Effects of hydrogen peroxide mouthwash on preventing ventilator-associated pneumonia in patients admitted to the intensive care unit

Abstract Aims The aim of the study was to determine the effect of hydrogen peroxide (HP) mouthwash on the incidence of ventilator associated pneumonia (VAP) in patients admitted to the intensive care unit (ICU). Methods This was a randomized clinical trial conducted on 68 patients. The intervention group used 3% HP as mouthwash and the control group used mouthwashes with 0.9% normal saline (NS) twice a day. Data were collected using a questionnaire and the Modified Clinical Pulmonary Infection Score (MCPIS). MCPIS includes five items, body temperature: white blood cell count, pulmonary secretions, the ratio of pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FiO2), and the chest X-ray. Each of these items scored 0–2. Scores ≥6 were considered as VAP signs. The SPSS-20 software was employed to analyze the data. Results In total, 14.7% patients of the HP group and 38.2% patients of the NS group contracted VAP. The risk of VAP in the NS group was 2.60 times greater than that in the HP group (RR = 2.60, 95% CI: 1.04–6.49, p = 0.0279). The mean ± SD MCPIS was calculated as 3.91 ± 1.35 in the HP group and 4.65 ± 1.55 in the NS group, a difference statistically significant (p = 0.042). There were no significant differences in the risk factors for VAP between the two groups. Conclusion HP mouthwash was found more effective than NS in reducing VAP. HP mouthwash can therefore be used in routine nursing care for reducing VAP.

Effects of hydrogen peroxide mouthwash on preventing ventilator-associated pneumonia in patients admitted to the intensive care unit.

AIMS: The aim of the study was to determine the effect of hydrogen peroxide (HP) mouthwash on the incidence of ventilator associated pneumonia (VAP) in patients admitted to the intensive care unit (ICU). METHODS: This was a randomized clinical trial conducted on 68 patients. The intervention group used 3% HP as mouthwash and the control group used mouthwashes with 0.9% normal saline (NS) twice a day. Data were collected using a questionnaire and the Modified Clinical Pulmonary Infection Score (MCPIS). MCPIS includes five items, body temperature: white blood cell count, pulmonary secretions, the ratio of pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FiO2), and the chest X-ray. Each of these items scored 0-2. Scores ≥6 were considered as VAP signs. The SPSS-20 software was employed to analyze the data. RESULTS: In total, 14.7% patients of the HP group and 38.2% patients of the NS group contracted VAP. The risk of VAP in the NS group was 2.60 times greater than that in the HP group (RR=2.60, 95% CI: 1.04-6.49, p=0.0279). The mean±SD MCPIS was calculated as 3.91±1.35 in the HP group and 4.65±1.55 in the NS group, a difference statistically significant (p=0.042). There were no significant differences in the risk factors for VAP between the two groups. CONCLUSION: HP mouthwash was found more effective than NS in reducing VAP. HP mouthwash can therefore be used in routine nursing care for reducing VAP.

Enhancement of immune responses against Iranian isolate of FMD-type O/IRN/1/2010 based on VP1 and human HSP70 genes and comparison with conventional vaccine

Background: Foot and mouth disease (FMD) is the causative agent and one of the most transmissible livestock diseaseswhich cause important economic losses. The genome of FMD virus is a positive-sense, single-stranded RNA and it wrappedwith 60 copies of 4 structural proteins, VP1, VP2, VP3 and VP4. The VP1 is a major immunogenic antigen with criticalepitopes for inducing immune responses. The current vaccine, which successfully prevents disease, includes inactivatedwhole virus antigen. However, it is not without problems. The aim of this study is enhancement of immune responsesagainst Iranian isolate of FMD-type O/IRN/1/2010 based on VP1 and human HSP70 fusion protein in BALB/c mice.Materials, Methods & Results: In this study FMD virus type O/IRN/2010 was isolated from vesicles of the infected cattlein Qoum, and serotyped as a new linage of type O (PanAsia-linage 2) in Iran. The isolated FMD virus was propagated onIBRS2 cell line and whole RNA of the infected cells was extracted by commercial kit instruction. The extracted RNA wasamplifi ed using VP1 gene-specifi c primer pairs by means of one-step RT-PCR. The specifi c primer pair was designed byAllelID6 software. There are sequences of Kpn I and BamH I restriction enzymes and three overhanging nucleotides atthe start of forward and reverse primers, respectively. The VP1 nucleotide sequence was deposit in Genbank-NCBI database under accession number JN 676146. The purifi ed VP1 gene was sub-cloned into PTZ57R/T vector. Then digestedVP1 gene by KpnI and BamHI enzymes was ligated in pcDNA3.1+ vector as a DNA vaccine. Also, the improved DNAimmunization system was constructed using pcDNA3.1+ plasmid contains VP1 gene of Iranian isolate FMD virus typeO/IRN/1/2010 and human HSP70 gene and expression of VP1-HSP70 fusion protein confi rmed in BHKT7 cell line byGuinea pig specifi c polyclonal antibody against FMD virus type O and conjugated rabbit...

Enhancement of immune responses against Iranian isolate of FMD-type O/IRN/1/2010 based on VP1 and human HSP70 genes and comparison with conventional vaccine

Background: Foot and mouth disease (FMD) is the causative agent and one of the most transmissible livestock diseaseswhich cause important economic losses. The genome of FMD virus is a positive-sense, single-stranded RNA and it wrappedwith 60 copies of 4 structural proteins, VP1, VP2, VP3 and VP4. The VP1 is a major immunogenic antigen with criticalepitopes for inducing immune responses. The current vaccine, which successfully prevents disease, includes inactivatedwhole virus antigen. However, it is not without problems. The aim of this study is enhancement of immune responsesagainst Iranian isolate of FMD-type O/IRN/1/2010 based on VP1 and human HSP70 fusion protein in BALB/c mice.Materials, Methods & Results: In this study FMD virus type O/IRN/2010 was isolated from vesicles of the infected cattlein Qoum, and serotyped as a new linage of type O (PanAsia-linage 2) in Iran. The isolated FMD virus was propagated onIBRS2 cell line and whole RNA of the infected cells was extracted by commercial kit instruction. The extracted RNA wasamplifi ed using VP1 gene-specifi c primer pairs by means of one-step RT-PCR. The specifi c primer pair was designed byAllelID6 software. There are sequences of Kpn I and BamH I restriction enzymes and three overhanging nucleotides atthe start of forward and reverse primers, respectively. The VP1 nucleotide sequence was deposit in Genbank-NCBI database under accession number JN 676146. The purifi ed VP1 gene was sub-cloned into PTZ57R/T vector. Then digestedVP1 gene by KpnI and BamHI enzymes was ligated in pcDNA3.1+ vector as a DNA vaccine. Also, the improved DNAimmunization system was constructed using pcDNA3.1+ plasmid contains VP1 gene of Iranian isolate FMD virus typeO/IRN/1/2010 and human HSP70 gene and expression of VP1-HSP70 fusion protein confi rmed in BHKT7 cell line byGuinea pig specifi c polyclonal antibody against FMD virus type O and conjugated rabbit...(AU)