Browsing by Author "Herruzo, Rafael"
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Item An exception to the rule “no association between antibiotic resistance and decreased microbicidal efficacy of disinfectants”: Orthophthalaldehyde (OPA) and Pseudomonas aeruginosa isolated from ICU patients.(Journal of Preventive Medicine and Hygiene, 2017) Herruzo, Rafael; Vizcaíno, María José; Herruzo Priego, IreneBackground: Antibiotic resistance and decreased susceptibility to disinfectants is no associated in divers microorganisms, but we have find an exception a this rule: P. aeruginosa vs orthophthalaldehyde (OPA). Material: Bactericidal effect of OPA at 10 minutes upon endodoncy files contaminated with an ATCC strain (control) and 206 strains of P. aeruginosa recently isolated from 206 ICU and paraplegic patients, of a tertiary university hospital, in two years. Results and Discussion: Differences in bactericidal effect of OPA were found between the strains isolated in each period (decreased susceptibility in the first year), but in each year the statistical differences (p<0.05) were maintained according to whether the strains were susceptible to antibiotics, resistant (one family of antibiotics) or multi‑resistant (more than one family). By contrast, there were no differences depending on the type of sample (as sputum, urine, feces, pharynx) or the type of ICU (as adults, newborns, burn patients). OPA against the 15 strains with an effect of less than 3.5 log in 10 minutes, showed a total bactericidal effect in 15 minutes. In conclusion, an association exists between antibiotic resistance and decreased susceptibility to OPA. Normally, does not imply an increase in disinfection time, but it must be considered in endoscope disinfection.Item Antimicrobial efficacy of a very stable hypochlorous acid formula compared with other antiseptics used in treating wounds: in-vitro study on micro-organisms with or without biofilm.(Journal of Hospital Infection, 2020) Herruzo, Rafael; Herruzo Priego, IreneBackground: Many antiseptics have been used to treat wounds. Aim: To compare the microbicidal efficacy of ClHO (Clortech ) with other antiseptics used on wounds, healthy skin and mucous membranes. Methods: The microbicidal efficacy of 13 antiseptic products on eight micro-organisms (three Gram-positive; three Gram-negative; two yeasts) inoculated on organic germcarriers was studied. In addition, the loss of efficacy against Staphylococcus aureus and Pseudomonas aeruginosa with biofilm was assessed with the six best-performing products. Findings: Chlorhexidine (1%) had the highest microbicidal effect at 1 min. At 5 min, 500 and 1500 mg/L ClHO showed similar, or better, activity than the other antiseptics studied. The ClHO concentration of 300 mg/L achieved this same efficacy at 10 min. The product that lost the most efficacy due to biofilm was 1% chlorhexidine, while 1% PVP-I and ClHO at either 300 or 500 mg/L were moderately affected by biofilm. The most effective in the presence of biofilm was ClHO at 1500 mg/L. Conclusions: ClHO at mediumelow concentrations (300 or 500 mg/L) is a good antiseptic that can be used on wounds and mucous membranes for 5e10 min. Lower concentrations of ClHO, as well as of the other antiseptics studied, were less effective or more altered by the biofilm. ClHO at a concentration of 1500 mg/L is very effective in the presence or absence of biofilm that can be used on healthy skin for 5 min.Item Hypochlorous acid in a double formulation (liquid plus gel) is a key prognostic factor for healing and absence of infection in chronic ulcers. A nonrandomized concurrent treatment study.(Health Science Reports, 2023) Herruzo, Rafael; Fondo Alvarez, Erika; Herruzo Priego, Irene; Garrido‐Estepa, Macarena; Santiso Casanova, Emma; Cerame Perez, SilviaBackground and Aims Diverse protocols prevent infection and/or improve ulcer epithelialization. The existing protocols tend to antagonize the risk factors that promote the chronicity of this type of wound. Hypochlorous acid (HOCl) is used to treat ulcers and wounds because of its antiseptic and noncytotoxic properties. Its liquid form is effective but has little residual effect, while in gel it has more residual power. Methods An experimental nonrandomized study has been carried out treating 346 chronic ulcers of various etiologies in 220 patients. Ulcer outcomes were originally classified as: “complete healing,” “incomplete healing without infection,” and “incomplete healing with infection.” Various antiseptic solutions were used as ulcers cleaning solutions: liquid HOCl, gel HOCl, polymeric biguanide, or chlorhexidine. Only one was applied to the lesion as monotherapy. But, in other cases, we used a combined HOCl (liquid then gel: bitherapy). Bivariate (Chi-square and variance tests) and multivariate studies (logistic regression) evaluated associations of ulcer characteristics and mono or bitherapy outcomes. Results Four factors reduce the probability of complete ulcer healing: patient age (odds ratio [OR]: 0.97); weeks of ulcer evolution (OR: 0.99); poor granulation on admission (OR: 0.35); and need for antibiotic therapy (OR: 0.41). One factor favored healing: combined HOCl therapy with liquid plus gel (OR: 4.8). Infections were associated with longer times of evolution (OR: 1.002) and bad odor of the ulcer on admission (OR: 14), but bitreatment with HOCl reduced the risk of infection (OR: 0.3). Conclusion A double HOCl formulation (liquid plus gel) reduces the probability of poor healing and infection, in chronic ulcers of various etiologies.Item Surface Disinfectants for Burn Units Evaluated by a New Double Method, Using Microorganisms Recently Isolated From Patients, on a Surface Germ-Carrier Model.(Journal of Burn Care & Research, 2017) Herruzo, Rafael; Vizcaino, Maria Jose; Herruzo Priego, Irene; Sánchez, ManuelAssessment methods of surface disinfection based on international standards (Environmental Protection Agency, European Norms, etc) do not correspond to hospital reality. New evaluation methods of surfaces disinfection are proposed to choose the most suitable disinfectant to act against clinically relevant microorganisms detected on the surfaces of burn units. 1) “Immediate effect”: 6 products were compared using a glass germ-carrier and 20 recently isolated microorganisms from different patients in the intensive care units. Disinfectants were applied with microfiber cloths. Log10 reductions were calculated for colony forming units produced after 15 minutes of disinfectant application. 2) “Residual effect”: the glass germ-carriers were previously impregnated with one of the studied disinfectants. After a 30-minute wait period, they were then contaminated with 1 microorganism (from the 20 above-mentioned). After 15 minutes, the disinfectant was inhibited and the log10 reduction of colony forming units was assessed. The immediate effect (disinfection and microorganism dragging and transferring from the surface to the cloth) produced complete elimination of the inoculums for all products used except one (a diluted quaternary ammonium). The average residual effect found on the 20 microorganisms was moderate: 2 to 3 log10 colony forming unit reduction with chlorine dioxide or 0.5% chlorhexidine (and lower with the other products), obtaining surfaces refractory to recontamination, at least, during 30 minutes. Two tests should be performed before advising surface disinfectant: 1) direct effect and 2) residual efficacy. These characteristics should be considered when a new surface disinfectant is chosen. Chlorine dioxide has a similar or better direct effect than sodium hypochlorite and a similar residual effect than chlorhexidine.Item Synergistic effect of two formulations of hypochlorous acid in the treatment of 346 chronic ulcers.(Wound Repair and Regeneration, 2023) Herruzo, Rafael; Fondo Alvarez, Erika; Herruzo Priego, Irene; Santiso Casanova, Emma; Cerame Perez, SilviaOur objective was to assess the efficacy of two successive applications of hypochlorous acid, first as a liquid and then as a gel because liquid hypochlorous acid is effective but has little residual effect, while the gel form has more residual power, and compare it with that of other products. An experimental non-randomised study was carried out, treating 346 chronic ulcers in 220 patients. The antiseptic treatment has been divided into ‘hypochlorous acid’ (Clortech), ‘hypochlorous acid liquid + gel’ (Clortech + Microdacyn60R-hydrogel) and ‘Others’ (Prontosan or Chlorhexidine or Microdacyn60R- hydrogel). Bivariate and multivariate studies analysed the characteristics of the patients and their ulcers, including size, symptoms, signs, treatments received and their duration, and so on. The ulcers were complicated, of long evolution, and most had a vascular origin. On average, antiseptic treatment lasted 14 weeks. At the time of their discharge, or last treatment in the clinics, 59% of the ulcers had healed completely, 9.5% worsened, and 6.9% had become infected during this period. In the bivariate and multivariate studies, we took as reference the ‘others’ treatments that showed no significant differences in healing time or infection rates compared with liquid hypochlorous acid 100–500 mg/L alone. However, hypochlorous acid liquid + gel showed a synergistic effect, with a higher probability of achieving complete healing (four times) and a lower probability of infection (a fifth), compared to the ‘other’ antiseptics. In conclusion, a synergistic effect was found with the successive application of hypochlorous acid in liquid followed by gel, an effect that increased healing probability and decreased the risk of the ulcer becoming infected.