ABSTRACT
Maintenance of the quality and hygiene of maxillofacial prosthesis allows to maintain the health of the residual tissues. Sampling of the maxillofacial prostheses has relieved presence of microbial colonization on silicone surfaces. Cleaning procedures of maxillofacial silicones are done using mechanical means or using adjunctive with chemical means. Cleaning with a 2-4% chlorhexidine gluconate spray or dipping in solution for a minute and then washing under running water can sufficiently condition to reduce the amount of bacterial contamination. Due to rising microorganism resistance and fewer adverse effects, phytoextracts appear to be a viable option. Additionally, the use of excipients derived from plants is provides new opportunities for the pharmaceutical industry into the creation of innovative pharmaceutical products that are sustainable. Aim: To evaluate and compare the leaf extracts of Mangifera indica (M.indica), Anacardium occidentale(A.occidentale) and 0.2% chlorhexidine gluconate (CHX) on disinfection of maxillofacial silicone material surface contaminated with Staphylococcus aureus (S.aureus) and Candida albicans (C.albicans). Methods: Of the 150 maxillofacial silicone elastomer silicone samples, 75 samples were contaminated with S. aureus and 75 with C.albicans. The contaminated disc was rolled on blood agar and pre-disinfection Colony Forming Units (CFU) were evaluated followed by subjecting the discs to disinfection protocols. The contaminated discs with S. aureus and C.albicans were disinfected using M.indica leaf extracts, A.occidentale leaf extracts and 0.2% CHX for 10 min. Post-disinfection CFUs were evaluated by rolling the disc on blood agar. The results were tabulated and analysed using dependent t-test, one-way ANOVA and Tukeys multiple posthoc procedure. Results: Pair-wise comparison of pre-and post-disinfection log CFU counts of S.aureus gave a statistical significance between 0.2% CHX and and M.indica leaf extract. No statistically significant results were found between 0.2% CHX and A.occidentale. Pair wise comparison of the log CFU from pre-disinfection to post-disinfection of C.albicans gave a statistical significance between all the three groups. Conclusions: In the present study A.occidentale leaf extract and M.indica leaf extract have shown significant reduction in CFU of both the organisms. 0.2% CHX showed the most CFU reduction post disinfection of maxillofacial silicone material surface contaminated S.aureus and C.albicans followed by A.occidentale leaf extracts and M.indica leaf extracts. Given the limitations of the current research, A.occidentale leaf extract and M.indica leaf extract can be used as an alternative for disinfection of maxillofacial silicone prosthesis.
ABSTRACT
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common complication of ventilatory support for patients with acute respiratory failure and is associated with increased morbidity and mortality. AIM OF THE STUDY: The present study was undertaken to do quantitative cultures of aerobic bacteria, perform the antibiotic susceptibility testing from the endotracheal aspirates and clinical outcome of the clinically suspected patients of VAP. METHODS: A prospective study was performed over a period of one year in a tertiary care hospital, enrolling patients on mechanical ventilation (MV) for ≥48 hr. Endotracheal aspirates (ETA) were collected from patients with suspected VAP, and direct gram's stain criteria was used to accept the sample. Quantitative cultures of ETA were performed with the threshold for microbiological diagnosis of VAP was taken as ≥10(5) colony forming units (cfu)/ml. RESULTS: Out of 53 cases, 2 (3.77%) were polymicrobial. Multidrug resistant bacteria, mainly Acinetobacter baumannii 49.09% (27/55) and Pseudomonas aeruginosa 30.91% (17/55) were the most common pathogens isolated. Metallo-beta lactamases (MBLs) was produced by 47.06% (8/17) of Pseudomonas aeruginosa and 62.96% (17/27) of Acinetobacter baumannii. CONCLUSION: The bacteriological approach for the management of VAP helps the clinicians in choosing the appropriate antibiotics. This study showed that quantitative cultures of endotracheal aspirate at a cutoff point of 10(5) cfu/ml is one of the alternative to bronchoscopy in the diagnosis of clinically suspected ventilator associated pneumonia.
