Bacteriostatic Solution Research Articles

Botulinum toxin therapy: reduction of injection site pain by pH normalisation.

Botulinum toxin (BT) is injected intramuscularily and may produce injection site pain (ISP). We wanted to explore whether the pH value of the reconstituted BT drug contributes to ISP and, if so, what strategies can be applied to reduce it. In part 1 of the study, pH values of different reconstitution solutions and of major BT drugs reconstituted with different reconstitution solutions were assessed. In part 2, the effects of reconstitution with normal saline (NS) and Ringer acetate (RA) were compared intraindividually and in a double blind fashion in 34 patients with blepharospasm. pH values of reconstitution solutions were 5.52±0.02 for NS, 6.98 for RA, 6.31 for Ringer lactate, 6.56 for electrolyte and 5.31 for bacteriostatic solution. pH values for NS-reconstitution were 6.09±0.20 for Botox(®), 5.95±0.24 for Dysport(®) and 5.81±0.18 for Xeomin(®). pH values for RA-reconstitution were 6.95±0.03 for Botox(®), 7.01±0.02 for Dysport(®) and 6.87±0.06 for Xeomin(®). By using RA instead of NS the pH could be increased by 0.86 for Botox(®), by 1.06 for Dysport(®) and by 1.06 for Xeomin(®). 47% of the patients experienced less ISP when Botox(®)-RA was given rather than Botox(®)-NS, 76% when Xeomin(®)-RA was given rather than Xeomin(®)-NS. None of the patients reported a difference in efficacy between NS- and RA-reconstitution. Despite previous reports, reconstituted BT type A drugs show acidic pH values. Normalising these pH values by use of RA instead of NS reduces ISP considerably without sacrificing clincial efficacy.

A Burkholderia cepacia complex non-ribosomal peptide-synthesized toxin is hemolytic and required for full virulence

Members of the Burkholderia cepacia complex (Bcc) have recently gained notoriety as significant bacterial pathogens due to their extreme levels of antibiotic resistance, their transmissibility in clinics, their persistence in bacteriostatic solutions, and their intracellular survival capabilities. As pathogens, the Bcc are known to elaborate a number of virulence factors including proteases, lipases and other exoproducts, as well as a number of secretion system associated effectors. Through random and directed mutagenesis studies, we have identified a Bcc gene cluster capable of expressing a toxin that is both hemolytic and required for full Bcc virulence. The Bcc toxin is synthesized via a non-ribosomal peptide synthetase mechanism, and appears to be related to the previously identified antifungal compound burkholdine or occidiofungin. Further testing shows mutations to this gene cluster cause a significant reduction in both hemolysis and Galleria mellonella mortality. Mutation to a glycosyltransferase gene putatively responsible for a structural-functional toxin variant causes only partial reduction in hemolysis. Molecular screening identifies the Bcc species containing this gene cluster, of which several strains produce hemolytic activity.

Losses of bacteriostats from injections in rubber-closed containers.

Abstract The losses of bacteriostats from rubber-closed multidose containers of injections are confirmed, and the mechanism of these losses by absorption, diffusion and volatilisation is discussed. The present B.P. methods of pretreating rubber closures are inadequate, and methods for their more satisfactory equilibration with various bacteriostatic solutions are given. From measurements of the partition ratios of the B.P. bacteriostats and of benzyl alcohol between rubber and water, phenol and benzyl alcohol appear to be the most stable and promising and phenylmercuric nitrate the least stable. The value of using closures equilibrated for phenol and benzyl alcohol is demonstrated and methods for preventing the diffusion losses are discussed.

Evaluation of Antimicrobial-Antibiofilm Activity of a Hydrogen Peroxide Decontaminating System Used in Dental Unit Water Lines

A dental unit water line (DUWL) equipped with a device designed to automatically and continually flush a bacteriostatic solution of hydrogen peroxide (WHE) and a discontinuous disinfecting system (BIOSTER) was evaluated. In the first instance a preliminary sensitivity test on a large number of microorganisms (bacteria and fungi) was tried with a H2O2 range from 100 to 800 ppm. The bacteria frequently reported in DUWL (including Pseudomonas spp, Streptococcus spp., Staphylococcus spp., E. coli) and some periodontal pathogens showed a minimum inhibitory concentration from 100 to 300 H2O2 ppm (also including M. marinum and C. albicans). However, H2O2 did not show any inhibitory effects against: A. actinomycetemcomitans, C. glabrata C. parapsilos, F. nucleatum, M. micros. In a second step, the DUWL was experimentally infected with S. faecalis, E. coli, P. aeruginosa, S. aureus. After disinfection steps with 3% H2O2, the inhibitory effect on planktonic forms and on sessile biofilm was measured. In a third step, the count of 16S rRNA gene copies by real time PCR at different points of the DUWL described an accrue of bacterial slime in “hot spot” regions characterized by irregular/slow water flux (valves, elbows). However these results suggest that hydrogen peroxide is not only able to inhibit bursts of planktonic bacteria inside the DUWL, but that it could also be effective against sessile biofilm containing heterotrophic microorganisms derived from domestic water line contamination. In addition some oral pathogens could be contaminating and surviving in DUWL.

Biocompatibility of aldehyde-fixed bovine pericardium: An in vitro and in vivo approach toward improvement of bioprosthetic heart valves

Aldehyde-induced side effects limit the clinical usefulness of bioprosthetic heart valves. Treatment of aldehyde-fixed pericardium with L-glutamic acid at pH 3.5 and storage in a nontoxic, bacteriostatic solution resulted in a lower degree of calcification in 63-day subcutaneous implants in rats (13.3 +/- 2 mg calcium per gram dry weight of tissue), as compared with commercially available tissue (169 +/- 24 mg/gm, p less than 0.05). Endothelial cells died within 1 day after seeding on the commercial tissue; however, considerable endothelial cell proliferation was measured, even 14 days after seeding on L-glutamic acid-treated pericardium. Improved biocompatibility of this alternative treatment may be due to stable chemical binding of free, reactive aldehyde groups.

Chemically modified collagen: a natural biomaterial for tissue replacement.

Glutaraldehyde crosslinking of native or reconstituted collagen fibrils and tissues rich in collagen significantly reduces biodegradation. Other aldehydes are less efficient than glutaraldehyde in generating chemically, biologically, and thermally stable crosslinks. Tissues crosslinked with glutaraldehyde retain many of the viscoelastic properties of the native collagen fibrillar network which render them suitable for bioprostheses. Implants of collagenous materials crosslinked with glutaraldehyde are subject long-term to calcification, biodegradation, and low-grade immune reactions. We have attempted to overcome these problems by enhancing crosslinking through bridging of activated carboxyl groups with diamines and using glutaraldehyde to crosslink the epsilon-NH2 groups in collagen and the unreacted amines introduced by aliphatic diamines. This crosslinking reduces tissue degradation and nearly eliminates humoral antibody induction. Covalent binding of diphosphonates, specifically 3-amino-1-hydroxypropane-1, 1-diphosphonic acid (3-APD), and chondroitin sulfate to collagen or to the crosslink-enhanced collagen network reduces its potential for calcification. Platelet aggregation is also reduced by glutaraldehyde crosslinking and nearly eliminated by the covalent binding of chondroitin sulfate to collagen. The cytotoxicity of residual glutaraldehyde--leaching through the interstices of the collagen fibrils or the tissue matrix--and of reactive aldehydes associated with the bound polymeric glutaraldehyde can be minimized by neutralization and thorough rinsing after crosslinking and storage in a nontoxic bacteriostatic solution.

Preparation of Sterile, Pyrogen-free, Bacteriostatic Solutions of Zinc Sulfate and Copper Sulfate

Preparation of Sterile, Pyrogen-free, Bacteriostatic Solutions of Zinc Sulfate and Copper Sulfate

Peritonitis during peritoneal dialysis—The role of the preheating water bath

Peritoneal dialysis has several potential complications including peritoneal infection. Assessment of this complication at UTMB during 116 patient hospitalizations revealed clinical peritonitis with positive bacterial cultures in 25% and positive peritoneal cultures in 45%. Because of the high incidence of peritonitis, an epidemiological evaluation strongly suggested a causal relationship with water baths used to preheat the dialysis solutions. To decrease exogenous contamination during preheating, the water baths were filled with 0.25% acetic acid which was changed every 8 hr. Analysis of the 50 subsequent hospitalizations indicated that clinical peritonitis was reduced to 10% ( P < 0.05) and positive cultures to 28% ( P < 0.02). The clinically important nosocomial infection may be prevented to a significant extent by aseptic care of dialysis bottles and tubing and by use of bacteriostatic solutions in the preheating water bath.

WASH BASIN CONTAMINATION IN OPERATING ROOMS

This bacteriologic investigation of contamination was occasioned by a recent change of solutions in the wash basins in the operating rooms of the New Haven Hospital. The weak bacteriostatic solution of iodine used previously was changed to sterile water in quantities of 1,000 cc. in each large shallow basin placed behind an operator, in which the operator washes off his gloves during the operative procedure. This change was made in the hope that discontinuance of the use of the iodine solution would decrease the dermatitis prevailing among the operating staff. In a few cases a disinfectant, zephiran, 1 was put in the basins in a concentration of 1: 5,000 in sterile water. This was done only when contamination of the basins during the operative procedure was most likely. TECHNIC The technic employed throughout these investigations was as follows: At the close of the operation 1 cc. of fluid was removed