Postgraduate medical journal
-
Various disinfectants were compared in terms of the duration of bactericidal activity against methicillin-sensitive Staphylococcus aureus (MSSA), and methicillin-resistant Staphylococcus aureus (MRSA), among S. aureus isolated in our hospital. Strains of S. aureus which showed minimum inhibitory concentrations of cloxacillin of less than 1.56 micrograms/ml and of 3.13 micrograms/ml or higher were designated MSSA and MRSA respectively. ⋯ All strains except for one strain of MRSA were killed within 20 seconds after disinfection with benzalkonium chloride. All strains were killed within 20 seconds after disinfection with alkyldiaminoethylglycine hydrochloride or povidone-iodine.
-
Infection is one of the most frequent complications of wound healing despite the use of antibiotics and modern sterile technique; it accounts for considerable patient morbidity, discomfort, and prolonged hospitalization, and it must be avoided to permit proper healing. For this purpose, topical antiseptics have been employed for several years. Among these povidone-iodine formulations (polyvinylpyrrolidone iodine; PVP-I; e.g., Betadine preparations), which consist of a water-soluble complex of elemental iodine and a synthetic polymer, have a broad antimicrobial spectrum, and have not been reported to develop bacterial resistance. ⋯ In human wounds, no delays occurred in healing, even when gel-type occlusive dressings were added to the wounds; in fact, bandage-wearing time was shortened in those patients treated with PVP-I ointment. PVP-I cream (5%) was also studied in humans; the cream formulation appeared to decrease healing time. Based on these studies, it can be concluded that povidone-iodine preparations do not have a deleterious effect on wound healing.
-
The prevalence and nosocomial acquisition of Clostridium difficile in elderly hospitalized patients.
Rectal swabs obtained from 10 of 49 chronic-care geriatric patients were positive for Clostridium difficile, for a prevalence rate of 20.4%. Simultaneous sampling of 29 patients in an acute geriatric ward revealed four colonized patients, for a prevalence rate of 13.7%. A prospective study of C. difficile colonization in 100 consecutive patients admitted to an acute geriatric ward was carried out. ⋯ Two patients (2%) were positive on admission, and 12 of the 98 initially negative patients became colonized, representing a nosocomial acquisition rate of 12.2%. A major determinant for C. difficile colonization in asymptomatic patients appears to be length of hospitalization. Previous antibiotic administration was not found to be a significant factor.
-
Seven species of periodontal pathogenic bacteria (Bacteroides, gingivalis, Bacteroides intermedius, Bacteroides melaninogenicus, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Capnocytophaga spp., Eikenella corrodens) and two control species (Streptococcus intermedius, Pseudomonas aeruginosa) were selected in order to study the bactericidal effects of 10% povidone-iodine (PVP-I) aqueous solution in vitro. The PVP-I solution was diluted to 10, 20, 50, 100, 200, 400, 800, 1600, 3200, 6400 and 12800 x and contact times were 15, 30 and 60 seconds. The strongest bactericidal effects on the seven periodontal pathogenic bacteria and two control bacteria were seen at a dilution of 400 x and a contact time of 15 seconds. Based on these findings, we advocate a 0.25% solution of 10% aqueous PVP-I for oral mucosa and periodontal pocket irrigation.
-
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged worldwide as a significant and difficult-to-treat source of nosocomial infection, emphasizing the ever-present need for reliable and effective antisepsis. Betadine Solution (10% povidone-iodine; PVP-I) and Betadine Cream (5% povidone-iodine) are broad-spectrum microbicides widely used for topical cleansing, wound treatment, and antisepsis. There have been no reports of bacterial resistance to Betadine preparations. ⋯ PVP-I cream killed four of the MRSA isolates within 30 seconds, and required a 2-3 minute killing time for one strain of MRSA and the strain of MSSA. These results are supported by four published in vitro studies which show that PVP-I is highly effective in killing MRSA. In addition, each study shows that PVP-I is more effective than chlorhexidine against MRSA.