醋酸氯己定与乙醇的协同杀菌效果

采用悬液定量杀菌试验,对醋酸氯己定与乙醇的协同杀菌效果进行了实验室研究。研究发现,0.1%醋酸氯己定与75%乙醇混合溶液对金黄色葡萄球菌、大肠埃希菌、白假丝酵母菌和黑曲霉均呈现出显著的协同杀菌作用。结果表明,醋酸氯己定与乙醇具有良好的协同杀菌效果。     

苯扎溴铵与艾叶水提物的协同杀菌效果

采用悬液定量杀菌试验,对苯扎溴铵与艾叶水提物的协同杀菌效果进行了实验室研究。研究发现,0.1%苯扎溴铵与艾叶水提物混合溶液对金黄色葡萄球菌、大肠埃希菌、枯草芽胞杆菌、白假丝酵母菌和黑曲霉均呈现出显著的协同杀菌作用。结果表明,苯扎溴铵与艾叶水提物具有良好的协同杀菌效果。     

两种根管冲洗液对狗牙根管内细菌抗菌作用的实验研究

目的观察2%洗必泰溶液和3%双氧水2种根管冲洗液对狗牙根管内粪肠球菌、溶血链球菌、微小消化链球菌、中间普氏菌及具核酸杆菌的影响,为临床根管治疗提供参考。方法选择成年健康杂种狗3只,共有24个实验牙,48个实验牙根。于狗牙根管内接种粪肠球菌、溶血链球菌、微小消化链球菌、中间普氏菌及具核酸杆菌。对狗牙完成根管治疗。于治疗后12个月拍摄根尖X线片,并记录牙齿和根尖周组织的临床表现。将患牙随机分为3组,每组7颗患牙,去除根管内充填物并进行根管预备,实验一组用2%洗必泰溶液冲洗根管,实验二组用3%双氧水冲洗根管,对照组用0.9%NaC l溶液冲洗根管。分别在根管预备前及根管预备冲洗后对根管内细菌取样,培养,鉴定并记录细菌菌落数量,测定根管内细菌变化情况。结果根管预备冲洗后3组根管内的细菌量均较根管预备前显著下降（P〈0.05）。2%洗必泰溶液和3%双氧水2种根管冲洗液的杀菌效果明显好于0.9%NaC l溶液（P〈0.05）,2%洗必泰溶液明显好于3%双氧水（P〈0.05）。结论2%洗必泰溶液是有效的根管冲洗药物,可明显减少狗牙根管内粪肠球菌、溶血链球菌、微小消化链球菌、中间普氏菌及具核酸杆菌的数量,但不能完全清除根管内的细菌。     

肉桂醛对根管内白色念珠菌生物膜作用的体外研究

目的研究肉桂醛对体外白色念珠菌生物膜的影响。方法采用琼脂扩散法进行肉桂醛和洗必泰对白色念珠菌敏感性的比较;MTT法评价肉桂醛对白色念珠菌生物膜及细胞黏附的影响。结果 2 048μg/mL肉桂醛与2%洗必泰抑菌环直径比较差异无统计学意义(P>0.05);4 096μg/mL肉桂醛对白色念珠菌生物膜的抑菌率达93.02%;不同浓度肉桂醛对60、90和120 min的白色念珠菌细胞粘附都具有抑制作用。结论肉桂醛对体外白色念珠菌生物膜有较明显的抑制作用。     

3种义齿清洁剂对3种活动义齿材料表面白色假丝酵母菌抑菌效果的比较

目的比较保丽净、高乐氏、洗必泰对不同活动性义齿表面白色假丝酵母菌的抑菌效果。方法分别制备带白色假丝酵母菌的钴铬基托试件、纯钛基托试件、热凝树脂基托试件,并分别浸泡于洗必泰、保丽净、高乐氏溶液中6h,评价上述3种义齿清洁剂的抑菌效果。结果同一清洁剂的不同基托间比较细菌下降率差异无统计学意义(F=0.02,P0.05);同一基托经过不同清洁剂处理,细菌下降率差异有统计学意义(F=8.04,P0.05);钴铬基托、纯钛基托、热凝树脂基托的除菌效果均为保丽净最高,洗必泰最低,差异均有统计学意义(P0.05)。结论保丽净可有效减少细菌滋生,可作为理想的活动性义齿清洁剂长期使用。     

次氯酸钠和洗必泰作为牙根管消毒冲洗液对根管内的感染物质的影响

摘要 目的：探究次氯酸钠和洗必泰作为牙根管消毒冲洗液的对根管内感染物质的影响。方法：选取76例接受根管治疗的患者根据随机数字表法分为观察组和对照组2组,其中对照组患者采用次氯酸钠治疗,观察组患者则采用次氯酸钠和洗必泰联合治疗。对比分析两组患者根管内细菌菌落计数、根管内感染物质、治疗效果、远期有效率和不良反应发生率。结果：根管消毒冲洗后观察组根管内细菌菌落计数和根管内感染物质显著低于对照组,差异具有统计学意义（P<0.05）;观察组患者治疗总有效率和不良反应的发生率分别为100.00%和13.16%,对照组患者治疗总有效率和不良反应的发生率分别为88.00%和65.79%,差异具有统计学意义（P<0.05）。另外,观察组患者第3个月、第6个月和1年后的治疗有效率均大于对照组。结论：次氯酸钠和洗必泰作为牙根管消毒冲洗液能够有效的减少根管内的感染物质的数量,提高治疗有效率,降低不良反应的发生率,值得临床推广使用。     

香口胶对牙菌斑及变形链球菌的影响

为了解不同类型的香口胶对牙菌斑及变链菌的影响,本研究观察了三种香口胶的作用,以寻找适合儿童食用的香口胶。作者以１１－１４岁儿童１８０名为受试对象。分别咀嚼大大泡泡糖、洗必泰口胶、健齿口胶。分别在咀嚼香口胶前后进行牙菌斑指数（ＱＨ－Ⅰ）测定,同时收取非刺激性唾液并计算变链菌ＣＦＵ。结果显示：咀嚼三种香口胶后可使牙菌斑指数明显下降（Ｐ＜００１）,其作用大小依次是健齿口胶＞洗必泰口胶＞大大泡泡糖。洗必泰香口胶健齿口胶可使变链菌ＣＦＵ明显下降（Ｐ＜００１）,而大大泡泡糖下降不明显（Ｐ＞００５）。     

4种消毒药杀菌效力的测定

洗必太(Chlorhexidinum),度米芬(Domiphenum),消毒净(Myristyl picolinii bromidum)和新洁尔灭(Bromo-geraminum),是近几年来开始普遍应用于临床的一类人工合成的阳离子表面活性消毒药,在化学结构上,它们都有亲水基和疏水基,与细菌接触后,其     

湛江球形棕囊藻赤潮除藻试验

2005年4月,在广东湛江港赤潮区采集球形棕囊藻(Phaeoecystisglobosa),在室内用新洁尔灭和异噻唑啉酮两种除藻剂进行棕囊藻的杀灭试验。结果表明,新洁尔灭对赤潮水体中球形棕囊藻的72hLC50为0.96mgL-1;与新洁尔灭相比,异噻唑啉酮的除藻效果更为明显,其对球形棕囊藻的72hLC50为0.54mgL-1。新洁尔灭和异噻唑啉酮复配时具有协同作用,可提高除藻能力,新洁尔灭和异噻唑啉酮浓度比为1.3:0.3(配比为4.3:1)时除藻效果最优,2d的除藻率达到89%,协同指数为0.78。两种除藻剂对鲻鱼(Mugilcephalus)苗72h的毒性试验表明,新洁尔灭和异噻唑啉酮浓度分别在2.0和0.3mgL-1以下除藻是安全的。     

醋酸氯己定的杀菌效果

采用悬液定量杀菌试验,对醋酸氯己定的杀菌效果进行实验室研究。研究发现,0.1%醋酸氯己定对金黄色葡萄球菌、大肠埃希菌、枯草芽胞杆菌、白假丝酵母菌和黑曲霉均具有明显的杀菌作用。通过模拟现场试验,醋酸氯己定起到了显著的杀菌效果。     

清清爽牌湿巾的杀菌效果

采用载体定量杀菌试验,对清清爽牌湿巾的杀菌消毒效果进行了实验室研究。发现清清爽牌湿巾对金黄色葡萄球菌、大肠埃希菌和白假丝酵母菌作用2 min,杀菌率分别达到99.98%、99.76%和99.20%。模拟现场试验,清清爽牌湿巾对手自然菌杀菌率达到99.99%,起到了显著地杀菌消毒效果。     

苦参水提液的杀菌效果

采用悬液定量杀菌试验,对苦参水提液的杀菌效果进行实验室研究。研究发现,苦参水提液对金黄色葡萄球菌、大肠埃希菌、枯草芽胞杆菌、白假丝酵母菌和黑曲霉均具有明显的杀菌作用。通过模拟现场试验,苦参水提液起到了显著地杀菌效果。     

艾叶提取物的杀菌效果

采用悬液定量杀菌试验,对艾叶提取物的杀菌效果进行实验室研究。研究发现,艾叶提取物对金黄色葡萄球菌、大肠埃希菌、枯草芽胞杆菌、白假丝酵母菌和黑曲霉均具有明显的杀菌作用。通过模拟现场试验,艾叶提取物有显著的杀菌效果。     

Comparative antimicrobial activity, in vitro and in vivo, of soft N-chloramine systems and chlorhexidine.

Antimicrobial activity of the following four new N-chloramine compounds was evaluated: two chlorinated simple amino acids, a chlorinated half-ester of succinic acid, and a chlorinated half-ester of glutaric acid. For comparison, the known bactericidal agents 3-chloro-4,4-dimethyl-2-oxazolidinone and chlorhexidine were evaluated by the same procedure. The contact germicidal efficiency screen was used to examine the in vitro bactericidal activity of all six compounds in the absence and presence of 5% horse serum or 5% Triton X-100. The four new compounds were found to have greater germicidal activity than the other compounds tested and to exhibit low toxicity and skin irritation values. The in vivo bactericidal activity was evaluated in two studies. In the occlusion test, three of the four new compounds plus chlorhexidine diacetate were tested. The N-chloramines were significantly superior to chlorhexidine in preventing the expansion of the normal flora under occlusion. In the scrub test, a gloved-hand wash method was used to compare the antimicrobial effect of a 1% solution of the chlorinated half-ester of succinic acid in triacetin with that of a commercial germicidal hand wash containing 4% chlorhexidine gluconate. The two preparations exhibited essentially the same hand-degerming activity.     

骨科内植物念珠菌生物被膜体外模型的构建及药物敏感性

利用24孔板在骨科内植物表面构建骨科内植物念珠菌生物被膜模型,并使用荧光镜检和菌落计数法（colony forming unit,CFU）检测醋酸氯己定（以下简称氯己定）与氟康唑对骨科内植物念珠菌生物被膜的联合抗菌效应。本研究成功在体外构建出骨科内植物念珠菌生物被膜模型,并发现无论是白念珠菌（SC5314）、近平滑念珠菌（ATCC22019）还是克柔念珠菌（ATCC00279）氟康唑单药组组间没有显著性差异;氯己定对骨科内植物念珠菌生物被膜的80%最低抑菌浓度（SMIC80）均≥16μg/mL,氟康唑对念珠菌生物被膜的80%最低抑菌浓度（SMIC80）均>64μg/mL。读取SMIC80时,氯己定与氟康唑的协同率高达100%,而两种药物的联合能够使氟康唑和醋酸氯己定的用药剂量减少4-8倍。本研究还发现在体外白念珠菌（SC5314）、近平滑念珠菌（ATCC22019）、克柔念珠菌（ATCC00279）、氟康唑耐药白念珠菌（64550）以及耳念珠菌（0389）均可以在骨科内植物表面形成真菌生物被膜并对氟康唑产生了耐药性;氯己定与抗真菌药物氟康唑对骨科内植物念珠菌生物被膜的杀伤具有明显的协同作用,且明显减少单药用药剂量。     

超声波对高电位氧化还原水灭菌效果影响的实验研究

观察超声波对高电位氧化还原水的微生物杀灭作用的影响。采用悬液法分别对高电位氧化还原水、超声波以及两者协同对微生物的杀灭效果进行检测。单独使用超声波处理10 min,对大肠杆菌的杀灭率为89.9%;单独使用高电位氧化还原水作用15 s,对大肠杆菌杀灭率为97.8%;超声波与高电位氧化还原水协同作用15 s,杀灭率为100%。单独使用超声波处理10 min、单独使用高电位氧化还原水作用1.5 min,可以将悬液内的HBsAg阳性血清的抗原性完全破坏,二者协同作用仅需30 s即可达到完全破坏。超声波对高电位氧化还原水的微生物杀灭具有明显的增效作用。     

The Forgotten Role of Alcohol: A Systematic Review and Meta-Analysis of the Clinical Efficacy and Perceived Role of Chlorhexidine in Skin Antisepsis

Background

Skin antisepsis is a simple and effective measure to prevent infections. The efficacy of chlorhexidine is actively discussed in the literature on skin antisepsis. However, study outcomes due to chlorhexidine-alcohol combinations are often attributed to chlorhexidine alone. Thus, we sought to review the efficacy of chlorhexidine for skin antisepsis and the extent of a possible misinterpretation of evidence.

Methods

We performed a systematic literature review of clinical trials and systematic reviews investigating chlorhexidine compounds for blood culture collection, vascular catheter insertion and surgical skin preparation. We searched PubMed, CINAHL, the Cochrane Library, the Agency for Healthcare Research and Quality website, several clinical trials registries and a manufacturer website. We extracted data on study design, antiseptic composition, and the following outcomes: blood culture contamination, catheter colonisation, catheter-related bloodstream infection and surgical site infection. We conducted meta-analyses of the clinical efficacy of chlorhexidine compounds and reviewed the appropriateness of the authors′ attribution.

Results

In all three application areas and for all outcomes, we found good evidence favouring chlorhexidine-alcohol over aqueous competitors, but not over competitors combined with alcohols. For blood cultures and surgery, we found no evidence supporting chlorhexidine alone. For catheters, we found evidence in support of chlorhexidine alone for preventing catheter colonisation, but not for preventing bloodstream infection. A range of 29 to 43% of articles attributed outcomes solely to chlorhexidine when the combination with alcohol was in fact used. Articles with ambiguous attribution were common (8–35%). Unsubstantiated recommendations for chlorhexidine alone instead of chlorhexidine-alcohol were identified in several practice recommendations and evidence-based guidelines.

Conclusions

Perceived efficacy of chlorhexidine is often in fact based on evidence for the efficacy of the chlorhexidine-alcohol combination. The role of alcohol has frequently been overlooked in evidence assessments. This has broader implications for knowledge translation as well as potential implications for patient safety.