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Introduction: According to common belief, supported by the authority of the World Health Organization - WHO, the common (social) hand washing is the simplest, cheapest and the most effective way of reduction the hospital-acquired infections. For this purpose products of"liquid soaps", present in a large number on the market, are most often applied. Microbiological status (microbiological purity and antimicrobial activity) of"liquid soaps" available on the Polish market is not known, because relevant routinely studies have not been performed. Only the antibacterial and / or antifungal activity of certain formulations is sometimes assessed, especially when the manufacturer suggests the standardized application of the products for surgical or hygienic procedures. The aim of this study was to determine the microbiological quality, especially microbiological purity and antimicrobial activity of the selected hands washing products, presents on the Polish market., Methods: The 12 selected commercial products, available on the market in Poland, dedicated for hands washing were included into study. Microbiological purity test was carried out in accordance with the Polish Pharmacopoeia (FP) monograph (FP monograph numbers correspond to numbers of the European Pharmacopoeia monograph- Ph. Eur.) No 2.6.12 "Microbiological examination of non-sterile products: microbial enumaration tests", and the monograph of FP No. 2.6.13 "Microbiological examination of non-sterile products: test for specified microorganisms". The following physico-chemical properties of soaps were examined: the pH of the formulations was measured according to the monograph FP No. 2.2.3. "Potentiometric determination of pH", the density of products was assayed according to the monograph FPNo. 2.2.5. "Relative density" and determination the water activity was performed by monograph FP No 2.9.39 "Water-solid interactions: determination of sorption-desorption isotherms and of water activity". Next, antibacterial and antifungal protection was determined in accordance with the monograph FP No 5.1.3. "Efficacy of antimicrobial preservation". The study of antimicrobial activity was carried out in accordance with PN-EN 1040 "Chemical disinfectants and antiseptics - Quantitative suspension test for the evaluation of basic bactericidal activity of chemical disinfectants and antiseptics - Test method and requirements (phase 1)". Finally, using the "time-kill" method the survival of microorganisms after different contact times of the products with bacteria and fungi were determined., Results: All the examined products showed a very high microbiological purity. None of the formulations was characterized by a high acidity or alkalinity. All the analyzed products were slightly thicker than water, but such density of the preparation does not seem to be important parameter in the growth of microorganisms. The results of water activity estimation - the parameter indicating the presence of free, not chemically bound water stimulating microbes growth - do not show that low water content in the preparation may inhibit bacteria and fungi growth. Taking into consideration the antimicrobial protection of the products demonstrated in the tests carried out in accordance within FP monograph No 5.1.3. and PN-EN 1040, and analysing curves indicating killing rate of bacteria and fungi obtained by "time-kill" method, the microorganisms contaminating the products generally should not multiply in their environment, and gradually they die - what can take many hours or even days., Conclusions: The cases of bacterial infections connected with the usage of non-medical liguid soaps, applied in the health care units and described in the literature, should be considered as related rather to contamination of plastic packaging and dosage system, then to contamination of preparation itself inside the package. It was proved, that in all tested products amount of contaminating microbes diminishes in time. The dynamics of this process depends on the microorganisms character - bacteria dies quicker then fungi. The special attention should be given to washing, cleaning and disinfection of preparation dispensing systems, to avoid microbial contamination of product doses applied directly on the hands. It should be emphasized that only formulations containing antimicrobial agents in an appropriate amount, eliminate microorganisms from the skin surface fast and effectively. In case of hygienic and surgical procedures following the standardized manner in order to obtain required reduction rate of microorganisms in a short time - only products complying with appropriate EN standards are suitable. For these puroposes, the popular "liquid soaps" should not be used.

Introduction: Antimicrobial properties of silver nanoparticles (SNP's) have been recentl well evaluated, and now are being considered as excellent candidates for therapeutic purposes. It is confirmed, that various solutions of colloidal SNP's possess significant antibacterial properties against such species as: Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa even at low concentrations, although there have been so far only a few researches evaluating antimicrobial activity of SNP's against cariogenic bacteria: Streptococcus mutans, Streptococcus salivarius and Streptococcus mitis responsible for initiation of dental carries. Tooth decay is infectious disease an worldwide, which may occur in patients of every age. Nanotechnology creates a new approach of designing of medical devices preventing or reducing bacterial colonization., Methods: Colloidal silver solution (CSS) of concentration 350 ppm was used in this research. Nanoparticles size, shape and solution stability were evaluated. 16 strains of cariogenic bacteria, 4 isolates of each species: S. mutans, S. salivarius, S. sanguinis and S, mitis were obtained from plaque swabs of 7 patients treated for dental carries at Department of Conservative Dentistry, Medical University of Warsaw. MIC and MBC values for CSS's were evaluated., Results: CSS used in this research is of good stability. No agglomeration or coalescence was observed during 24 hours of experiment. Silver nanoparticles were of round shape and had mean size of 67 nm. MIC values were: 12-25 ppm for S. salivarius, 25 ppm for S. sanguinis, 50-100 ppm for S. mitis and 50 ppm for S. mutans, while MBC values after 1 hour of bacterial contact with nanoparticles were 200-350 ppm for all cariogenic bacterial species. After 24 hours of contact MBC values were: 25-50 ppm for S. salivarius and S. sanguinis, 100-200 ppm for S. mitis and 200 ppmfor S. mutans., Conclusions: Antimicrobial properties of CSS depend on nanoparticles concentration and interaction time with bacteria. The susceptibility of cariogenic oral streptococci to silver nanoparticles is diversified. Sufficient concentration which inhibited all cariogenic bacteria in our research was 200 ppm after long (24 hours) period of silver nanoparticles interaction with bacteria.

Introduction: Cotton as well as synthetic textile medical products are widely used as barrier materials and individual protection against displacement of biological infectious factors. The required level of protection of these products for multiple use and disposable multilayer laminates against the penetration of microbes depends on the risk connected with type of surgical procedure defined in normative documents. METHODS. Cotton and syntetic medical textiles for multiple use, 30-times subjected to processes simulating conditions of the use as well as disposable multilayer surgical drapes were tested. Resistance to microbial wet penetration was conducted according to the PN-EN ISO 22610: 2007 standard., Results: The barrier of cotton fabrics was reduced after first washing and then systematically grew after each often cycles to the value close to the value at the beginning. From the twentieth cycle of simulated conditions of the use, barrier index was reduced. The barrier of the synthetic textile stayed on the average level, while multilayer disposable products ensured the full impermeability for the bacteria., Conclusions: Natural cotton textiles for multiple use could be apply on operative blocks in limited range because of the changes of the cotton structure caused by repeated laundering process and sterilization. Synthetic materials also have limited application, although are more resistant to cleaning and sterilization processes. Disposable synthetic laminates with many layers use guarantee impermeability for bacteria and may be applied in operative blocks without restrictions.

Twenty vancomycin resistant E. faecium strains (VRE) isolated from patients of three different hospital wards in 2005-2008 were examined. The strains originated from patients of intensive therapy, urological and internistic wards. The chosen wards differ significantly in their specificity. In all cases the presence of o vanA and lack of vanB, vanD, vanE and vanG genes and were found. Strains were compared by using RFLP-PFGE, the reference method for molecular typing of VRE. One group including fourteen strains showing similarity higher than 79.5% was distinguished. This group was divided into subgroups. The greatest similarity was found among strains from patients of intensive therapy ward. Two subgroups of strains showing similarity more than 93.3%, of four strains each were identified. The similarity between these two subgroups was 79.5%. Most strains from other two wards showed less than 79.5% similarity and they could be recognised as not related. Only one strain from internal ward and two strains from urologic ward were similar in 82.1 - 86.4% to one of subgroups of strains originated from intensive therapy.

The purpose of this study was to evaluate two screening methods for detection of biofilm formation by eighty clinical Staphylococcus aureus isolates from patients with cystic fibrosis, and evaluation of biofilm production on the polystyrene 96-well tissue culture plates, depending on media applied. All clinical strains were incubated in three different media: Luria-Bertani broth (LB), tryptic soy broth supplemented with 2% glucose (TSBglu) and brain heart infusion (BHI). Biofilm production was screened by staining with crystal violet (CV) or with 2,3,5-triphenyltetrazolium chloride (TTC). Both CV and TTC assays showed, that all analyzed isolates created biofilm, in all tested media, however with different intensity. In conclusion, the CV method was found to be more sensitive than the TTC method, when we need information about whole mass of biofilm. The most optimal medium for the biofilm culture was LB medium.

Textile medical products can be widely used as barrier materials and individual protection against biological threats. Rules of introducing such products to market are regulated by the Directive 93/42/ EEC. Detailed requirements and testing methods of textile medical products are presented in obligatory norms. The required level of protection of these products against the penetration of microbes depends on the risk connected with planned type surgical procedure, the duration of the surgical intervention, risks of bleeding or presences of other body liquids of the patient and susceptibilities of the patient to infection. The aim of the study was to establish resistance of medical textiles to wet bacterial penetration. Materials were examined by the apparatus dedicated to this type of testing and obtained results were rated with reference to obligatory contracted requirements. assured Textiles laminated with foils possessed best protective proprieties, whereas medical products made from the cotton do not provide the sufficient level of the protection against microbes.

The aim of this study was to analyse P aeruginosa biofilm growing in three media, using three methods of biofilm staining: with 2% crystal violet solution (CV), with 1% 2,3,5-triphenyltetrazolium chloride solution (TTC) and 3-(4,5-dimethyl-2-thiazolyl)-2,5 diphenyl-2H-tetrazolium bromide (MTT). Using the method with MTT solution we could observe growth of strains forming biofilm both slowly or quickly. Achieved values of absorbation allow to observe dynamic of growing selected strains in the period of time. Among three groups of analysed strains, the biggest percentage of medium growing strains were achieved, while in the fourth group (strains isolated from spit of patients with cystic fibrosis) the biggest percentage of low growing strains was observed. Achieved results allow to select the strains quickly forming biofilm, the best media (LB, TSB2%glu) and method of biofilm staining (MTT), which will be used in the further studies.

The MIC of nine different disinfectants and antiseptics were determined for the Gram-negative and Gram-positive bacteria. Strains originated from clinical specimens, drugs and environment. A sensitivity was determined against chlorhexidinum digluconate (Gram-negative: 0,625-80 mg/L, Gram-positive: 0,3-10 mg/L), benzalconium chloride (Gram-negative: 2,5-1280 mg/L, Gram-positive: 1,25-20 mg/L), salicilic acid (Gram-negative and Gram-positive: 400-1600 mg/L), benzoic acid (Gram-negative: 800-1600 mg/L, Gram-positive: 400-1 600 mg/L), boric acid (Gram-negative: 800-12 800 mg/L, Gram-positive: 1 600-6400 mg/L), chloramine B (Gram-negative: 1600-6400 mg/L, Gram-positive:800- 6400 mg/L), jodine (Gram-negative: 200-1600 mg/L, Gram-positive: 200-1600 mg/L), etacridine lactate (Gram-negative: 40 do > 20480 mg/L, Gram-positive: 40-1280 mg/L) and resorcine (Gram-negative: 1600-6400 mg/L, Gram-positive: 800-6400 mg/L). Diversified values of MIC for different strains were obtained, especially in the case of benzalconium chloride, etacridine lactate, chlorhexidinum digluconate, boric acid and iodine. Strains isolated from environment were usually more susceptible to examined compounds than clinical strains. The biggest diversification of sensitivity was observed among strains originated from drugs where besides sensitive appeared strains characterizing by very high MIC values of some substances, eg. boric acid.

Infections due to vancomycin resistant enterococci (VRE) constitute a serious therapeutic problem in some cases. Up to date there is only poor knowledge about the frequency of isolation of VRE inthe Polish hospitals. The aim of our investigations was to compare the number and the assortment of VRE isolated during eight years (1998-2005) in the one big clinical hospital in Warsaw. All resistant strains were checked for possessing the vanA or van B ligase genes in the PCR reaction. The identification of the strains was proven by PCR with using of the ddl primers. The significant increase in the number of VRE was observed in the 2005 compared with recent years. All strains isolated in recent years possessed vanA ligase genes. Although among all enterococci E. faecalis made majority (over 70%), among VRE predominated E. faecium.

The aim of this study was to compare checkerboard method with E-test assay for interaction analysis of aminoglycosides in combination with other antibiotics on selected clinical bacterial strains. In the first step, MIC values of analysed antibiotics, against particular bacterial strain were established. In the next step, antibiotics interaction was analysed by checkerboard technique and E-test. We found some difficulties while comparing these two methods. The checkerboard and E-test results corresponded in about 55%. Twenty-one percentage of results obtained by both methods showed some discrepancies. In 15% of cases, because of high MICs values, comparison of the results was impossible. Some investigators declare FIC indexes, from over 0.5 up to 4, for neutral effects. Sharing this point of view, above 21% of discrepancies results agreed. In such situation, definite disagreement was observed only in 8% of obtained results. In this investigation, additive and neutral effects were dominant. The E-test technique is less-laborous than standard agar method. In this study the E-test assay indicated synergy in only one case. Because of the manner in which the E-test strips were placed on the agar (scales intersecting at the MICs) only dramatic cases of antagonism were detected. Mild cases were undetected because the inhibition zone run under the crossed strips and was therefore unreadable and interpreted as indifference. On the basis of these results, examination of interactions between antibiotics by E-test, appears to be possible alternative to checkerboard method with mentioned limitations.

Activity interaction analysis of two antibiotics by two methods: checkerboard and "time-kill" was compared during this study. Combinations of procaine penicillin, polymyxin B and bacitracin with neomycin and procaine penicillin with dihydrostreptomycin were examined. Checkerboard method is the most widely used technique for antimicrobials interactions analyses. The "time-kill" method, performed by the broth macrodilution technique, provides a dynamic picture of antimicrobial action and interaction over time (based on serial colony counts). Differences of "time-kill" method and the checkerboard technique, allow single visual examination (after 16 to 24 hours of incubation). Additive and inhibition effects were observed in combinations of neomycin with beta-lactam antibiotic (procaine penicillin) and peptide antibiotics (bacitracin and polymyxin B) on clinical strain S. Enteritidis IL 35 "Time-kill" method also confirmed observations mentioned above. In combinations of procaine penicillin with dihydrostreptomycin on strains E. coli IL 531 and E. coli IL 256 synergy effects on checkerboard technique were noticed. Such observation was not confirmed by the "time-kill" method. The methodologies and definitions of synergism are variable and not standardized. This situation should be improved, because comparison of the results obtained by different methods becomes a very difficult task.

The aim of this study was to analyse the activity interaction of aminoglycosides (gentamicin, kanamycin, streptomycin and dihydrostreptomycin) when combined with other antibiotics (lincomycin, benzylpenicillin, amoxicillin, cephalexin, spectinomycin and erythromycin), on selected clinical bacterial strains. The checkerboard method has been selected from the traditional assays for the measurement of antibiotic interaction. Checkerboard results for all strains demonstrated synergism for nine cases (9/112--8%). Additive effects were predominant--73/112--65.2%. In 12.5% neutral effects were shown, but in 11.6% of combinations FIC indexes were not possible to calculate, because of the resistance of clinical strains to the highest concentration of at least one antibiotic. The best results were achieved for combinations of dihydrostreptomycin with procaine penicillin because of higher number of cases synergy effect was observed. Antagonism of aminoglycosides and beta-lactams in case of gentamicin and amoxicillin for E. coli and E. cloacea strains were shown. Potential activity for combination of streptomycin and erythromycin was shown.

The aim of this study was to evaluate antimicrobial activity of selected alcoholic antiseptics against clinical strains, which possessed in majority a high level of drug resistance: MRSA (7), MSSA (3), E. coli: (9): strains producing ESBL (4), P. aeruginosa: (4), E. cloacae: (3), K. pneumoniae: (3). These strains were defined by MIC value, using antibiotic agar dilution method according to NCCLS. Fourteen alcoholic antiseptics were used in this study. Beside alcohol, they contained other active substances like iodine, hydrogen peroxide, chlorhexidine. Some additional agents were included for easier application, such as: gelling, moisturizing, aromatic or coloring substances. The objective of this study was also to determine the dependence of bactericidal activity on preparations (concentration). Product undiluted and diluted two and four times in water was analyzed according to prEN 12054 standard; 30 seconds and 1 minute contact time was used. The obtained data indicate that all tested undiluted antiseptics possessed bactericidal activity described by producers. However antiseptics (dilution leads to decrease and even loss of bactericidal activity. Two-times dilution of gel almost completely inactivated the product. Antimicrobial activity after 30 seconds of contact time was not affected by presence of additional agents in the tested antiseptics.

Antimicrobial combinations are used most frequently to provide broad-spectrum empirical coverage in the treatment of bacterial infections. However, combination of two antibiotics may not influence their activity, may lead to synergy or antagonism in the activity. Neomycin may be combined with one of the following antibiotics: ampicillin, procaine penicillin, gramicidin, bacitracin, polymyxin B, lincomycin, oxytetracycline, and erythromycin in some human and veterinary multiantibiotic drugs distributed in Poland. The checkerboard method has been one of the traditional assays for the measurement of antibiotic interactions. The aim of this study was to analyse the activity interaction of neomycin with second antibiotic in multiantibiotic drugs distributed in Poland on standards and clinical bacterial strains. Checkerboard results for all strains demonstrated synergism for 2.5% of combinations, only for standards strains. In one case Salmonella Enteritidis, in combination of neomycin with bacitracin, inhibition effect was observed. Additive effects were predominant--49%. In 18% neutral effects were shown, but in 26% of combinations FIC indexes were not possible to calculate, because of the resistance of clinical strains to the highest concentration of at least one antibiotic. In combination of aminoglycoside (neomycin) with beta-lactams antibiotics (ampicillin, procaine penicillin) in vitro, no synergy was observed for all examined strains. The best results were achieved for combinations of neomycin with peptide antibiotics (polymyxin, gramicidin and bacitracin)--5 for all 6 synergy effect observed.

Standards PN-EN 1040 and EN 12054 describe test methods and minimum requirements for bactericidal activities of antiseptics. However, standard procedures are time consuming and require 48 hours of incubation. New alternative technique based on impedimetric procedure provides possibilities to reduce this time to several hours. The Bactometer (BioMerieux, Vitek System, USA) is a fully automated impedance technology system used to microbial quantitation of products. Impedance measures microbial activity by electrical methods. The aim of the study was to adaptate the impedimetric method utilising Bactometer--system to microbiological activity control of chemical antiseptics. Eight different products were utilised throughout the study. The samples for classical and alternative method were prepared in the same way as described in standards. The method of choice was dilution-neutralization method. All procedures conducted in Bactometer were verified by plate count method. The high correlation was observed between results obtained by normative methods and impedimetric measurement. All tested products meet requirements. The procedure utilising the Bactometer, provides a rapid and accurate system for the determination of bacterial content. The results of validation carried out during this study indicate, possibility to use impedimetric method alternatively to traditional methods.

Pharmacopoeias contain preservation efficacy test for estimating antimicrobial activity of chemical compounds added to pharmaceutical preparations in multidose containers in order to inhibit bioburden growth. This method involves the treating of preserved products with bacteria and yeast cells and monitoring the survival of microorganisms through the specified time periods up to 28 days. The last stage of assay--incubation and colony counting--is very time consuming. Recent advance in technology enables faster and more convenient detection in comparison to traditional methods. Impedance method is based on the principle that conductance and capacitance of cultivation medium increases when bacteria grow and metabolize, Impedance time detection is inversely proportional to initial bacterial population. Six different products were utilised throughout the study. The calibration curves were calculated for each of the tested strains by comparison between standard plate count method and detection time measured in Bactometer system. In our study log reduction calculated in alternative method were similar to those obtained in plate count assay. All of the tested preparations, except one, exhibited acceptable activity against bacteria and fungi and meet the pharmacopoeal requirements. The studies indicated a positive correlation between standard plate count results and impedance reading. The procedure with the usage of Bactometer, provides a rapid and accurate system for the determination of bacterial content.