BACKGROUND AND OBJECTIVE

The human nasal passages host major human pathogens. Recent research suggests that the microbial communities inhabiting the epithelial surfaces of the nasal passages play a key factor in maintaining a healthy microenvironment by affecting both resistance to pathogens and immunological responses. Colonization of the nasal cavity by different pathogens such as Staphylococcus aureus and Klebsiella aerogenes, is associated with a higher postoperative infection morbidity. Povidone-iodine (PVP-I) as an antiseptic has been proven to display high antibacterial, antiviral, and antifungal properties even at low concentrations, and was shown to be effective in the control of infections to limit their impact and spread. It can be used as a topical antiseptic for skin decontamination and wound management, as a nasal spray, or as a gargle. There are different methods in testing the efficacy of potential antimicrobial suspensions. This study aimed to determine the concentration of PVP-I that is most effective in nasal decolonization using microsuspension test and colorimetric minimum inhibitory concentration (MIC) determination assays, resazurin microtiter assay (REMA), and Dey-Engley (D/E) neutralizer assay. The findings of this study will contribute to knowledge regarding the intended use of PVP-I in microbial control, particularly in bacterial infections.

METHODS

Several dilutions (2.0%, 1.0%, 0.5%, 0.25%, 0.1% and 0.09%) of commercially bought 10% (10 mg per 100 ml) povidone-iodine were prepared and tested against a standardized inoculum (1x105) of Staphylococcus aureus and Klebsiella aerogenes at different contacttimes (5 seconds, 10 seconds, 30 seconds, 1 minute, and 5 minutes). Microdilution suspension test was performed to determine the log reduction per variable, while REMA and D/E neutralizer assay were used to determine the MIC. A value of greater than or equal to 5 log reduction was considered effective for microdilution suspension test. Estimates of agreement statistics were used to interpret the results of the assay in which the overall percent agreement (OPA), positive percent agreement (PPA), negative percent agreement (NPA), and Cohen’s kappa statistics were calculated.

RESULTS

Povidone-iodine concentration of 0.25% exhibited ?5 log reduction against K. aerogenes at the minimum contact time of 5 seconds. On the other hand,  a slightly higher PVP-I concentration was required to achieve ?5 log reduction for S. aureus at 0.5% concentration and a minimum contact time of 1 minute. There was an observed concordance of the results of REMA and D/E neutralizer as MIC colorimetric indicators, which yielded an overall test percent agreement of 90.30% (95% CI: 84.73–94.36), and a strong level of agreement (? = 0.8, pCONCLUSION

Low povidone-iodine concentrations (i.e., 0.5% against S. aureus and 0.25% against K. aerogenes) were observed to have bactericidal activity of at least 5 log reduction as rapid as the minimum contact time of 5 seconds. Furthermore, D/E and REMA, as colorimetric indicators, had comparable performance (OPA = 90.30%; ? = 0.8, p
Human ; Bacteria ; Povidone-iodine ; Microbial Sensitivity Tests ; Anti-infective Agents, Local ; Enterobacter Aerogenes ; Staphylococcus Aureus

During the recent emergence of COVID-19, an increased practice of hand hygiene coincided with the reduced incidence of the norovirus epidemic in Japan, which is similar to experience with the pandemic flu in 2009. We investigated the relationship between the sales of hand hygiene products, including liquid hand soap and alcohol-based hand sanitizer, and the trend of norovirus epidemic. We used national gastroenteritis surveillance data across Japan in 2020 and 2021 and compared the base statistics of incidence of these two years with the average of the previous 10 years (2010-2019). We calculated the correlations (Spearman's Rho) between monthly sales of hand hygiene products and monthly norovirus cases and fitted them to a regression model. In 2020, there was no epidemic, and the incidence peak was the lowest in recent norovirus epidemics. In 2021, the incidence peak was delayed for five weeks to the usual epidemic seasons. Correlation coefficients between monthly sales of liquid hand soap and skin antiseptics and norovirus incidence showed a significantly negative correlation (Spearman's Rho = -0.88 and p = 0.002 for liquid hand soap; Spearman's Rho = -0.81 and p = 0.007 for skin antiseptics). Exponential regression models were fitted between the sales of each hand hygiene product and norovirus cases, respectively. The results suggest hand hygiene using these products is a potentially useful prevention method against norovirus epidemics. Effective ways of hand hygiene for increasing the prevention of norovirus should therefore be studied.
Humans ; Japan/epidemiology* ; COVID-19 ; Hand Hygiene ; Soaps ; Anti-Infective Agents, Local ; Norovirus

Inflatable penile prostheses are an important tool in the treatment of medically refractory erectile dysfunction. One of the major complications associated with these prostheses is infections, which ultimately require device explanation and placement of a new device. Over the past several decades, significant work has been done to reduce infection rates and optimize treatment strategies to reduce patient morbidity. This article reviews the current state of knowledge surrounding penile prosthesis infections, with attention to the evidence for methods to prevent infection and best practices for device reimplantation.
Anti-Bacterial Agents/therapeutic use* ; Anti-Infective Agents, Local/therapeutic use* ; Antibiotic Prophylaxis/methods* ; Bandages ; Carrier State/drug therapy* ; Chlorhexidine/therapeutic use* ; Coated Materials, Biocompatible ; Device Removal ; Diabetes Mellitus/epidemiology* ; Erectile Dysfunction/surgery* ; Gram-Negative Bacterial Infections/therapy* ; Hair Removal/methods* ; Humans ; Immunocompromised Host/immunology* ; Male ; Penile Implantation/methods* ; Penile Prosthesis ; Preoperative Care/methods* ; Prosthesis-Related Infections/therapy* ; Reoperation ; Risk Factors ; Spinal Cord Injuries/epidemiology* ; Staphylococcal Infections/therapy* ; Staphylococcus aureus ; Staphylococcus epidermidis ; Surgical Drapes ; Surgical Instruments ; Surgical Wound Infection/therapy*

Background: Extracts from several citrus plants have antimicrobial properties and have been used for certain infectious skin conditions. Objective: To compare the efficacy of 12.5% pomelo peel ointment and 2% mupirocin ointment in the management of localized impetigo contagiosa. Design: Randomized, double-blind, controlled trial. Setting: Dermatology Outpatient Clinic in Southern Philippines Medical Center, Davao City, from September 2012 to November 2012. Participants: 46 male and female patients, aged 2-15 years old, and clinically diagnosed with localized impetigo contagiosa. Interventions : Participants were randomized to receive either 12.5% pomelo peel ointment (PPO) or 2% mupirocin ointment (MO), thinly applied on impetigo lesions twice daily for 7 days. Main outcome measures: Clinical success defined as either ‘complete resolution of lesions’ or ‘dryness of the lesions without crusts, with intact skin, and with no to minimal local erythema’ at any time within 7 days from the start of intervention. Main results: The 23 patients in 12.5% PPO group had similar baseline demographic and clinical characteristics as the 23 patients in the 2% MO group. Within 7 days from the start of intervention, 15 of the 23 patients (65.22%) in the PPO group and 19 of the 23 patients (82.61%) in the MO group had clinical success (p=0.1792). Conclusion Pomelo peel ointment is as efficacious as mupirocin ointment in the management of localized impetigo contagiosa.
Anti-Infective Agents, Local ; Citrus ; Staphylococcus aureus

Topical anesthetics are commonly used in oral & maxillofacial surgery to control pain in the oral cavity mucosa before local anesthetic injection. These anesthetic agents come in many forms, developed for different usages, to minimize adverse reactions, and for optimal anesthetic efficiency. Earlier studies have revealed that these agents may also limit the growth of microorganisms in the area of anesthetic application. Many topical anesthetic agents show different levels of antimicrobial activity against various bacterial strains and Candida. The dosage of local anesthetic agent used in some clinical preparations is too low to show a significant effect on microbial activity. Efficiency of antimicrobial activity depends on the local anesthetic agent's properties of diffusion within the bloodstream and binding efficiency with cytoplasmic membrane, which is followed by disruption of the bacterial cell membrane. The antimicrobial properties of these agents may extend their usage in patients to both control pain and infection. To develop the topical local anesthetic optimal usage and antimicrobial effect, a collaborating antiseptic agent may be used to benefit the local anesthetic. However, more research is required regarding minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of topical local anesthetic agents with drug interaction between anesthetics and antiseptic agents.
Anesthetics ; Anesthetics, Local ; Anti-Infective Agents ; Candida ; Cell Membrane ; Dentistry ; Diffusion ; Drug Interactions ; Humans ; Microbial Sensitivity Tests ; Mouth ; Mucous Membrane ; Surgery, Oral

PURPOSE: It is well known the advantages of scalp donor split thickness skin graft(STSG) in deep burn wound because of its scarless donor healing, and good color match in face. Inspite of the advantages of scalp as a skin donor site during split thickness skin graft some authors report the frequent postoperative folliculitis, and partial alopecia on scalp donor site. We had experienced 21 burn patients, who had full thickness skin defects caused by burn injuries, were successfully managed with scalp donor split thickness skin graft with our optimal donor management protocols. METHODS: We had 21 deep burn patients, who were managed with thin STSG from scalp donor for coverage of full thickness skin defects. The operative techniques of the harvesting scalp STSG, and scalp donor dressing care are such as followings. After the infiltration of the donor scalp area with 1:1,000,000 epinephrine diluted with saline, then usually 0.012~0.015 inch thickness skin were harvested with air driven Zimmer® dermatome. On postoperative 6days, the one layer of adhered Vaseline gauze at donor scalp site was manually removed, and the entire scalp was cleansed with water. After then the daily hair washing was continued to remove the desiccated scaly crust with thick exudate at the growing hair and follicle. RESULTS: The scalp split thickness skin graft at the recipient sites in 21 burn patients were survived completely. Ranges of patient's age were 8 months to 56. The size ranges of scalp STSG were 2×2 cm~12×15 cm. The grafted scalp donor STSG were survived in all cases. The mean epithelialization period of scalp donor was 7.2 days. The one case of transient folliculitis (5%) from the postoperative 8days was occurred, and it was disappeared slowly with vigorous daily hair washing, antiseptics and systemic antibiotics. In all cases, there was no micro-alopecia or alopecia, and scars in scalp donor after follow ups. The donor site pain was markedly disappeared within 1~2 postoperative day. The hemorrhage from the scalp donor site during operation was not noticeable. The newly growing hair at the scalp donor was noted from the 3 postoperative days by palpation or unaided eye through the Vaseline gauze dressing. The average lengths of newly growing hair shaft are 2~3 mm in postoperative 8 days, 5~6 mm in postoperative 14 days. CONCLUSION: We had successful reconstruction of postburn skin defects using scalp donor split thickness skin graft without donor scars, persistent folliculitis or alopecia on scalp donor. From the postoperative 6~7 days after harvesting the scalp donor STSG, early vigorous daily washing with water and open dressing of scalp donor site should be recommended in order to prevent folliculitis. After long-term follow ups, the scalp split skin grafted recipient sites showed reliable, and relatively good color match with surrounding skin in face and dorsum of hand.
Alopecia ; Anti-Bacterial Agents ; Anti-Infective Agents, Local ; Bandages ; Burns* ; Cicatrix ; Epinephrine ; Exudates and Transudates ; Folliculitis ; Follow-Up Studies ; Hair ; Hand ; Hemorrhage ; Humans ; Palpation ; Petrolatum ; Scalp* ; Skin* ; Tissue Donors* ; Transplants* ; Water ; Wounds and Injuries

PURPOSE: Nosocomial infections account for one of the most serious complications in hospitalized patients around the world. Surgical site infections have significant economic implications, and surgical antisepsis plays an important role in such processes. METHODS: With prior approval by the Institutional Review Board and informed consent, 10 volunteers were randomly assigned to 3 protocols on hand antisepsis: protocol A (chloroxylenol 3%), protocol B (benzalkonium chloride at 1%), and protocol C (ethyl alcohol 61%, 1% chlorhexidine gluconate). Smears from both hands were cultured after each hand pro tocol (t0) and at the end of suturing (t1). Colony forming units were counted (CFUs on blood agar dishes) with digital counting software (Open CFU). Friedman test was used to compare the mean values among the groups, and a Bonferroni correction was made to determine the dissimilar group, with a P = 0.015. RESULTS: At t0 for protocol A the CFU count was 82.8 ± 1.3; protocol B was 9.7 ± 30; protocol C was 0.1 ± 0.3 (P < 0.001). At t1 for protocol A the CFU was 80.7 ± 89.4; protocol B was 7.5 ± 32; protocol C was 0.0 ± 0.0 (P < 0.001). No adverse events were present among the subjects. CONCLUSION: Ethyl alcohol at 61% with 1% chlorhexidine gluconate showed higher efficacy than the traditional washing antiseptics.
Agar ; Anti-Infective Agents, Local ; Antisepsis* ; Chlorhexidine ; Cross Infection ; Ethanol ; Ethics Committees, Research ; Hand* ; Humans ; Infection Control ; Informed Consent ; Stem Cells ; Surgical Wound Infection ; Volunteers

ObjectiveTo study the influence of povidone-iodine (PI) versus that of the benzethonium chloride wipe (BCW) on semen collection and semen quality of sperm donors undergoing penile skin disinfection and provide some evidence for the selection of disinfection methods for semen collection.

METHODSWe used PI from August to December 2015 and BCWs from January to July 2016 for penile skin disinfection before semen collection, with two samples from each donor, one collected with and the other without penis skin disinfection (the blank control group). After semen collection, we conducted a questionnaire investigation on the influence of the two disinfection methods on semen collection and compared the semen parameters between the two groups of sperm donors.

RESULTSTotally, 185 sperm donors were included in this study, of whom 63 underwent penile skin disinfection with PI and the other 122 with BCWs before semen collection. Statistically significant differences were found between the PI and BCW groups in the adaptability to the disinfectant and rigid disinfection procedures (P <0.05), but not in the other items of the questionnaire (P >0.05). Compared with the sperm donors of the blank control group, those of the PI group showed statistically significant difference in the percentage of progressively motile sperm (PMS) (［63.02 ± 3.18］% vs ［61.45 ± 4.78］%, P<0.05), but not in the abstinence time (［4.97 ± 1.79］ vs ［4.7 ± 0.94］ d, P >0.05), semen volume (［4.11 ± 1.54］ vs ［4.15 ± 1.61］ ml, P >0.05), sperm concentration (［110 ± 29.6］ vs ［107.5 ± 31.79］ ×10⁶/ml, P >0.05), or total sperm count (［439.10 ± 170.13］ vs ［434.02 ± 186.91］ ×106/ejaculate, P >0.05), while those of the BCW group exhibited no remarkable difference in any of the above parameters (P >0.05). Among the samples with abnormal semen quality, significantly fewer were found with abnormal PMS in the BCW than in the PI group (1.64% ［2/122］ vs 9.68% ［6/62］, P <0.05). However, there were no significant differences between the PI and BCW groups in the abnormal semen volume, abnormal sperm concentration, or the rate of semen bacterial contamination (P >0.05).

CONCLUSIONSBefore semen collection from donors, penile skin disinfection with povidone-iodine may affect both the semen collection process and the quality of donor sperm, while the benzethonium chloride wipe can reduce the influence on the semen collection process and does not affect the semen parameters.

Anti-Infective Agents, Local ; administration & dosage ; Benzethonium ; administration & dosage ; Disinfection ; methods ; statistics & numerical data ; Humans ; Male ; Penis ; Povidone-Iodine ; administration & dosage ; Semen ; Semen Analysis ; Skin ; Sperm Count ; Sperm Retrieval ; Spermatozoa ; Tissue Donors

ObjectiveTo evaluate the effectiveness and safety of low-concentration hydrogen peroxide solution (HPS) for continuous bladder irrigation after transurethral resection of the prostate (TURP).

METHODSWe retrospectively analyzed the clinical data about 148 cases of benign prostatic hyperplasia (BPH) treated by TURP from January 2013 to January 2016. Seventy-six of the patients received postoperative continuous bladder irrigation with 0.15% HPS (group A) and the other 72 with normal saline (group B). We compared the two groups of patients in their postoperative hemoglobin (Hb) levels, duration of bladder irrigation, frequency of catheter blockage, time of catheterization, and length of hospital stay.

RESULTSThere were no statistically significant differences between the two groups of patients preoperatively in the prostate volume, International Prostate Symptoms Score, maximum urinary flow rate, postvoid residual urine, or levels of serum PSA and Hb (P > 0.05). At 48 hours after operation, a significantly less reduction was observed in the Hb level in group A than in group B (［3.38 ± 2.56］ vs ［7.29 ± 6.58］ g/L, P < 0.01). The patients of group A, in comparison with those of group B, also showed remarkably shorter duration of postoperative bladder irrigation (［32.57 ± 5.99］ vs ［46.10 ± 8.79］ h, P < 0.01), lower rate of catheter blockage (3.3% vs 11.8%, P < 0.01), shorter time of catheterization (［3.74 ± 0.79］ vs ［4.79 ± 0.93］ d, P < 0.01), and fewer days of postoperative hospital stay (［4.22 ± 0.81］ vs ［4.67 ± 0.88］ d, P < 0.01).

CONCLUSIONSLow-concentration HPS for continuous bladder irrigation after TURP can reduce blood loss, catheter blockage, bladder irrigation duration, catheterization time, and hospital stay, and therefore deserves a wide clinical application.

Anti-Infective Agents, Local ; administration & dosage ; Catheter Obstruction ; Humans ; Hydrogen Peroxide ; administration & dosage ; Length of Stay ; Male ; Postoperative Hemorrhage ; prevention & control ; Postoperative Period ; Prostatic Hyperplasia ; blood ; surgery ; Quality of Life ; Retrospective Studies ; Therapeutic Irrigation ; methods ; statistics & numerical data ; Transurethral Resection of Prostate ; Treatment Outcome ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; prevention & control ; Urinary Retention

Anaphylaxis ; chemically induced ; diagnosis ; Anti-Infective Agents, Local ; adverse effects ; Chlorhexidine ; adverse effects ; Humans ; Male ; Middle Aged