povidone-iodine and Pseudomonas-Infections

A critical elevation of povidone-iodine absorption which occurred in a burn patient who was topically treated with 10% povidone-iodine (PI) gel is herein reported. A 65-year-old man was admitted to our hospital for deep second- and third-degree burns covering 26% of his total body surface area. The intravenous administration with lactated Ringer's solution and topical treatment with silver sulfadiazine were applied in addition to such treatments as debridement and skin grafting. However, wound infection occurred due to Pseudomonas aeruginosa. Topical treatment with PI gel was effective for this condition. Persistent nodal bradycardia with hypotension, metabolic acidosis, and renal failure occurred 16 days after the start of PI gel treatment. Iodine toxicosis caused by PI gel was suspected with a serum iodine level of 20600 microg/dl (normal range 2-9 microg/dl). The PI gel treatment was therefore discontinued immediately, and hemodialysis was scheduled. However, the patient's family refused hemodialysis and he died 44 days after admission. To our knowledge, only eight patients with iodine toxicosis have been reported in burn patients treated with PI gel.

Topics: Absorption; Acidosis; Aged; Anti-Infective Agents, Local; Bradycardia; Burns; Debridement; Fatal Outcome; Gels; Humans; Hypotension; Iodine; Male; Povidone-Iodine; Pseudomonas Infections; Renal Insufficiency; Silver Sulfadiazine; Skin Transplantation; Wound Infection

Exit site infection is a major risk factor for the development of peritonitis in continuous ambulatory peritoneal dialysis. The frequency of infection can be reduced by scrupulous exit site care with or without topical antiseptics. A randomized trial was performed of 149 catheters in 130 patients to assess any additional benefits conferred by the use of povidine iodine dry powder spray at dressing changes over an existing strict protocol of exit care. Exit infections occurred in 14 (18%) of 77 patients using spray and in 15 (21%) of 72 patients not using spray. The risk of peritonitis was also similar in each group. The proportion of infections caused by Staphylococcus aureus was reduced in the spray group, but those caused by Pseudomonas aeruginosa were increased. Rash occurred in 6% of those using the spray. The use of the spray did not therefore seem justified.

Topics: Aged; Aged, 80 and over; Anti-Infective Agents, Local; Catheterization; Female; Humans; Infection Control; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Povidone-Iodine; Pseudomonas Infections; Staphylococcal Infections

Bioshell calcium oxide (BiSCaO) possesses deodorizing properties and broad microbicidal activity. This study aimed to investigate the application of BiSCaO ointment for the prevention and treatment of infection in chronic wounds in healing-impaired patients, without delaying wound healing. The bactericidal activities of 0.04, 0.2, 1, and 5 wt% BiSCaO ointment, 3 wt% povidone iodine ointment, and control (ointment only) were compared to evaluate the in vivo disinfection and healing of

Topics: Animal Shells; Animals; Anti-Bacterial Agents; Calcium Compounds; Disinfection; Male; Ointments; Oxides; Pectinidae; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Rats, Hairless; Wound Infection

Scallop shell powder is called bioshell calcium oxide (BiSCaO), which is known to possess deodorizing properties and broad antimicrobial activity against various pathogenic microbes, including viruses, bacteria, spores, and fungi.. This study aims to investigate the applications of BiSCaO suspension cleansing in clinical situations, for instance for the prevention and treatment of infections in chronic wounds in healing-impaired patients, without delaying wound healing.. The bactericidal activities of 1000 ppm BiSCaO suspension; 500 ppm hypochlorous acid; 1000 ppm povidone iodine; and saline were compared to evaluate in vivo disinfection and healing of Pseudomonas aeruginosa-infected wounds in hairless rats.. Cleansing of the infected wounds with BiSCaO suspension daily for 3 days significantly enhanced wound healing and reduced the in vivo bacterial counts, in comparison to hypochlorous acid, povidone iodine, and saline. Furthermore, histological examinations showed significantly advanced granulation tissue and capillary formation in the wounds cleansed with BiSCaO suspension than in those cleansed with the other solutions.. This study suggested that the possibility of using BiSCaO suspension as a disinfectant for infected wounds and limiting disinfection to 3 days may be sufficient to avoid the negative effects on wound repair.

Topics: Animal Shells; Animals; Anti-Bacterial Agents; Bacterial Load; Calcium Compounds; Disease Models, Animal; Disinfection; Male; Mice; Microbial Sensitivity Tests; Oxides; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Rats; Rats, Hairless; Staphylococcal Skin Infections; Therapeutic Irrigation; Wound Healing

Negative pressure wound therapy with instillation (NPWTi) is increasingly used as an adjunct therapy for a wide variety of infected wounds. However, the effect of NPWTi on mature biofilm in wounds has not been determined. This study assessed the effects of NPWTi using saline or various antimicrobial solutions on mature Pseudomonas aeruginosa biofilm using an ex vivo porcine skin explant biofilm model. Treatment consisted of six cycles with 10-minute exposure to instillation solution followed by 4 hours of negative pressure at -125 mm Hg over a 24-hour period. NPWTi using saline reduced bacterial levels by 1-log (logarithmic) of 7-log total colony-forming units (CFUs). In contrast, instillation of 1% povidone iodine (2-log), L-solution (3-log), 0·05% chlorhexidine gluconate (3-log), 0·1% polyhexamethylene biguanide (4-log), 0·2% polydiallyldimethylammonium chloride (4-log) and 10% povidone iodine (5-log), all significantly reduced (P < 0·001) total CFUs. Scanning electron micrographs showed disrupted exopolymeric matrix of biofilms and damaged bacterial cells that correlated with CFU levels. Compared with previous studies assessing microbicidal effects of topical antimicrobial dressings on biofilms cultured on porcine skin explants, these ex vivo model data suggest that NPWTi with delivery of active antimicrobial agents enhances the reduction of CFUs by increasing destruction and removal of biofilm bacteria. These results must be confirmed in human studies.

Topics: Animals; Anti-Infective Agents, Local; Bacterial Load; Biguanides; Biofilms; Chlorhexidine; Microscopy, Electron, Scanning; Models, Animal; Negative-Pressure Wound Therapy; Polyethylenes; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Quaternary Ammonium Compounds; Skin; Sodium Chloride; Swine; Therapeutic Irrigation; Wound Healing

Infections with Pseudomonas aeruginosa can cause the hot-foot syndrome, presenting with painful plantar erythematous nodules. Particularly, the mechanically stressed areas of the foot are affected after contact with contaminated water from saunas, swimming pools, hot tubs, etc. We report an outbreak of hot-foot syndrome caused by Pseudomonas in 10 patients. The therapeutic regimens applied reached from local antiseptic therapy to systemic antibiotics.

Topics: Adult; Anti-Infective Agents; Ceftazidime; Child; Child, Preschool; Ciprofloxacin; Diagnosis, Differential; Disease Outbreaks; Female; Foot Dermatoses; Gentamicins; Humans; Infusions, Intravenous; Male; Ointments; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Swimming Pools

In 2009, the American Academy Of Orthopedic Surgeons recommended lifelong prophylaxis after orthopedic total joint replacement (TJR) before these patients undergo dental, aerodigestive, genitourinary (GU), and gastrointestinal (GI) procedures. Because oral and maxillofacial surgeons worldwide are implanting alloplastic total temporomandibular joint replacements (TMJ TJRs), it appeared reasonable to survey these surgeons to obtain data that might shed some light, not only on this issue, but also to obtain some data to begin to develop preliminary guidelines for the peri- and postoperative use of antibiotics for TMJ TJR using these results and the orthopedic data.. A total of 35 surgeons worldwide, members of either the TMJ Concepts or Biomet Microfixation online networks were e-mailed a standard questionnaire surveying their perioperative, postoperative, and prophylactic use of antibiotics for their TMJ TJR cases.. Of the 35 surgeons, 26 (74.2%) from 8 different countries responded. A total of 2,476 cases (3,368 joints) were retrospectively surveyed. Of the responding surgeons, 96.2% used, in order of frequency, cefazolin, clindamycin, cephalosporin, or penicillin-based antibiotics in the perioperative period and continued their use for a mean of 7 days (range 5 to 14) postoperatively. Also, 46.2% soaked the TJR components either in the perioperative antibiotic or in vancomycin, poviodine, gentamycin, or peroxide before implantation. In addition, 61.5% irrigated the wounds after device implantation with bacitracin, vancomycin, poviodine, peroxide, or the perioperative antibiotic. These surgeons reported that 51 joints (1.51%) had become infected within a mean of 6 months (range 2 weeks to 12 years) postoperatively. A total of 32 devices (0.95%) required removal and/or replacement. In cases in which the organisms were isolated, the organisms commonly associated with biofilm infection of TJR devices, Staphylococcus aureus, S epidermidis, Peptostreptococcus, and Pseudamonas aeruginosa, were cultured. In only 1 joint (0.003%) was there a suggestion of an association with an invasive dental/aerodigestive, GU/GI procedure. Regarding prophylaxis after TMJ TJRs and before dental/aerodigestive, GU, or GI procedures, 53.8% of the respondents reported that they provided prophylaxis. Of these, 1 recommended doing this for 6 months and 4 for 2 years, such as has been the American Dental Association/American Academy of Orthopedic Surgeons recommendation since 2003; and 9 reported they believe these TMJ TJR patients should have lifetime antibiotic prophylaxis before invasive dental/aerodigestive, GU, or GI procedures.. The evidence provided from the present small study survey and a review of the orthopedic data could provide the opportunity to develop guidelines for the preoperative, intraoperative, and postoperative antibiotic management for TMJ TJRs and spur additional research into this important area of patient management.

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Arthroplasty, Replacement; Bacitracin; Biofilms; Cefazolin; Cephalosporins; Clindamycin; Device Removal; Disinfection; Gentamicins; Gram-Positive Bacterial Infections; Humans; Joint Prosthesis; Penicillins; Peptostreptococcus; Peroxides; Povidone-Iodine; Practice Guidelines as Topic; Practice Patterns, Dentists'; Pseudomonas aeruginosa; Pseudomonas Infections; Retrospective Studies; Staphylococcal Infections; Staphylococcus epidermidis; Surgical Wound Infection; Temporomandibular Joint; Therapeutic Irrigation; Vancomycin

We investigated the efficacy of disinfection of the upper airway using povidone-iodine against nosocomial pneumonia in geriatric wards. Cases of nosocomial pneumonia were retrospectively analyzed between January 1991 and March 1995 in geriatric wards (190 beds). Moreover, the relationship concerning methicillin-resistant Staphylococcus aureus (MRSA) isolates between patient and environment was investigated using pulsed-field gel electrophoresis (PFGE) with the SmaI restriction enzyme. The incidence of nosocomial pneumonia decreased significantly (p < 0.05). Major causative organisms of nosocomial pneumonia were MRSA and Pseudomonas aeruginosa, which significantly decreased. PFGE studies showed that the patterns of MRSA isolates show a strong association between patient and environment. Our study indicates that disinfection of the upper airways by povidone-iodine is very important in the prevention of nosocomial pneumonia in geriatric wards.

Topics: Aged; Anti-Infective Agents, Local; Bacterial Typing Techniques; Carrier State; Cross Infection; Disease Transmission, Infectious; Electrophoresis, Gel, Pulsed-Field; Environmental Microbiology; Geriatrics; Hospital Units; Humans; Infection Control; Methicillin Resistance; Mouth; Nasal Cavity; Pneumonia, Bacterial; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Retrospective Studies; Staphylococcal Infections; Staphylococcus aureus

Shiunko is a traditional botanic formula (ointment) which is used clinically for the treatment of wounded skin caused by cuts, abrasions, frost or burn. The aim of this study was to evaluate the effect of Shiunko on epithelization of wounded skin. Experimental cutting wounds on the back skin of Sprague-Dawley rats were induced. Different bacterial inoculations (Pseudomonus aeruginosa and Staphylococcus aureus) and treatment (Shiunko, Povidone-iodine and saline) were arranged herein. The incidences of infection and the speed of epithelization were evaluated. We observed that the incidences of wound infection following Pseudomonas aeruginosa inoculation were lower on both the Shiunko-treated group (0%, p < 0.01) and Povidine-iodine-treated group (5%, p < 0.05), than the saline-treated group (40%). The Shiunko-treated group reported higher percentages of complete epithelization not only on the sterilized wounds (100%) but also on the contaminated wounds (90%) when compared to the saline-treated group (60% sterilized wounds, 40% and 50% contaminated wounds) on day 7 (p < 0.01). Povidone-iodine did not promote epithelization of wounded skin, whereas Shiunko did.

Topics: Animals; Anti-Infective Agents, Local; Drugs, Chinese Herbal; Male; Medicine, Kampo; Microbial Sensitivity Tests; Ointments; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Rats; Rats, Sprague-Dawley; Skin; Staphylococcal Skin Infections; Staphylococcus aureus; Wound Healing; Wound Infection; Wounds, Penetrating

The in vitro activities of povidone iodine, potassium peroxymonosulfate, and dimethyldidecylammonium chloride were investigated against 379 nosocomial isolates of Staphylococcus aureus and Pseudomonas aeruginosa responsible for surgical wound infections in patients operated on between July 1995 and June 2001. Overall, the isolates were inhibited by the antiseptics at concentrations below those used routinely. In spite of increasing resistance to the various antibiotics used to treat surgical wound infections, no significant variation in the susceptibility to antiseptics was demonstrated during this 6-year study.

Topics: Anti-Infective Agents, Local; Bacterial Infections; Drug Resistance, Bacterial; Humans; Microbial Sensitivity Tests; Peroxides; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Quaternary Ammonium Compounds; Staphylococcal Infections; Staphylococcus aureus; Surgical Wound Infection; Time Factors

The iodine content of a tulle gras-type dressing medicated with povidone-iodine (Poviderm) has been measured and its potential efficacy in wound care explored by means of laboratory models. Simple tests demonstrated the ready diffusibility and antibacterial activity of povidone-iodine. Wound models clearly showed that the limiting factor for useful dressing life is extent of exudation. It seems likely that this dressing would provide good topical antibacterial prophylaxis and may reduce the bacterial burden of colonised wounds. The dressing should help contain wound bacteria and thus assist infection control.

Topics: Anti-Bacterial Agents; Bandages; Chronic Disease; Diffusion; Drug Evaluation, Preclinical; Humans; Povidone-Iodine; Pseudomonas Infections; Staphylococcal Infections; Wound Infection

In pressure sore wounds after spinal cord injury, methicillin-resistant Staphylococcus aureus can be detected in 2% of the cases. The elimination of the germ is the aim of the treatment. Pressure sore wounds are an often found complication after spinal cord injury. For local treatment five commercially available antiseptics for the skin and mucous membrane were tested in vitro. The method used is a modified qualitative and quantitative suspension test. The antiseptics were tested without and with addition of 5% albumin in order to simulate the conditions of the wound in vivo. The results show a superior efficacy of the povidone-iodine preparations. Betadine, probably due to the higher concentration, is more efficacious than Braunol; chlorhexidine is sufficiently efficacious without the addition of albumin. These results still have to be confirmed by in vivo studies.

Topics: Anti-Infective Agents, Local; Biguanides; Chamomile; Chlorhexidine; Escherichia coli; Escherichia coli Infections; Flavonoids; Humans; Imines; Iodophors; Methicillin Resistance; Oils, Volatile; Plants, Medicinal; Povidone-Iodine; Pressure Ulcer; Pseudomonas aeruginosa; Pseudomonas Infections; Pyridines; Quaternary Ammonium Compounds; Serum Albumin; Skin; Spinal Cord Injuries; Staphylococcal Infections; Staphylococcus aureus

The use of quantitative bacteriology in the burns unit has been thought to be efficient in predicting sepsis or graft loss. To examine the relationship between clinical outcome and bacterial densities on and in the burn wound, 69 biopsy/surface swab pairs were collected from 47 patients on 64 occasions, either immediately prior to excision and grafting, or at routine change of dressings. The mean per cent TBSA burn was 16 (range 1-65). There was a significant correlation between log total bacterial count by biopsy with total white cell count and age (P = 0.028), and a significant negative correlation between total bacterial count by swab with per cent TBSA (P = 0.006). There was no significant difference in bacterial counts between patients judged to be a clinical success or clinical failure (72 h follow-up), either after undergoing excision and grafting, or change of dressings, and no difference in counts between patients with perioperative bacteraemia and those without. With burns > 15 per cent TBSA, a relationship between bacterial counts and subsequent sepsis or graft loss still was not demonstrated. It is suggested that quantitative bacteriology by burn wound biopsy or surface swab does not aid the prediction of sepsis or graft loss.

Topics: Age Factors; Alginates; Anti-Infective Agents, Local; Bacteremia; Bacteria; Bandages; Biopsy; Body Surface Area; Burns; Cerium; Chlorhexidine; Colony Count, Microbial; Follow-Up Studies; Forecasting; Graft Survival; Humans; Leukocyte Count; Linear Models; Povidone-Iodine; Pseudomonas Infections; Silver Sulfadiazine; Skin Transplantation; Staphylococcal Infections; Treatment Failure; Treatment Outcome; Wound Infection

Topical 5% povidone-iodine for the treatment of corneal ulcers was observed in Sierra Leone, West Africa by one of us (D.J.D.). To test the efficacy of topical 5% povidone-iodine for infectious keratitis, experimental Pseudomonas aeruginosa keratitis was induced in 12 rabbits by first abrading the central 3 mm of corneal epithelium. Thirty milliliters of broth of P. aeruginosa strain ATCC 27835 (1.8 x 10(7) viable bacteria) was dropped twice on the wounded cornea. After 22 h, all corneas were clinically infected. Eight rabbits were treated with 5% povidone-iodine solution and four with 0.9% NaCl solution. All were given hourly drops. Twenty-four hours after treatment began, the central 8-mm button of the infected cornea was excised, homogenized, and serial dilutions plated onto MacConkey agar. The total number of viable Pseudomonas organisms was calculated. The treatment group had 5.2 +/- 0.4 CFUs (colony-forming units) per cornea. The control group had 4.8 +/- 0.4 CFUs per cornea (p = 0.11). The clinical scores (Hobden grading system) were 6.9 +/- 1.5 for the treated group and 7.3 +/- 2.5 for the control group (p = 0.74). There was no statistical difference between the treated and control groups. Povidone-iodine (5%) is not effective in the acute treatment of P. aeruginosa keratitis in this rabbit model.

Topics: Animals; Anti-Infective Agents, Local; Colony Count, Microbial; Cornea; Corneal Ulcer; Disease Models, Animal; Eye Infections, Bacterial; Ophthalmic Solutions; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Rabbits

In this paper, we report two successful cases of empyema treated by pleural washing with povidone-iodine solution. In these two cases, empyema was caused by secondary infection of multi-drug resistant Pseudomonas aeruginosa. First, we replaced intrathoracic drainage tube and washed intrathoracic space with 500-1000 ml saline containing antibiotics (tobramycin, aztreonam) every 8 hours for 10-14 days. But, cultural studies of pleural effusion were positive even after this treatment. So, we tried pleural washing with warm povidone-iodine solution 1:20 diluted with saline every 8 hours. Surprisingly, after 3 days treatment, cultural studies of the pleural effusion became negative. This pleural washing method with povidone-iodine was very effective for treatment of empyema patients.

Topics: Aged; Empyema, Pleural; Humans; Male; Middle Aged; Povidone-Iodine; Pseudomonas Infections; Superinfection; Therapeutic Irrigation

In 1989 we investigated the first instance of Pseudomonas cepacia infections due to intrinsic contamination of a povidone-iodine product. Six patients in a Texas pediatric facility had P. cepacia infection or pseudoinfection (three, peritonitis; one, pseudoperitonitis; and two, pseudobacteremia). Epidemiological studies showed one risk factor for infection of peritoneal fluid with P. cepacia: performance of peritoneal dialysis in the dialysis unit with use of one lot of povidone-iodine later found to be intrinsically contaminated (4/5 vs. 0/16, P = .001). Blood cultures yielded P. cepacia after nurses wiped the tops of blood culture bottles with the povidone-iodine solution before inoculation. P. cepacia was cultured from three povidone-iodine containers used at the hospital and from four containers of the same lot obtained from other health-care facilities in Texas and California. Isolates from patients and the povidone-iodine had similar antibiograms, identical plasmid profiles, and identical DNA banding patterns on the basis of results of ribonucleotide typing. This investigation demonstrates that intrinsic contamination of povidone-iodine solution with P. cepacia can result in infections in addition to colonization and/or pseudoinfection.

Topics: Bacteremia; Burkholderia cepacia; Child, Preschool; Cohort Studies; Cross Infection; Disease Outbreaks; Drug Contamination; Humans; Infant; Intensive Care Units, Pediatric; Peritoneal Dialysis; Peritonitis; Povidone-Iodine; Pseudomonas Infections; Retrospective Studies; Risk Factors; Texas

This study compares CO2 laser sterilization with iodine surgical scrub in infected pseudomonas wounds in the rabbit, and on frequency of wound breakdown secondary to sepsis. Thirty-three New Zealand rabbits underwent bilateral flank incisions and infection with a standard solution of pseudomonas aeruginosa. After 4 days of incubation, the wounds were randomized to receive laser sterilization and routine iodine surgical scrub respectively. Following sterilization, excision of the wound, and suturing was carried out. After 12 days, the wounds were assessed for evidence of residual infection as well as wound breakdown in a double blind fashion. Clinical observation, qualitative microbiology, and in some cases histology, were used to document the presence of infection. Statistical analysis of wound breakdown secondary to infection revealed a significant difference in breakdown rates. Three laser and 12 iodine treated wounds displayed breakdown secondary to sepsis. We conclude that the CO2 laser sterilization technique is more effective than routine iodine surgical scrub.

Topics: Abscess; Animals; Carbon Dioxide; Double-Blind Method; Epithelium; Laser Therapy; Light Coagulation; Male; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Rabbits; Skin; Sterilization; Suppuration; Surgical Wound Infection; Wound Healing

Topics: Anti-Infective Agents, Local; Burns; Drug Combinations; Humans; Nitrofurazone; Potassium Iodide; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Staphylococcal Infections; Staphylococcus aureus; Wound Infection

A new topical antiseptic agent, 5 per cent polyvinylpyrrolidone-iodine (PVP-I) cream, with altered physicochemical properties, incorporated in a different carrier base has proved in vivo to be more effective in controlling burn wound infections than 10 per cent PVP-I ointment. Important biodynamic properties of the new formulation have not, however, been elucidated in vivo. Hence the need for a controlled study to evaluate the bioavailability of the active component after penetration through burn eschar; the bactericidal efficacy of the cream and determination of the bactericidal time of the cream in comparison with 10 per cent PVP-I ointment. A modified Walker burn wound model was used to define the rate of trans-eschar penetration, biodynamic availability and bactericidal efficacy of 5 per cent povidone iodine cream in established Pseudomonas aeruginosa burn wound infection. In vitro penetration confirmed the effective diffusion of PVP-I cream through 1.5 mm eschar within 6 h. A single topical application of PVP-I cream resulted in a 98.8 per cent (6.088 x 10(9) c.f.u./g of tissue to 7.367 x 10(7) c.f.u./g of tissue) reduction in intra-eschar viable organisms within 18 h after application. A second topical application of PVP-I cream at 18 h resulted in a total reduction of 99.8 per cent in viable organisms (2.90 x 10(9) c.f.u./g of tissue to 7.009 x 10(6) c.f.u./g of tissue) within 48 h. Comparing the in vitro bactericidal time of povidone iodine ointment with cream against Pseudomonas aeruginosa, Staphylococcus aureus and a Klebsiella pneumoniae revealed that the PVP-I cream killed organisms ten-fold more quickly than the ointment.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Topical; Animals; Biological Availability; Burns; Emollients; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Rats

Antibacterial activity of surgical adhesive films containing various antiseptics in the adhesive layer was studied experimentally. It was shown that the adhesive films containing 0.1 to 1% (in terms of active iodine) of iodopyrone had a stable bactericidal action and were effective against to the main causative agents of surgical infections, i. e. Staphylococcus spp., E. coli, Klebsiella spp., Pseudomonas aeruginosa and others.

Topics: Anti-Infective Agents, Local; Antisepsis; Drug Combinations; Drug Evaluation, Preclinical; Enterobacteriaceae; Enterobacteriaceae Infections; Humans; Occlusive Dressings; Potassium Iodide; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections; Staphylococcal Infections; Staphylococcus aureus; Surgical Wound Infection; Tissue Adhesives

Pseudomonas cepacia organisms were recently recovered from a povidone-iodine antiseptic solution. During the subsequent investigation, laboratory studies were initiated to determine the survival time of these organisms in the iodophor solution, which contains 1% titratable iodine. The solution was sampled weekly upon receipt in our laboratory, and P. cepacia was subsequently recovered through 29 weeks of sampling. Current laboratory data and lot production date information from the manufacturer indicate that P. cepacia survived for up to 68 weeks from the time of manufacture. Scanning electron microscopic examination of contaminated solution demonstrated bacterial cells embedded in extracellular material.

Topics: Colony Count, Microbial; Drug Contamination; Humans; Microscopy, Electron, Scanning; Povidone-Iodine; Pseudomonas; Pseudomonas Infections

Topics: Drug Contamination; Humans; Peritonitis; Povidone; Povidone-Iodine; Pseudomonas; Pseudomonas Infections; Texas

Fifteen episodes of infection due to Pseudomonas aeruginosa, including peritonitis and catheter site infections, occurred in nine patients receiving continuous ambulatory peritoneal dialysis over a 27-month period. Eight episodes were associated with catheter loss. Occurrence of P aeruginosa infection was significantly associated with use of povidone-iodine solution to cleanse the catheter site. There was no association with use of povidone-iodine solution to disinfect tubing connections, use of other skin care products or exposure to other environmental sources of P aeruginosa. Cultures of available povidone-iodine products were negative. Local irritation and alteration in skin flora caused by antiseptic solution or low-level contamination of povidone-iodine solution are potential mechanisms of infection.

Topics: Catheters, Indwelling; Follow-Up Studies; Humans; Kidney Failure, Chronic; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Povidone; Povidone-Iodine; Pseudomonas aeruginosa; Pseudomonas Infections

Standardized burns without experimental infection and such with infection by a constant number of bacteria of a fixed Pseudomonas-aeruginosa-strain were treated differently. Silver sulfadiazine- and Cefsulodin-cream, Polyvidon-iodine-ointment (PVP-Jod), and hyperbaric oxygen (OHP) were used to them. The courses of healing were checked by determination of the wound area daily. The best results showed the experimental uninfected untreated wounds. Wounds infected by Pseudomonas were healing most quickly by immediate and continuous application of hyperbaric oxygen. By silver sulfadiazine- and Cefsulodin-cream treated burns showed statistical significant better results than the control group. The courses of healing were significantly poorer in delayed application of OHP (only from the 8th day after the burn) or in case of therapy with PVP-iodine alone.

Topics: Administration, Topical; Animals; Burns; Cefsulodin; Female; Guinea Pigs; Hyperbaric Oxygenation; Ointments; Povidone-Iodine; Pseudomonas Infections; Silver Sulfadiazine; Wound Healing; Wound Infection

Topics: Animals; Drug Combinations; Potassium Iodide; Povidone; Povidone-Iodine; Pseudomonas Infections; Rabbits; Staphylococcal Infections; Wound Infection

A chlorine dioxide-containing gel was compared with 3 commercially available antimicrobials and 1 antibiotic intended for topical use. This gel was tested at 0.5 X and 4 X and was found to be more effective as a 4 X gel in treating Pseudomonas aeruginosa-infected excised wounds on mice. To further compare this gel with other antiseptics, a murine bioassay was developed. This wound model consisted of an excised cutaneous wound on the dorsum of mice which were irradiated (800 rad) and inoculated with P aeruginosa at 10-fold dilutions, from 10(-2) to 10(-10). The wounds were observed for latency of infection or mice survival time as a function of concentration of viable organisms remaining after treatment. The advantage of this model was demonstrated where a standard curve based on latency did not consume as many test subjects and yet provided an estimate of viable organisms in each wound. In this model, the chlorine dioxide-containing gel was more active than were preparations of providone-iodine, chlorhexidene, or silver sulfadiazine and was similar to polymyxin-bacitracin-neomycin ointment as a topical antiseptic. The effectiveness of the tested gel was reduced if delays in treatment were longer than 1 hour.

Topics: Animals; Anti-Infective Agents, Local; Bacitracin; Chlorhexidine; Chlorine; Chlorine Compounds; Drug Combinations; Gels; Male; Mice; Neomycin; Oxides; Polymyxin B; Povidone-Iodine; Pseudomonas Infections; Silver Sulfadiazine

Topics: Administration, Topical; Anti-Bacterial Agents; Burns; Chlorhexidine; Gentamicins; Humans; Kinetics; Mafenide; Polymyxins; Povidone-Iodine; Pseudomonas Infections; Silver Nitrate; Silver Sulfadiazine; Staphylococcal Infections; Streptococcal Infections; Wound Infection

Topics: Adult; Aged; Bacteriological Techniques; Cross Infection; Diagnosis, Differential; Disease Outbreaks; Drug Contamination; Humans; Middle Aged; Povidone; Povidone-Iodine; Pseudomonas; Pseudomonas Infections; Sepsis

Using an experimental animal model, the infection rate of contaminated bone grafts after irrigation with either normal saline, povidone-iodine, or a cefazolin solution was evaluated. Mechanical cleansing appears to be the important factor in preventing infection in these grafts, since all the solutions showed almost equal effectiveness. As the amount of bulk and dead space increases, particularly in Pseudomonas infections, povidone-iodine might be slightly superior, although this difference was not statistically significant.

Topics: Animals; Bone Transplantation; Cefazolin; Disinfection; Povidone-Iodine; Pseudomonas Infections; Rabbits; Ribs; Saline Solution, Hypertonic; Staphylococcal Infections; Sterilization; Surgical Wound Infection; Transplantation, Autologous; Transplantation, Homologous

The bacteriocidal effect of three substances is discussed: 10% povidone iodine ointment (Betadine, betaisodona), 11,2% mafenide acetate (Naplatan) and silver sulphadiazine (Flamazine, Silvadene, Silvertone). A modified Walker burn model using male Long-Evans rats was studied. The infections were produced with a solution of 3 times 10(8) Pseudomonas aeruginosa pyocin type H. organisms. The authors described the pharmacological properties of the three substances and report the following results. All three substances are able to penetrate third degree burns. It takes 4 hours for povidone iodone, 12 for mafenide acetate and 24 for silver sulphadiazine to penetrate the burn. Mafenide acetate and silver sulphadiazine were the most useful agents after 12 and 24 hours respectively. When the substances were applied for a second time 24 hours after the first application only mafenide acetate was highly effective. The effectiveness of povidone iodine and silver sulphadiazine decreased by half when compared with the first application. For practical purposes the following recommendations are made: For deep burns povidone iodine should be applied every 4--6 hours, mafenide acetate every 12--18 hours and silver sulphadiazine once every 24 hours in order to ensure an antibacterial effect.

Topics: Administration, Topical; Animals; Burns; Disease Models, Animal; Mafenide; Male; Povidone; Povidone-Iodine; Pseudomonas Infections; Rats; Silver Sulfadiazine; Sulfadiazine; Sulfonamides; Time Factors; Wound Infection

Pseudomonas cepacia was recovered from the blood cultures of 52 patients in four hospitals in New York over 6 months from April through October 1980. Epidemiologic investigation in one hospital indicated that the positive results of blood culture represented pseudobacteremias and implicated a 10% povidone-iodine solution used as an antiseptic and disinfectant (Pharmadine; Sherwood Pharmaceutical Company, Mahwah, New Jersey) as the source of contamination. Physicians who drew blood cultures positive for P. cepacia were more likely to have left povidone-iodine on the skin before venipuncture (p = 0.026) and were more likely to have applied povidone-iodine to the blood culture bottle tops and to have left it there while inoculating the blood culture media (p = 0.007) than those who drew cultures negative for P. cepacia. Direct inoculation of Pharmadine into brain-heart infusion broth yielded P. cepacia; however, 2 weeks after the first cultures, the same Pharmadine bottles were culture negative. The iodine concentrations of the contaminated Pharmadine solutions were similar to those of 10% povidone-iodine solutions distributed by other manufacturers.

Topics: Blood Specimen Collection; Drug Contamination; Humans; Povidone; Povidone-Iodine; Pseudomonas Infections; Sepsis

Topics: Cross Infection; Humans; Povidone; Povidone-Iodine; Pseudomonas Infections; Sterilization; United States

Topics: Aged; Bacterial Infections; Cardiac Surgical Procedures; Child, Preschool; Enterobacter; Enterobacteriaceae Infections; Escherichia coli Infections; Female; Humans; Infant; Klebsiella Infections; Male; Mediastinal Diseases; Middle Aged; Povidone; Povidone-Iodine; Proteus Infections; Pseudomonas Infections; Serratia; Staphylococcal Infections; Sternum; Streptococcal Infections; Surgical Wound Infection; Therapeutic Irrigation

Topics: Administration, Topical; Adolescent; Adult; Aged; Burns; Candidiasis; Child; Child, Preschool; Escherichia coli Infections; Female; Humans; Infant; Infection Control; Klebsiella Infections; Male; Middle Aged; Ointments; Povidone; Povidone-Iodine; Proteus Infections; Pseudomonas Infections; Staphylococcal Infections; Streptococcal Infections

Topics: Cross Infection; Disinfectants; Drug Packaging; Drug Storage; Povidone-Iodine; Pseudomonas Infections