Abstract
IntroductionRecent virus epidemics and rising antibiotic resistance highlight the importance of hygiene measures to prevent and control outbreaks. We investigated the in vitro bactericidal and virucidal efficacy of povidone-iodine (PVP-I) 7% gargle/mouthwash at defined dilution against oral and respiratory tract pathogens.MethodsPVP-I was tested against Klebsiella pneumoniae and Streptococcus pneumoniae according to bactericidal quantitative suspension test EN13727 and against severe acute respiratory syndrome and Middle East respiratory syndrome coronaviruses (SARS-CoV and MERS-CoV), rotavirus strain Wa and influenza virus A subtype H1N1 according to virucidal quantitative suspension test EN14476. PVP-I 7% gargle/mouthwash was diluted 1:30 with water to a concentration of 0.23% (the recommended concentration for “real-life” use in Japan) and tested at room temperature under clean conditions [0.3 g/l bovine serum albumin (BSA), viruses only] and dirty conditions (3.0 g/l BSA + 3.0 ml/l erythrocytes) as an interfering substance for defined contact times (minimum 15 s). Rotavirus was tested without protein load. A ≥ 5 log10 (99.999%) decrease of bacteria and ≥ 4 log10 (99.99%) reduction in viral titre represented effective bactericidal and virucidal activity, respectively, per European standards.ResultsPVP-I gargle/mouthwash diluted 1:30 (equivalent to a concentration of 0.23% PVP-I) showed effective bactericidal activity against Klebsiella pneumoniae and Streptococcus pneumoniae and rapidly inactivated SARS-CoV, MERS-CoV, influenza virus A (H1N1) and rotavirus after 15 s of exposure.ConclusionPVP-I 7% gargle/mouthwash showed rapid bactericidal activity and virucidal efficacy in vitro at a concentration of 0.23% PVP-I and may provide a protective oropharyngeal hygiene measure for individuals at high risk of exposure to oral and respiratory pathogens.FundingMundipharma Research GmbH & Co. KG (MRG).
Highlights
Recent virus epidemics and rising antibiotic resistance highlight the importance of hygiene measures to prevent and control outbreaks
Oral and respiratory tract infections caused by bacteria such as Streptococcus pneumoniae and Klebsiella pneumoniae pose a particular threat because of the rise of antibiotic-resistant strains, with vulnerable patient populations at high risk of infection [2, 3]
This study investigated the in vitro bactericidal and virucidal efficacy of PVP-I 7% gargle/mouthwash against relevant oral and respiratory tract pathogens based on the European standards EN13727 [27] and EN14476 [28]
Summary
Recent virus epidemics and rising antibiotic resistance highlight the importance of hygiene measures to prevent and control outbreaks. Oral and respiratory tract infections caused by bacteria such as Streptococcus pneumoniae and Klebsiella pneumoniae pose a particular threat because of the rise of antibiotic-resistant strains, with vulnerable patient populations at high risk of infection [2, 3]. Seasonal endemic viruses such as influenza are another significant cause of respiratory infection; worldwide, annual influenza epidemics are estimated to result in about 3–5 million cases of severe illness and about 250,000–500,000 deaths [4]. Be quickly and effectively controlled with preventive strategies based upon early accurate viral diagnosis, knowledge of the current epidemiological season and effective hygiene practices to decrease the risk of transmission [8]
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