Safety alert for hospital environments and health professional: chlorhexidine is ineffective for coronavirus

SUMMARY An alarming fact was revealed by recent publications concerning disinfectants: chlorhexidine digluconate is ineffective for disinfecting surfaces contaminated by the new coronavirus. This is a finding that requires immediate disclosure since this substance is widely used for the disinfection of hands and forearms of surgeons and auxiliaries and in the antisepsis of patients in minimally invasive procedures commonly performed in hospital environments. The objective of this study is to compare the different disinfectants used for disinfection on several surfaces, in a review of worldwide works. Scientific studies were researched in the BVS (Virtual Health Library), PubMed, Medline, and ANVISA (National Health Surveillance Agency) databases. The following agents were studied: alcohol 62-71%, hydrogen peroxide 0.5%, sodium hypochlorite 0.1%, benzalkonium chloride 0.05-0.2%, povidone-iodine 10%, and chlorhexidine digluconate 0.02%, on metal, aluminum, wood, paper, glass, plastic, PVC, silicone, latex (gloves), disposable gowns, ceramic, and Teflon surfaces. Studies have shown that chlorhexidine digluconate is ineffective for inactivating some coronavirus subtypes, suggesting that it is also ineffective to the new coronavirus.

RESUMO Um dado alarmante revelado por publicações a respeito dos agentes desinfetantes: o digluconato de clorexidina é ineficaz para desinfecção de superfícies contaminadas por coronavírus. Trata-se de uma constatação que reclama imediata divulgação, uma vez que essa substância é amplamente usada para degermação de mãos e antebraços dos cirurgiões e auxiliares e na antissepsia dos pacientes, em procedimentos minimamente invasivos, comumente em ambientes hospitalares. O objetivo deste trabalho foi comparar os diferentes desinfetantes usados para desinfecção em diversas superfícies em revisão de trabalhos mundiais. Foram pesquisados trabalhos científicos na BVS (Biblioteca Virtual de Saúde), PubMed, Medline e Anvisa (Agência Nacional de Vigilância Sanitária). Foram estudados os seguintes agentes: álcool 62-71%, peróxido de hidrogênio 0,5%, hipoclorito de sódio 0,1%, cloreto de benzancônio 0,05-0,2%, iodo povidina 10% e digluconato de clorexidina 0,02%, em superfícies de metal, alumínio, madeira, papel, vidro, plástico, PVC, silicone, látex (luvas), avental descartável, cerâmica e teflon. Os estudos demonstraram que o digluconato de clorexidina é ineficaz para a inativação de alguns subtipos de coronavírus, sugerindo que também seja ineficaz contra o novo coronavírus.

The family's role as a support network for people living with HIV/AIDS: a review of Brazilian research into the theme / A família como rede de apoio às pessoas que vivem com HIV/AIDS: uma revisão na literatura brasileira

The study of HIV transmission and the implementation of AIDS prevention actions recognize the importance of social networks in the transmission of the disease, the adherence to treatment and the quality of life of those infected. For this relevance there was a review of articles on social support networks to people living with HIV /AIDS available in the Virtual Health Library (VHL) were published in Brazil between 2002 and 2012. In this study 31 articles were used from journals covering the following áreas: Nursing (n = 15), Psychology (n = 6) and Science Health / Biomedica (n = 6), were included, which some principal authors were affiliated to higher education public institutions (n = 17). In relation to the methodology used, priority wasgiven to conducting: qualitative research (n = 18), cross-sectional studies (n = 19) and studies that involved talking to people living with HIV/AIDS (n = 13). Particular importance was placed on analytic categories related to: adherence to treatment (n = 6), the family (n = 4), vulnerability (n = 3) and support from social networks (n = 5). Within this paper we argue for more investments into studies that focus on the family, carers and their households, as well as deepening the theoretical study of the themes discussed and the use of developed theories for the analysis of Social Networks.

O estudo da transmissão do HIV e a implementação de ações de prevenção da AIDS reconhece a importância das redes sociais na contaminação, adesão ao tratamento e qualidade de vida das pessoas infectadas. Por tal relevância, realizou-se uma revisão de artigos sobre redes sociais de apoio às pessoas que vivem com HIV/ AIDS, disponíveis na Biblioteca Virtual em Saúde (BVS) e publicados no Brasil no período de 2002 a 2012. Encontraram-se 31 artigos em revistas de Enfermagem (n = 15), Psicologia (n = 6) e Ciências da Saúde/Biomédicas (n = 6), produzidos por primeiros autores associados a Instituições de Ensino Superior públicas (n = 17). Quanto à metodologia, priorizou-se o método qualitativo (n = 18), estudos transversais (n = 19) e a participação exclusiva de pessoas que vivem com HIV/AIDS (n = 13). Houve predomínio de categorias analíticas relacionadas à adesão ao tratamento (n = 6), família (n = 4), vulnerabilidade (n = 3) e apoio/suporte social/ rede de apoio (n = 5). Discute-se a necessidade de investimento em estudos que privilegiem familiares e cuidadores como participantes e seus domicílios como lócus de investigação, bem como maior aprofundamento teórico nos estudos das temáticas abordadas e utilização de teorias desenvolvidas para análise de Redes Sociais.

[Comparison of efficacy of hand washing with betadin and sterillium on bacterial colony count in intensive care unit personnel]

Nosocomial infections are common with known complications and high mortality and morbidity rate. There are several efficient and quick-acting antiseptic alcohol solutions such as Sterillium that require no scrubbing. The aim of this study was to compare the efficacy of betadin and Sterillium hand rubs for hand disinfection in a before-after trial according to prEN12054 prEN 1500. We compared Betadin and Sterillium hand rubbing for hand disinfection in a before-after study. The study was done with 72 healthy ICU staff, whose hand microbial flora were measured before and after 30 seconds hands washing with Betadin and Sterillium. Sampling was achieved according to the stratified randomization. Samples cultured on BA and EMB media and the frequency of microorganisms and the efficacy of two agents were determined. Then we compared results of Betadin and Sterillium by using Chi square and Fisher's Exact and McNemar tests. The most frequent pathogens were staph epidermidis [32], aerobacter aerogenosa [4], staph saprofiticus [3], pseudomonas [1], klebsiella [1], acintobacter [1], and E.coli [1]. The percentage of organism reduction following the usage of antibacterial agents was 94% for betadin and 87% for Sterillium [P = 0.8]. This reduction was significant statistically. We did not find significant difference about sex, ward, shift and job before and after washing with regard to Betadin, but in Sterillum we found significant difference[P = 0.04] only after rubbing. The rate of negative culture about Betadin was more than Sterillium but was not statistically significant. Since skin is a routine source of infections transmission, and with respect to the satisfactory results, we advise the usage of this agent for ICU staff for hand disinfection

[ effect of duration of disinfection on bacterial flora of surgical site]

Skin disinfection is an effective method of preventing surgical site infection [SSI], but there is controversy about the duration of skin preparation. Therefore this study was conducted to determine the effect of duration of skin preparation on skin microbial flora in orthopedic patients admitted to Hamadan Mobasher hospital. This randomized clinical trial study was performed on 46 patients that underwent orthopedic surgery. For data collection, a checklist was used and microbial culture results also were considered. Four skin cultures were obtained, the first sample was collected before skin preparation and the others were collected 2, 5 and 10 minutes after beginning of skin preparation, respectively, from surgical site. Samples were examined for total colony forming units [CFU] and king of aerobic bacterial flora. The findings showed a statistically significant relationship between mean skin bacterial CFU and duration of skin preparation [P<0.01], except for comparison between the fifth and tenth minute skin preparation [P= 0.057]. Exact binomial test showed there was statistically significant decrease in the kind of skin bacterial flora with increasing in duration of skin preparation [P<0.05], but there was no growth for diphtheroid in the fifth minute and for other bacteria, in the tenth minute. According to the findings, it is enough to disinfect surgical site with 7.5% providon iodine for 5 minutes to diminish skin bacterial count in surgical patient

Persistence of antimicrobial effect of antiseptics in surgical hand hygiene regimens.

OBJECTIVES: To determine the persistence of antimicrobial effect of antiseptic solutions used in surgical hand hygiene procedure, and the in-house preparation was compared to the commercial solution for its efficacy. MATERIAL AND METHOD: The present study was performed in a 150-bed hospital involving 19 staff from general, orthopedics, KUB, and OB-GYN surgical teams in 48 operations. The antimicrobial effects from 4 different solutions were determined and compared. RESULTS: The study showed that the commercial alcohol-based antiseptic solution was equally or more effective than long-time accepted povidone-iodine or chlorhexidine gluconate solutions and had better persistent effect. The in-house preparation was effective comparable to the commercial solution. CONCLUSION: The commercial alcohol-based antiseptic solution had better persistence of antimicrobial effects compared to the in-house alcohol-based hand rub, povidone iodine and chlorhexidine gluconate.

Antifungal activity of three mouth rinses--in vitro study.

Mouthrinses are nowadays routinely included in the home care oral hygiene maintenance besides dentifrice/tooth paste. Mouthrinses prevent bacterial attachment and prevent or slow down bacterial proliferation. Fungal organisms have now gained more importance due to increased incidence of AIDS/HIV. This has necessitated for mouthrinses to possess antifungal activity also. The mouthrinses used were Povidone iodine ( Wokadine), Thymol with Eucalyptol and Benzoic acid (Listerine) and fluoride with Triclosan (Colgate Plax), which were tested against oral isolates of different species of Candida. The agar diffusion test was used to evaluate the inhibitory activity of the mouthrinses and all of them exhibited antifungal activity especially against Candida albicans.

A study to evaluate the antimicrobial activity of feracrylum and its comparison with povidone-iodine.

Feracrylum, a water-soluble polymer of polyacrylic acid is known for its hemostatic property. Present work is an effort to evaluate its minimum inhibitory concentration (MIC) and compare it with the MIC of povidone-iodine. Ten different species of pathogenic microorganisms were selected, strains of which were obtained from Haffkine Institute. The organisms were maintained under appropriate culture media. The MIC of Freracrylum was determined by using tube culture method where its activity was compared against a standard antimicrobial agent providone-iodine. The study parameters showed that Feracrylum exhibits antimicrobial activity against a wide variety of microorganisms and its efficacy is comparable to that of povidone-iodine.

Avaliaçäo do tempo de escovaçäo na antissepsia pré-operatória das mäos e antebraços das equipes cirúrgicas / Evaluation of time of scrubbing in the pre-operative antisepsis of hands and forearms of surgical teams

No presente estudo, os autores avaliaram o efeito do tempo de escovaçäo na preparaçäo das equipes cirúrgicas. Para tanto, foram incluídos 85 membros de equipes cirúrgicas em 48 atos operatórios realizados no Hospital Universitário de Santa Maria (HUSM). Foi coletado material da mäo e antebraço de cada participante e incubado em meio de cultura, tioglicolato (DIFICO). Concluiu-se que houve melhor eficácia com o aumento do tempo de escovaçäo. A melhor performance foi observada no grupo que escovou por mais de 5 minutos, quando comparado com aquele que escovou entre 1 e 3 minutos e 3 e 5 minutos

Diseño de una formulación yodo-povidona solución / Design of a formulation of povidone-iodine solution

Se trabajó en el diseño de una formulaciòn líquida de yodo-povidona, para uso tópico, con una concentración del 10% del yodóforo, de manera que suministrara alrededor del 1% del yodo disponible. Se estudiaron, además del comportamiento tecnológico en el tiempo, las propiedades tensoactivas de la solución, así como su caracterìsticas de flujo. Farmacològicamente se evaluaron su acción irritante y la actividad bactericida in vivo e in vitro de la misma. De esta forma se logró la obtención de un producto terminado cuya fórmula y técnica de preparación brindan una solución física, química y microbiológicamente estable y que ofrece una acción terapéutica efectiva comprobada, pudiendo ser reprocida a mayores volúmenes

A model for testing antiseptic efficacy: a preliminary study on Betadine and Germidine.

Efficacy of povidone iodine antiseptic, betadine and germidine, was tested against normal skin flora and four pathogenic bacteria namely S. aureus, S. epidermidis, E. coli and Pseudomonas aeruginosa by a new model. The study was performed on the volar surface of forearms of ten patients. First of all, the skin flora was cultured then 10(8) cu/ml of the tested organisms was applied by a cotton swab and left to dry for 1 minute before the culture was repeated. Betadine or germidine was applied over the area previously painted with the organism. The culture was taken 1 to 2 minutes thereafter. The results showed that this model was feasible and convenient. Betadine and germidine are efficacious against normal skin flora and pathogenic bacteria.

Ensayo de una solución de iodopolivinilpirrolidona para la antisepsia de las manos de los cirujanos / Assay with a polyvinylpyrrolidone iodine solution for antisepsis of surgeons' hands

Se realizó un ensayo para comprobar la utilidad de una solución de iodopolivinilpirrolidona con un detergente como agente antiséptico para el lavado de las manos del personal quirúrgico. Para ello se tomó un grupo de control de 84 cirujanos y auxiliares que emplearon el lavado con jabón de tocador durante 10 minutos, seguido del enjuague con alcohol iodado, y dos grupos experimentales de 42 sujetos cada uno que utilizaron la solución objeto de estudio durante 5 y 10 minutos respectivamente. La selección del método a emplear en cada caso se hizo aleatoriamente. El producto ensayado no elimina las bacterias en todos los casos, pero su empleo durante 10 minutos tiene mayor probabilidad de suprimir o evitar la contaminación bacteriana que con los otros dos métodos incluidos en el ensayo