was lower than PBS, and there is no significance between Chlorhexidine gluconate group and DAPC group after 24 hours incubation.Conclus ion New antibacterial agent DAPC have significant effect in inhibiting of Streptococcus mutans.And the residual of DAPC on teeth can maintain a long time of antibacterial effect to inhibit Streptococcus mutans' adhesion.

Research of effect about two disinfectors on prevention for central line-associated blood stream infection in hemodialysis / 中国医学装备

Objective: To explore the clinical effect of two disinfectors on prevention for central line-associated blood stream infection (CLABSI) in hemodialysis. Methods: 168 patients received blood purification through central venous indwelling catheter were divided into control group (82 cases) and observation group (86 cases) as random table. The patients of control group were disinfected by using iodophor disinfectant on central venous catheter and skin around puncture, while the patients of observation group were disinfected by using medical chlorhexidine gluconate (2% chlorhexidine gluconate, 70% isopropanol and 28%injection) on the same positions. In different stages, before and after central venous indwelling catheter and 24 hours after central venous indwelling catheter, the colony count and incidence of CLABSI of patients between two groups were compared. Results: There was no significant difference between the two groups for colony count around puncture before central venous indwelling catheter (t=-1.478, P>0.05). The colony count of observation group was lower than that of control group after 24 hours of disinfection. According to the diagnosis standards of CLABSI, the incidence of CLABSI in observation group was significant lower than that in control group (x2=6.048, P<0.05). Conclusion: The disinfector of chlorhexidine gluconate can decrease the incidence of CLABSI in hemodialysis and its bacteriostatic time is longer than that of iodophor disinfectant. Therefore, this method is worthy for promotion in clinical practice.

Influência da clorexidina na resistência de união longitudinal à dentina: estudo in vitro / Influence of chlorhexidine on longitudinal bond strength to dentin: in vitro study

Objetivo: Este estudo avaliou o efeito da solução de gluconato de clorexidina 0,2% (CHX) usado como primer terapêutico sobre a resistência de união longitudinal de adesivo convencional a dentina. Material e Métodos: dentes bovinos foram desgastados para obter uma área de dentina, e foram divididos em 2 grupos: Grupo C (Controle) - ácido fosfórico à 37%) + 0,2% CHX por 30s + Single Bond. Blocos de resina composta form fabricados e armazenados por 24 h e 6 meses, seccionados e submetidos ao teste de resistência a microtração. Os resultados foram analisados por ANOVA dois-fatores seguido pelo teste de Tukey. Resultados: Valores de média (±Desvio-padrão) (MPa): Grupo CHX/24h - 41,8(±2,62)A; Grupo C/24h - 40,8(±3,35)AB; Grupo CHX/6 meses ­ 36,4(±3,52)B; Grupo CHX/6 meses - 26,1(±1,54) C. Resultados: Valores de média (±Desvio-padrão) (MPa): CHX (24 h) ­ 41,76 (±2,62)a; C (24h) ­ 40,81 (±3,35)ab; GT (24h): 37,38(2,98)abc; CHX (6 meses) ­ 36,04 (±3,52) bcd; EGCG (24h) ­ 35,91 (±4,82)cd; EGCG (6 meses) ­ 35,75 (±4,44)cd; GT (6 meses) ­ 31,95 (±3,40)de; C (6 meses): 30,05 (±1,54)e. Conclusão: CHX aumentou a resistência de união imediata da interface dentina-resina e significantemente reduziu a perda de resistência de união após 6 meses de armazenagem em água quando comparado ao grupo controle.(AU)

Objective: This study evaluated the effect of 0.2% chlorhexidine gluconate solution used as an therapeutic primer on the long-term bond strength of etch-and-rinse adhesive to dentin. Material and Methods: Bovine incisors were worn to expose an area of dentin and were divided into 2 groups: Group C (Control) - acid etching with 37% phosphoric acid + Single Bond; Group CHX (0.2% CHX) - acid etching with 37% phosphoric acid + 0.2% CHX for 30 s + Single Bond. Blocks of composite were fabricated and stored for 24 h or 6 months, sectioned into beams and submitted to microtensile tests. Results were analyzed by two-way ANOVA and Tukey tests. Results: Mean (±SD) values (in MPa) were as follow: Group CHX/24h - 41.8(±2.62)A; Group C/24h - 40.8(±3.35)AB; Group CHX/6 months ­ 36.4(±3.52)B; Group CHX/6 months - 26.1(±1.54)C. Conclusion: CHX improve the imediatte bond strength of resin-dentin and significantly lowered the loss of bond strength after 6 months water storage as seen in the control bonds.(AU)

Effect of chlorhexidine, green tea and egcg as therapeutic primers to increase the durability of resin-dentin bond / Efeito da clorexidina, do chá verde e do EGCG como primers terapêuticos para aumentar a durabilidade da adesão resinadentina

Objetivo: este estudo avaliou o efeito da solução de gluconato de clorexidina 0,2% (CHX), do chá verde e do componente ativo epigallocatequina 3-gallato (gel de EGCG) usados como primers terapêuticos sobre a resistência de união longitudinal de adesivo convencional a dentina. Material e Métodos: oitenta dentes bovinos foram desgastados para obter uma área de dentina plana, que foi condicionada (ácido fosfórico à 37%) seguida de lavagem. Os dentes foram divididos em 4 grupos (n- 20): Grupo C (Controle) - Single Bond; Grupo CHX – 0,2% CHX por 30s + Single Bond; Grupo EGCG - gel de EGCG 10µM por 30s + Single Bond; Group GT – chá verde aquoso por 30s + Single Bond. Blocos de resina composta form fabricados e armazenados por 24 h e 6 meses, seccionados e submetidos ao teste de resistência a microtração. Os resultados foram analisados por ANOVA dois-fatores seguido pelo teste de Tukey. Resultados: Valores de média (±Desvio-padrão) (MPa): CHX (24 h) – 41,76 (±2,62)a; C (24 h) – 40,81 (±3,35)ab; GT (24h): 37,38(2,98)abc; CHX (6 meses) – 36,04 (±3,52) bcd; EGCG (24h) – 35,91 (±4,82)cd; EGCG (6 meses) – 35,75 (±4,44)cd; GT (6 meses) – 31,95 (±3,40)de; C (6 meses): 30,05 (±1,54)e. Conclusão: O gel de EGCG produziu uma interface adesiva dentina-resina que não alterou os valores de resistência de união após 6 meses de armazenagem em água, mas reduziu a resistência de união para o tempo de 24 h quando comparado com os grupos Controle e CHX.

Objective: This study evaluated the effect of 0.2% chlorhexidine gluconate solution (CHX), green tea and active epigallocatechin-gallate (EGCG) used as therapeutic primers on the longterm bond strength of etch-and-rinse adhesive to dentin. Material and Methods: Eighty bovine incisors were worn to expose an area of dentin, that were acid-etched (37% phosphoric acid) and rinsed. The teeth were divided into 4 groups (n = 20): Group C (Control) - Single Bond; Group CHX - 0.2% CHX for 30s + Single Bond; Group EGCG - active EGCG gel at 10 µM for 30 s + Single Bond; Group GT - aqueous green tea for 30s + Single Bond. Blocks of composite were fabricated and stored for 24 h or 6 months, sectioned into beams and submitted to microtensile tests. Results were analyzed by two-way ANOVA and Tukey’s test (5%). Results: Mean (±SD) values (in MPa) were as follow: CHX (24 h) – 41.76 (±2.62); C (24 h) - 40.81 (±3.35); GT (24 h): 37.38(2.98); CHX (6 months) - 36.04 (±3.52); EGCG (24h) - 35.91 (±4.82); EGCG (6 months) - 35.75 (±4.44); GT (6 months) - 31.95 (±3.40); C (6 months): 30.05 (±1.54). Conclusion: EGCG produced resin-dentin bonds that did not change after 6 months water storage but it decreased the immediate bond strength when compared to control and chlorhexidine groups

Antimicrobial activity of different disinfectants against cariogenic microorganisms

Abstract The aim of this study was to assess the in vitro antimicrobial effects of chlorhexidine digluconate (CHX), polyhexamethylene biguanide (PHBM), and octenidine dihydrochloride (OCT) on cariogenic microorganisms by using their minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). CHX, PHBM, and OCT were diluted in distilled water to the final test concentrations. Using the in-tube dilution method, Streptococcus mutans, Lactobacillus acidophilus, Lactobacillus rhamnosus, and Actinomyces viscosus were cultivated on blood agar and Mueller-Hinton broth (MHB) at 37°C for 48 h. They were read using a spectrophotometer to detect MIC. To determine MBC, samples in the range of the turbidity threshold after 24 h were transferred onto blood agar and evaluated for growth after 24 h. Different MICs and MBCs were observed in all disinfectants against each microorganism. The lowest MIC and MBC against S. mutans (60 mg/L) were obtained from PHBM. The lowest values against L. rhamnosus (15 mg/L, 30 mg/L), A. viscosus (30 mg/L), and L. acidophilus (15 mg/L, 30 mg/L) were determined by OCT. PHBM and OCT have the potential to be replaced with CHX because they were effective against cariogenic microorganisms.

The efficacy of daily chlorhexidine bathing for preventing healthcare-associated infections in adult intensive care units

BACKGROUND/AIMS: Healthcare-associated infections (HAIs) in critically ill patients with prolonged length of hospital stay and increased medical costs. The aim of this study is to assess whether daily chlorhexidine gluconate (CHG) bathing will significantly reduce the rates of HAIs in adult intensive care units (ICUs). METHODS: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were systematically searched until December 31, 2014 to identify relevant studies. Two authors independently reviewed and extracted data from included studies. All data was analyzed by Review Manager version 5.3. RESULTS: Fifteen studies including three randomized controlled trials and 12 quasi-experimental studies were available in this study. The outcomes showed that daily CHG bathing were associated with significant reduction in the rates of primary outcomes: catheter-related bloodstream infection (risk ratio [RR], 0.44; 95% confidence interval [CI], 0.32 to 0.63; p < 0.00001), catheter-associated urinary tract infection (RR, 0.68; 95% CI, 0.52 to 0.88; p = 0.004), ventilator-associated pneumonia (RR, 0.73; 95% CI, 0.57 to 0.93; p = 0.01), acquisition of methicillin-resistant Staphylococcus aureus (RR, 0.78; 95% CI, 0.68 to 0.91; p = 0.001) and vancomycin-resistant Enterococcus (RR, 0.56; 95% CI, 0.31 to 0.99; p = 0.05). CONCLUSIONS: Our study suggests that the use of daily CHG bathing can significantly prevent HAIs in ICUs. However, more well-designed studies are needed to confirm these findings.

Chlorhexidine prevents surgical site infection in craniocerebral operations / 上海预防医学

Objective To investigate the effect of chlorhexidine gluconate in prevention of surgical site infection ( SSI ) . Methods Randomized controlled clinical trial method was used in the study. Comparison was made in the rates of SSI between the experiment group using 2% chlorhexidine gluconate and the control group. Results The rate of SSI in experiment group was significantly lower than that in control group (0.83% vs.5.83%, χ2 =3.23,P =0.035).Differences of hospital stay, total cost, infection in other sites and mortality rate of SSI were not statistically significant between the two groups ( P>0 .05 ) . Conclusion Preoperative head disinfection by chlorhexidine gluconate has remarkable effect in prevention of cerebral surgical site infection.

In-vitro antimicrobial effectiveness of herbal-based mouthrinses against oral microorganisms

OBJECTIVE: To evaluate the in vitro antimicrobial effectiveness of commercial herbal-based mouthrinses against oral microorganisms. METHODS: A total of three mouthrinses (OX, Pesona and Watsons) were tested for their antimicrobial activity against six oral organisms, Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Lactobacillus salivarius (L. salivarius), Staphylococcus aureus (S. aureus), Pseudomonas aeruginosa (P. aeruginosa) and Candida albicans (C. albicans) by standard agar-disk diffusion assay. Oradex mouthrinse containing 0.12% chlorhexidine gluconate and sterile distilled water was served as positive and negative controls, respectively. RESULTS: All mouthrinse formulations were effective in inhibiting the growth of S. mutans, S. sobrinus, L. salivarius and C. albicans. Among the tested mouthrinses, Pesona was the only effective mouthrinse against S. aureus and P. aeruginosa, similar to Oradex mouthrinse. Pesona mouthrinse formulation appears to be as effective as Oradex mouthrinse formulation to kill S. aureus and P. aeruginosa. Statistical analysis showed no significant difference among the tested formulations regarding their antimicrobial activities (P > 0.05). CONCLUSIONS: Pesona was not the only herbal mouthrinse effective in inhibiting the growth of S. mutans, S. sobrinus, L. salivarius and C. albicans in vitro. All tested formulations were effective against those strains. Our findings may serve as a guide for selecting a kind of herbal mouthrinses as well as providing information to the dental professionals about the efficacy of these products.

Sealing ability of white and gray mineral trioxide aggregate mixed with distilled water and 0.12% chlorhexidine gluconate as a root end filling material: An ex vivo evaluation.

Aim: The aim of this study was to evaluate the sealing ability of white and gray mineral trioxide aggregate (MTA) mixed with distilled water and 0.12% chlorhexidine (CHX) gluconate when used as a root-end filling material using the dye-penetration technique. Materials and Methods: A total of 48 single-rooted human teeth were cleaned, shaped, and obturated with gutta-percha and AH Plus sealer. The apical 3 mm of each root was resected, and 3-mm deep root-end cavity preparations were made. The teeth were randomly divided into 4 experimental groups, each containing 8 teeth, and 2 negative and positive control groups, each containing 8 teeth. Root-end cavities in the experimental groups were filled with the experimental materials. After application of nail polish, the teeth were exposed to India ink for 72 h and longitudinally sectioned, and the extent of dye penetration was measured with a stereomicroscope. Results : No statistically significant differences were observed in the sealing ability of gray and white MTA mixed with distilled water and 0.12% CHX. Conclusion : CHX appears to be a good alternative to replace distilled water, as a solution to be mixed with MTA.

Comparison of the effectiveness of 0.5% tea, 2% neem and 0.2% chlorhexidine mouthwashes on oral health: A randomized control trial.

Background: The aim of this study was to evaluate and compare the effectiveness of 0.5% tea, 2% neem, and 0.2% chlorhexidine mouthwashes on oral health. Materials and Methods: A randomized blinded controlled trial with 30 healthy human volunteers of age group 18-25 years was carried out. The subjects were randomly assigned to 3 groups i.e., group A - 0.2% chlorhexidine gluconate (bench mark control), Group B - 2% neem, and group C - 0.5% tea of 10 subjects per group. Plaque accumulation and gingival condition were recorded using plaque index and gingival index. Oral hygiene was assessed by simplified oral hygiene index (OHIS). Salivary pH was assessed by indikrom pH strips. Plaque, gingival, and simplified OHI scores as well as salivary pH were recorded at baseline, immediately after 1 st rinse, after 1 week, 2 nd week, and 3 rd week. The 3 rd week was skipped for group A. Results: Mean plaque and gingival scores were reduced over the 3 week trial period for experimental and control groups. Anti-plaque effectiveness was observed in all groups and the highest being in group C (P < 0.05). Neem and tea showed comparative effectiveness on gingiva better than chlorhexidine (P < 0.05). The salivary pH rise was sustained and significant in Group B and C compared to Group A. Oral hygiene improvement was better appreciated in Group B and Group C. Conclusion: The effectiveness of 0.5% tea was more compared to 2% neem and 0.2% chlorhexidine mouth rinse.

Evaluation of therapeutic efficacy of medical shampoo containing terbinafine hydrochloride and chlorhexidine in dogs with dermatophytosis complicated with bacterial infection / 동물의과학연구지

This study evaluated the efficacy and safety of medical shampoo containing terbinafine hydrochloride and chlorhexidine gluconate in dogs with dermatophytos is complicated with bacterial infection. Although several studies in dogs and cats with fungal dermatitis have found that oral administration of terbinafine is effective for controlling clinical signs, the topical form of terbinafine has rarely been studied in dogs and cats. Therefore, this study evaluated the efficacy of medical shampoo containing terbinafine hydrochloride and chlorhexidine gluconate in dogs with dermatophytos is complicated with bacterial infection. Eight dogs infected with Microsporum spp. complicated with bacterial infection were enrolled in this study. These dogs were further blindly divided into Group 1 (no treatment, fourdogs) and group 2 (treated with medical shampoo with terbinafine/chlorhexidine, four dogs). Clinical improvement was evaluated using bacterial and fungal cultural evaluation combined with clinical evaluation. This study found that the medical shampoo has sufficient efficacy to treat varying degrees of dermatophytosis complicated with bacterial infection in dogs, although the speed of improvement differed according to the degree and type of infection. Our study also found that combined therapy using antifungal and antibacterial agents can improve clinical signs more effectively and rapidly, suggesting that concurrent bacterial infection plays a significant role in the development of dermatitis.

Effects of 0.12% Chlorhexidine Gluconate on the Oral Hygiene of Endotracheal Intubation Patients at Intensive Care Units / 병원감염관리

BACKGROUND: This study tested the efficacy of 0.12% chlorhexidine gluconate for improving oral hygiene in intubated intensive care patients. METHODS: In a group of 57 ventilated patients, 29 received normal saline (NS) for oral hygiene, and 28 were treated with chlorhexidine gluconate (CHG). Data on oral bacterial colonization was collected for 11 months from October 2005 to August 2006. Tests of oral hygiene and oral microorganism culture were performed on the day of the ventilation, and repeated on days 4, 8, and 12. RESULTS: Oral hygiene was significantly improved in the CHG group compared to that in the NS group (P<.001). Further, all patients (100%) in the NS group tested positive for Staphylococcus aureus on the 12th day after the endotracheal intubation, whereas only 42.9% (P=0.026) of the CHG group were positive. The NS group also had higher isolation rates of Pseudomonas aeruginosa at 66.7% on the 8th day after intubation and 87.5% on the 12th day. At these same intervals, the CHG group had isolation rates of 29.4% (P=.028) and 14.3% (P=.010) respectively. CONCLUSION: The longer the period of endotracheal intubation, the more effective the 0.12% CHG treatment was for improved oral hygiene and reduction of S. aureus and P. aeruginosa colonization when compared to treatment with NS.

Efficacy of a chlorhexidine-gluconate impregnated patch for prevention of catheter-related infections in pediatric patients: systematic review and meta-analysis

Background. Nosocomial infections are risk factors related to intrahospital mortality. Among other factors, these infections are strongly associated with invasive devices. In pediatric patients, the central venous catheter (CVC) is one of the most frequently related device-associated bloodstream infections. The aim of this study was to evaluate the efficacy and safety of a chlorhexidine-gluconate impregnated patch (CHGp) in reducing infections related to CVC in pediatric patients. Methods. We conducted a systematic review and meta-analysis. An electronic search of the literature (Medline, EMBASE, Lilacs and the Cochrane Library Plus) from 1966 to December 2010 was carried out for clinical trials comparing the CHGp vs. standard case management for prevention of catheter tip colonization (CTC); bloodstream infections (BSI) were retrieved. Results. Only two clinical trials were found with a total of 850 participants. Patients randomized to the CHGp group showed a lower incidence of CTC than the control group (14% vs. 25%), relative risk [RR]: 0.61, 95% confidence interval [CI 95% (0.45, 0.81)], p = 0.001), with a number needed to treat of 11. BSI showed a RR: 1.14, ([CI 95% (0.57, 2.28)], p = 0.71). Adverse events were found mainly in the CHGp group and were described as local skin reactions in 5.6% (RR 8.17 [95% CI: 1.19-56.14], p = 0.04). Local necrosis was present in only two infants of very low birth weight (0.48%). Conclusions. This meta-analysis demonstrated that the chlorhexidine-gluconate impregnated patch is effective in reducing CVC-related infections in the pediatric population. Serious adverse events are rare.

Chitosan-based polyherbal toothpaste: As novel oral hygiene product.

Objective: The objective of the present work was to develop chitosan-based polyherbal toothpaste and evaluate its plaque-reducing potential and efficacy in reduction of dental pathogens. Materials and Methods: Antimicrobial activity of herbal extracts against dental pathogens were performed by using disk diffusion method. The pharmaceutical evaluation of toothpaste was carried out as per the US Government Tooth Paste Specifications. A 4-week clinical study was conducted in patients with oro-dental problems to evaluate the plaque removing efficacy of chitosan-based polyherbal toothpaste with commercially available chlorhexidine gluconate (0.2% w/v) mouthwash as positive control. Total microbial count was carried out to determine the percentage decrease in the oral bacterial count over the period of treatment. Result: Herbal extracts were found to possess satisfactory antimicrobial activity against most of the dental pathogens. Chitosan-containing polyherbal toothpaste significantly reduces the plaque index by 70.47% and bacterial count by 85.29%, and thus fulfills the majority of esthetic and medicinal requirements of oral hygiene products. Conclusion: Chitosan-based polyherbal toothpaste proves itself as a promising novel oral hygiene product as compared with currently available oral hygiene products. A further study to confirm the exact mechanism and active constituents behind antiplaque and antimicrobial activity of chitosan-based polyherbal toothpaste and its efficacy in large number of patient population is on high demand.

Investigation of bacteremia after toothbrushing in orthodontic patients / 대한치과교정학회지

OBJECTIVE: The aim of this study was to investigate the occurrence rate of bacteremia following toothbrushing with toothpastes composed of several antibacterial agents and compare the results with the conventional oral hygiene maintaining methods in orthodontic patients. METHODS: This clinical study included 100 adult orthodontic patients who were divided into 4 groups. Each group comprised of 25 patients, wearing fixed orthodontic appliances. In the first group, bacteremia was assessed after toothbrushing without using any toothpaste. In the second group, a 0.2% chlorhexidine gluconate mouthrinse was used before brushing with no toothpaste. In the third group, subjects brushed with a commonly used toothpaste which did not include an additional antimicrobial agent. The fourth experimental group used toothpaste which included tea tree oil, clove oil, peppermint oil and bisabolol as antimicrobial elements. Pre- and post-brushing blood samples were obtained using a strict aseptic technique. All samples were microbiologically evaluated using blood culture bottles. RESULTS: Toothbrushing in orthodontic patients yielded to an increase in the occurrence rate of bacteremia when using normal toothpaste or no toothpaste at all. CONCLUSIONS: The use of chlorhexidine mouthwash before toothbrushing, and brushing with antimicrobial toothpaste did not show a statistically significant difference in preventing the occurrence of bacteremia (p > 0.05).