sodium-hypochlorite and Bacteremia

To investigate the lethal activity of photoactivated disinfection (PAD) on Enterococcus faecalis (ATCC 29212) and mixed populations of aerobic or anaerobic bacteria in infected root canals using a diode laser after the application of a photosensitizer (PS).. First, the bactericidal activity of a low power diode laser (200 mW) against E. faecalis ATCC 29212 pre-treated with a PS (toluidine blue) for 2 min were examined after different irradiation times (30 s, 60 s and 90 s). The bactericidal activity in the presence of human serum or human serum albumin (HSA) was also examined. Second, root canals were infected with E. faecalis or with mixed aerobic or anaerobic microbial populations for 3 days and then irrigated with 1.5% sodium hypochlorite and exposed to PAD for 60 s.. Photosensitization followed by laser irradiation for 60 s was sufficient to kill E. faecalis. Bacteria suspended in human serum (25% v/v) were totally eradicated after 30 s of irradiation. The addition of HSA (25 mg/ml or 50 mg/ml) to bacterial suspensions increased the antimicrobial efficacy of PAD after an irradiation time of 30 s, but no longer. The bactericidal effect of sodium hypochlorite was only enhanced by PAD during the early stages of treatment. PAD did not enhance the activity of sodium hypochlorite against a mixture of anaerobic bacteria.. The bactericidal activity of PAD appears to be enhanced by serum proteins in vitro, but is limited to bacteria present within the root canal.

Topics: Actinobacteria; Actinomyces; Bacteremia; Bacterial Load; Bifidobacterium; Blood Bactericidal Activity; Dental Pulp Cavity; Disinfection; Enterococcus faecalis; Humans; Lasers, Semiconductor; Low-Level Light Therapy; Materials Testing; Peptostreptococcus; Photochemotherapy; Photosensitizing Agents; Root Canal Irrigants; Serum Albumin; Shewanella; Sodium Hypochlorite; Time Factors; Tolonium Chloride

Vascular access in hemodialysis is a major point of concern in the management of chronic patients. Although arteriovenous fistula remains as the access of first choice, tunneled central venous catheters are still commonly used. Infection remains the principal cause of catheter dysfunction or loss. Many protocols have been used in order to prevent exit site infections and bacteremia. We describe our experience with the use of sodium hypochlorite, an electrolytic chloroxidizer used as a topical disinfectant. It has been shown to be active against a broad spectrum of potential pathogens and has other specific advantages compared to other cleansing agents, including its non-toxic, non-irritating nature and its low cost. We conclude that sodium hypochlorite solution in different concentrations (10 and 50%) is effective in preventing exit site infections and bacteremia associated with tunneled central venous catheters in chronic hemodialysis patients.

Topics: Bacteremia; Candidiasis; Catheterization, Central Venous; Catheters, Indwelling; Cross Infection; Disinfectants; Dose-Response Relationship, Drug; Equipment Contamination; Humans; Incidence; Infection Control; Kidney Failure, Chronic; Renal Dialysis; Sodium Hypochlorite

Some dental procedures initiate a bacteraemia. In certain compromised patients, this bacteraemia may lead to distant site infections, most notably infective endocarditis.. To investigate whether a detectable bacteraemia was produced during non-surgical root canal therapy.. Thirty patients receiving non-surgical root canal therapy were studied. Three blood samples were taken per patient: pre-operatively, peri-operatively and post-operatively. In addition, a paper point sample was collected from the root canal. The blood samples were cultured by pour plate and blood bottle methods. The isolated organisms were identified by standard techniques. Blood samples were analysed for the presence of bacterial DNA by the polymerase chain reaction (PCR). In two cases where the same species of organism was identified in the root canal and the bloodstream, the isolates were typed by pulsed field gel electrophoresis (PFGE).. By conventional culturing, a detectable bacteraemia was present in 9 (30%) of the 30 patients who had no positive pre-operative control blood sample. In 7 (23.3%) patients, the same species of organism was identified in both the bloodstream and in the paper point sample from the root canal system. Overall, PCR gave lower detection rates compared with conventional culture, with 10 of 90 (11%) of the blood samples displaying bacterial DNA. PFGE typing was undertaken for two pairs of culture isolates from blood and paper points; these were found to be genetically identical.. Non-surgical root canal treatment may invoke a detectable bacteraemia.

Topics: Anti-Infective Agents, Local; Bacteremia; Bacteria; Bacteriological Techniques; Chlorhexidine; Dental Cavity Preparation; Dental Pulp Cavity; Electrophoresis, Agar Gel; Electrophoresis, Gel, Pulsed-Field; Female; Gutta-Percha; Humans; Hydrogen Peroxide; Male; Middle Aged; Polymerase Chain Reaction; Potassium Iodide; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Root Canal Therapy; Rubber Dams; Sodium Hypochlorite