povidone-iodine and Staphylococcal-Skin-Infections

Preoperative showering with antiseptic skin cleansers is common in elective operations, although the value of this procedure in reducing surgical wound infections has not been established. The authors designed a prospective study to assess the influence of povidone-iodine preoperative showers on skin colonization in elective plastic surgery procedures.. Patients older than 18 years scheduled for elective and clean plastic surgery procedures on the thorax or abdomen were assigned randomly to the povidone-iodine group (n = 57) or to a control group (n = 57). Patients allocated to the povidone-iodine group took a shower with liquid detergent-based povidone-iodine 10% 2 hours before surgery. For the control group, no special instructions for showering were implemented before surgery. Quantitative skin cultures were obtained just before the preoperative scrub in the operating room. Samples were plated on hypertonic mannitol agar, blood agar, Sabouraud agar with chloramphenicol, and eosin-methylene blue agar. Samples were collected and processed, and results were assessed by blinded investigators.. Staphylococcal skin colonization was significantly lower in the povidone-iodine group (p < 0.001). No microorganism growth was observed on 33 percent of the postshower skin cultures from patients in the povidone-iodine shower group compared with 0 percent of the cultures from patients in the control group. Colonies of fungi and enterobacteria were recovered in small amounts in both groups, and povidone-iodine showers did not significantly reduce skin colonization by these microorganisms.. Single preoperative povidone-iodine showers are effective in reducing staphylococcal skin colonization before elective clean plastic surgical procedures on the thorax and abdomen.

Topics: Administration, Topical; Anti-Infective Agents, Local; Elective Surgical Procedures; Humans; Plastic Surgery Procedures; Povidone-Iodine; Preoperative Care; Prospective Studies; Skin; Skin Care; Staphylococcal Skin Infections; Staphylococcus; Surgical 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

As antimicrobial resistance continues to increase, revisiting old antimicrobial agents, modified to enhance efficacy and safety, becomes important. Iodine has been widely used for more than 150 years as a wound and skin disinfectant; it is an effective broad range bactericide and does not promote the development of resistant strains. The most important iodine-based agent is povidone-iodine (PVP-I) which provides excellent antibacterial activity. However, its safety profile has been questioned.. To evaluate the in-vitro antibacterial efficacy and kinetic properties of a novel iodine-based compound, iodine lithium alpha-dextrin (ILαD), against Staphylococcus aureus, and compare the in-vitro cytotoxicity profiles of ILαD and PVP-I.. A minimum inhibitory concentration (MIC) microbroth dilution method was performed against 12 meticillin-resistant (MRSA) and eight meticillin-susceptible (MSSA) S. aureus clinical isolates using ILαD and PVP-I. Time-kill and post-antibiotic effect studies of ILαD provided rate-of-kill information. MTT cytotoxicity assays were performed using three cell lines, treated with MIC doses of ILαD and PVP-I.. The MIC values of ILαD and PVP-I against the MRSA strains were 125 mg/L and 31.25 mg/L, respectively. Time-kill and post-antibiotic effect studies of ILαD revealed a log10 reduction factor of 3 within 8 h of exposure at a 2 × MIC dose; the post-antibiotic effect was calculated at 5±0.3h. Cell viability was affected slightly at the MIC dose of ILαD, while the MIC dose of PVP-I exerted a strong cell growth inhibitory effect of 90-95%.. ILαD could be a promising solution against staphylococcal infections as it is effective, does not promote the development of resistant strains, and in-vitro testing indicates that it may be safer than PVP-I. Further studies are justified to determine whether ILαD overcomes the clinical limitations of PVP-I.

Topics: Anti-Infective Agents, Local; Cell Line; Cell Survival; Colony Count, Microbial; Dextrins; Humans; Lithium; Microbial Sensitivity Tests; Microbial Viability; Povidone-Iodine; Staphylococcal Skin Infections; Staphylococcus aureus

Staphylococcal extracellular polymeric substances (EPS) such as extracellular DNA (eDNA) and poly-N-acetylglucosamine surface polysaccharide (PNAG) mediate numerous virulence traits including host colonization and antimicrobial resistance. Previous studies showed that EPS-degrading enzymes increase staphylococcal biocide susceptibility in vitro and in vivo, and decrease virulence in animal models. In the present study we tested the effect of EPS-degrading enzymes on staphylococcal skin colonization and povidone iodine susceptibility using a novel in vivo pig model that enabled us to colonize and treat 96 isolated areas of skin on a single animal in vivo. To quantitate skin colonization, punch biopsies of colonized areas were homogenized, diluted, and plated on agar for colony forming unit enumeration. Skin was colonized with either Staphylococcus epidermidis or Staphylococcus aureus. Two EPS-degrading enzymes, DNase I and the PNAG-degrading enzyme dispersin B, were employed. Enzymes were tested for their ability to inhibit skin colonization and detach preattached bacteria. The effect of enzymes on the susceptibility of preattached S. aureus to killing by povidone iodine was also measured. We found that dispersin B significantly inhibited skin colonization by S. epidermidis and detached preattached S. epidermidis cells from skin. A cocktail of dispersin B and DNase I detached preattached S. aureus cells from skin and increased their susceptibility to killing by povidone iodine. These findings suggest that staphylococcal EPS components such as eDNA and PNAG contribute to skin colonization and biocide resistance in vivo. EPS-degrading enzymes may be a useful adjunct to conventional skin antisepsis procedures in order to further reduce skin bioburden.

Topics: Animals; Anti-Bacterial Agents; Bacterial Adhesion; Deoxyribonuclease I; Disease Models, Animal; Drug Resistance, Bacterial; Extracellular Polymeric Substance Matrix; Female; Humans; Povidone-Iodine; Recombinant Proteins; Staphylococcal Skin Infections; Staphylococcus aureus; Staphylococcus epidermidis; Sus scrofa

The topical application of a mixture of sugar and povidone-iodine (PI) has been reported to accelerate the healing of cutaneous wounds and ulcers by promoting reepithelialization and granulation tissue formation, as well as by having an anti-microbial effect. In order to clarify the efficacy of a 70% sugar and 3% PI paste (U-PASTA(SP) on infectious skin ulcers, we made a bacterial infection model using methicillin-resistant Staphylococcus aureus (MRSA) on the skin of diabetic db/db mice, and investigated the effect of the paste on the healing process of wounds. Full-thickness wounds were made on the backs of female diabetic mice, (C57BL/ksJ db/db) and inoculated with S. aureus. SP was applied to the closed wounds for 8 days. The degree of repair was evaluated using three histological parameters: The degree of reepithelialization was given a percentage value of 0-100%; the amount of granulation tissue was quantified by measuring the area of granulation (mm(2)); and the number of capillary lumens in the granulation tissue was counted in the complete wound cross-section at 100x magnification. In addition, the colony-forming units (CFU) of MRSA on the wounds were counted. Continuous MRSA infection in the wounds of db/db mice was demonstrated with macroscopic and histopathological images. Wounding and infection caused by MRSA on the back of the diabetic mice significantly induced delayed reepithelialization, granulation tissue formation with inflammatory cell infiltrate and increased CFU on wounds (P < 0.01, respectively) compared to those of the MRSA-infected normal mice. Application of SP significantly accelerated reepithelialization (P < 0.01) and decreased CFU (P < 0.05) of the ulcers in the MRSA-infected wounds, compared to the non-treated group. Histopathological evaluation and CFU on this animal model revealed no significant difference between Methicilin-sensitive Staphylococcus aureus and MRSA infection. These results indicate that wounding on db/db mice provides a useful animal model of bacterial skin infections, and that SP is an effective topical agent for the treatment of diabetic skin ulcers.

Topics: Administration, Cutaneous; Animals; Anti-Infective Agents, Local; Capillaries; Colony Count, Microbial; Diabetes Complications; Disease Models, Animal; Drug Combinations; Epithelial Cells; Female; Granulation Tissue; Methicillin Resistance; Mice; Mice, Inbred C57BL; Mice, Mutant Strains; Ointments; Povidone-Iodine; Skin Ulcer; Staphylococcal Skin Infections; Staphylococcus aureus; Sucrose; Time Factors; Wound Healing

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

Tufted hair folliculitis (THF) is a rare disease which is characterized by the emergence of multiple hairs from widely dilated follicular orifices surrounded by an inflammatory infiltrate resulting in scarring alopecia. The pathogenesis is not yet fully understood. Although colonization with Staphylococcus aureus could not always be detected and systemic treatment with antibiotics alone is not sufficient, this microorganism is considered to play an important role. Around 30 patients with THF have been reported since the first publication. We present a patient with pemphigus vulgaris who developed THF. To our knowledge, this is the fourth case with an association of these two entities. Amongst other causing mechanisms, the autoimmune reaction may play an important role for the development of THF.

Topics: Administration, Topical; Alopecia; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Dermatologic Agents; Drug Therapy, Combination; Folliculitis; Glucocorticoids; Humans; Male; Methylprednisolone; Middle Aged; Mycophenolic Acid; Pemphigus; Povidone-Iodine; Staphylococcal Skin Infections; Staphylococcus aureus

The combination of the local disinfection therapy against Staphylococcus aureus with the conventional therapy for atopic dermatitis has been widely used, and the improvement in skin lesions has been reported to be associated with a remarkable decrease in IgE levels and reagin antibody titers. We have already reported that affected organs were not only the skin but also the gastrointestinal tract in a case with atopic dermatitis. In the present study, the duodenal tissues were examined by biopsy in 32 patients with atopic dermatitis, and mild or chronic duodenitis was observed in all samples. Toxins were examined by PCR from 180 Staphylococcus aureus strains obtained from our patients. The detection rate of toxins was 82.8%. In many patients, antitoxin IgE antibody titers corresponding to their types of toxin and IgE levels were decreased in a parallel manner as time passed. We found 1 patient who complained of paresthesia in all four limbs, and her neurological and radiological examinations showed moderate cervical spondylosis. Neurological examinations revealed some abnormalities in 43 out of 50 patients with atopic dermatitis, such as hyperreflexia of the legs. Cervical MRI was carried out randomly and showed abnormal findings in 21 of 25 patients, in whom 18 duodenal tissues were examined by biopsies.

Topics: Adolescent; Adult; Anti-Infective Agents, Local; Antibodies, Bacterial; Biopsy; Child, Preschool; Dermatitis, Atopic; Duodenitis; Female; Humans; Immunoglobulin E; Male; Povidone-Iodine; Staphylococcal Skin Infections; Surveys and Questionnaires

In chronic wounds (ulcus cruris) of lymphedematous patients (n = 25) opportunistic infections caused by gram-negative rods and methicillin-resistant Staphylococcus aureus can be detected in 35% of cases. The healing of the wound takes a long time, which is the reason why the patients are taught how to manage the wound care. Local antibiotics must be avoided. The elimination of the wound infections is the first step of the complex decongestive physiotherapy. The infection aggravates the lymphostasis and makes the complaints of the patients (inflammation, pain, odor) more unacceptable, the systemic infections (erysipelas, lymphadenopathy, fever) more probable and the costs of the treatment higher. Betadine solution and ointment were used locally. The clinical and bacteriological efficacy of povidone-iodine has been validated. Excellent local tolerability has also been observed. The opinion of the patients was registered on a visual analog scale and statistically analyzed. No development of resistance has been noted. For local treatment, Betadine proved to be an effective preparation tolerable for a long time in the treatment of chronic wounds.

Topics: Adult; Anti-Infective Agents, Local; Chronic Disease; Female; Humans; Leg Ulcer; Lymphedema; Male; Middle Aged; Povidone-Iodine; Skin Diseases, Bacterial; Staphylococcal Skin Infections; Staphylococcus aureus

For the treatment of atopic dermatitis, a variety of therapies are used including folk medicine. At present, there is no single treatment which is effective to cure the symptoms of atopic dermatitis completely in all patients. We are drawing attention to the high isolation rate of Staphylococcus aureus when starting disinfectant treatment combined with topical steroid therapies for the purpose of killing S. aureus. As a result, we examined many patients in whom almost a complete remission was obtained even after short periods of therapy, though it had been difficult to obtain improvement by conventional treatments. In many patients, IgE values and reagin antibody titer decrease dramatically soon after starting treatment. As a disinfectant, 10% povidone-iodine solution was used. We investigated also the effect of iodine contained in the povidone-iodine solution on the thyroid gland.

Topics: Administration, Topical; Adolescent; Adult; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Child; Dermatitis, Atopic; Emollients; Female; Glucocorticoids; Humans; Immunoglobulin E; Iodine; Iodophors; Male; Medicine, Traditional; Methicillin Resistance; Patient Satisfaction; Petrolatum; Povidone-Iodine; Reagins; Remission Induction; Staphylococcal Skin Infections; Staphylococcus aureus; Surveys and Questionnaires; Thyroid Gland; Thyrotropin; Thyroxine; Triiodothyronine

A case-control study was performed to examine the efficacy of 10% povidone-iodine solution applied to atopic dermatitis patients. The density of Staphylococcus aureus on the eczematous lesions and the lesion severity before and after the topical application of povidone-iodine were compared. We found a 10-100-fold decrease in the density of S. aureus after povidone-iodine treatment in patients colonizing S. aureus at an initial density of > 1000 CFU/10 cm2. Erythema and exudation also decreased after povidone-iodine treatment in patients colonizing S. aureus at an initial density of > 1000 CFU/10 cm2. The 10% povidone-iodine solution disinfected S. aureus cells when added immediately after the cells were mixed in human plasma; however, 10% povidone-iodine solution only reduced the density of S. aureus cells by 10-100-fold when S. aureus cells were harvested after a 24 h incubation in human plasma. Staphylococcus aureus cells harvested after 24 h incubation in human plasma were often surrounded by fibrin bundles and cells circumscribed by fibrin bundles could not be disinfected with 10% povidone-iodine solution. We suggest that S. aureus cells may produce biofilm-like structures in atopic dermatitis patients and that these structures may help S. aureus cells resist the 10% povidone-iodine treatment.

Topics: Administration, Topical; Adolescent; Adult; Anti-Infective Agents, Local; Case-Control Studies; Child; Dermatitis, Atopic; Female; Humans; Male; Microscopy, Electron; Povidone-Iodine; Staphylococcal Skin Infections; Staphylococcus aureus

We studied the effects of scrubbing with poloxamer 188 (SCR), irrigating with povidone iodine (PI), and scrubbing followed by irrigation (SCR-PI) on staphylococcal and streptococcal counts in inoculated guinea pig lacerations. PI irrigation and SCR-PI significantly lowered streptococcal counts (P < 0.05). Staphylococcal counts were not different from those in controls.

Topics: Animals; Colony Count, Microbial; Disease Models, Animal; Disinfection; Guinea Pigs; Poloxalene; Povidone-Iodine; Staphylococcal Skin Infections; Staphylococcus aureus; Streptococcal Infections; Streptococcus pyogenes; Therapeutic Irrigation; Wound Infection

Fifty-six S. aureus episodes of catheter exit-site tunnel infections were diagnosed in 40 out of 163 patients treated by CAPD for 30 +/- 22 months, with standard double-cuff Tenckhoff catheters. The rate of infection was 1 episode every 29 patient/months. Local care and antibiotic therapy were effective in 52% of the cases. Whereas in 29 episodes in which the medical therapy failed to eradicate the infection the entire area of granulation tissue and cellulitis was excised then the outer dacron cuff was shaved from the silicone catheter. With this treatment 13 episodes (48%) were cured while, in the remaining 14 patients the catheters were removed because of peritonitis in 10; and for failure to eradicate the infection in 4.

Topics: Catheters, Indwelling; Debridement; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Povidone-Iodine; Rifampin; Staphylococcal Skin Infections; Vancomycin