Figures index

From

The Immunomodulatory, Antimicrobial and Bactericidal Efficacy of Commonly Used Commercial Household Disinfectants, Sterilizers and Antiseptics in Vitro: Putative Anti-Inflammatory Infection Control Mechanisms and Comparative Biochemical Analysis of the Microbial Growth of Gram-Positive Bacteria

Niveen M. Masri, Lama B. Hanbali, Ahmad H. Kamar, Lana M.S. Kanafani, Mohamed B. Hanbali, John J. Haddad

American Journal of Medical and Biological Research. 2013, 1(4), 103-133 doi:10.12691/ajmbr-1-4-4
  • Figure 1. Descending order of resistance to germicidal chemicals. This hierarchy considers broad classifications of microbial categories. It is considered a rough guide to general susceptibility patterns of microorganisms to disinfectants. (Adapted, courtesy of: Favero, M.S.; Bond, W.V. Chemical disinfection of medical and surgical materials. In: Block, S.S.; ed. Disinfection, sterilization and preservation. 4thed. Philadelphia: Lea and Febiger, 1991, 621.)
  • Figure 2. Depictive comparative assessment of the antimicrobial efficacy of various detergents against gram-positive Bacillus subtilisbacteria, as comparedwith novobiocin (30 μg). The zone of inhibition of novobiocin was set asa reference (lane 24; horizontal straight line),and that for absolute methanol (MetOH) is shown in lane 23, and all values of the zones of inhibition at undiluted concentrations of disinfectant/sterilizer/antiseptic were compared against those references (Lanes 23 and 24). Lanes 1 – 5 represent Class A (Daily Mouthwash); Lanes 6 – 14 represent Class B (Toilet Bowl Cleaners/Bleaches/Sanitizers); Lanes 15 – 19 represent Class C (Surface and Floor Mopping Cleaners/Detergents); and Lanes 20 – 22 represent Class D (Hand and Body Wash Gels). This comparative analysis allows descriptive visualization of the antimicrobial effectiveness relative to novobiocin, on one hand, and various classes (A – D), on the other hand, thereby showing the most effective class and/or detergent within a given category against a specific type of bacteria. The number of experimental observations is n = 3, * P< 0.05, ** P< 0.01, *** P< 0.001, as compared with either novobiocin or absolute MetOH. NI = No inhibition.
  • Figure 3. Depictive comparative assessment of the antimicrobial efficacy of various detergents against gram-positive Enterococcus Group D (E. faecalis) bacteria, as compared with novobiocin (30 μg). The zone of inhibition of novobiocin was set as a reference (lane 24; horizontal straight line), and that for absolute methanol (MetOH) is shown in lane 23, and all values of the zones of inhibition at undiluted concentrations of disinfectant/sterilizer/antiseptic were compared against those references (Lanes 23 and 24). Lanes 1 – 5 represent Class A (Daily Mouthwash); Lanes 6 – 14 represent Class B (Toilet Bowl Cleaners/Bleaches/Sanitizers); Lanes 15 – 19 represent Class C (Surface and Floor Mopping Cleaners/Detergents); and Lanes 20 – 22 represent Class D (Hand and Body Wash Gels). This comparative analysis allows descriptive visualization of the antimicrobial effectiveness relative to novobiocin, on one hand, and various classes (A – D), on the other hand, thereby showing the most effective class and/or detergent within a given category against a specific type of bacteria. The number of experimental observations is n = 3, * P< 0.05, ** P< 0.01, *** P< 0.001, as compared with either novobiocin or absolute MetOH. NI = No inhibition
  • Figure 4. Depictive comparative assessment of the antimicrobial efficacy of various detergents against gram-positive Staphylococcus aureus bacteria, as compared with novobiocin (30 μg). The zone of inhibition of novobiocin was set as a reference (lane 24; horizontal straight line), and that for absolute methanol (MetOH) is shown in lane 23, and all values of the zones of inhibition at undiluted concentrations of disinfectant/sterilizer/antiseptic were compared against those references (Lanes 23 and 24). Lanes 1 – 5 represent Class A (Daily Mouthwash); Lanes 6 – 14 represent Class B (Toilet Bowl Cleaners/Bleaches/Sanitizers); Lanes 15 – 19 represent Class C (Surface and Floor Mopping Cleaners/Detergents); and Lanes 20 – 22 represent Class D (Hand and Body Wash Gels). This comparative analysis allows descriptive visualization of the antimicrobial effectiveness relative to novobiocin, on one hand, and various classes (A – D), on the other hand, thereby showing the most effective class and/or detergent within a given category against a specific type of bacteria. The number of experimental observations is n = 3, * P< 0.05, ** P< 0.01, *** P< 0.001, as compared with either novobiocin or absolute MetOH. NI = No inhibition
  • Figure 5. Depictive comparative assessment of the antimicrobial efficacy of various detergents against gram-positive Streptococcus Group A (S. pyogenes) bacteria, as compared with novobiocin (30 μg). The zone of inhibition of novobiocin was set as a reference (lane 24; horizontal straight line), and that for absolute methanol (MetOH) is shown in lane 23, and all values of the zones of inhibition at undiluted concentrations of disinfectant/sterilizer/antiseptic were compared against those references (Lanes 23 and 24). Lanes 1 – 5 represent Class A (Daily Mouthwash); Lanes 6 – 14 represent Class B (Toilet Bowl Cleaners/Bleaches/Sanitizers); Lanes 15 – 19 represent Class C (Surface and Floor Mopping Cleaners/Detergents); and Lanes 20 – 22 represent Class D (Hand and Body Wash Gels). This comparative analysis allows descriptive visualization of the antimicrobial effectiveness relative to novobiocin, on one hand, and various classes (A – D), on the other hand, thereby showing the most effective class and/or detergent within a given category against a specific type of bacteria. The number of experimental observations is n = 3, * P< 0.05, ** P< 0.01, *** P< 0.001, as compared with either novobiocin or absolute MetOH. NI = No inhibition.
  • Figure 6. Depictive comparative assessment of the antimicrobial efficacy of various detergents against gram-positive Streptococcus Group B (S. agalactiae) bacteria, as compared with novobiocin (30 μg). The zone of inhibition of novobiocin was set as a reference (lane 24; horizontal straight line), and that for absolute methanol (MetOH) is shown in lane 23, and all values of the zones of inhibition at undiluted concentrations of disinfectant/sterilizer/antiseptic were compared against those references (Lanes 23 and 24). Lanes 1 – 5 represent Class A (Daily Mouthwash); Lanes 6 – 14 represent Class B (Toilet Bowl Cleaners/Bleaches/Sanitizers); Lanes 15 – 19 represent Class C (Surface and Floor Mopping Cleaners/Detergents); and Lanes 20 – 22 represent Class D (Hand and Body Wash Gels). This comparative analysis allows descriptive visualization of the antimicrobial effectiveness relative to novobiocin, on one hand, and various classes (A – D), on the other hand, thereby showing the most effective class and/or detergent within a given category against a specific type of bacteria. The number of experimental observations is n = 3, * P< 0.05, ** P< 0.01, *** P< 0.001, as compared with either novobiocin or absolute MetOH. NI = No inhibition.
  • Figure 7. The putative immunomodulatory/anti-inflammatory, anti-microbial and bactericidal mechanisms are estimated by determining the probable effective ratios. The maximal effective ratio (ER) of Class A (Daily Mouthwash) on gram-positive bacteria. ER was calculated as the ratio of each bacterium with maximal zone of inhibition against the minimum zone of inhibition (set as 1) within the same category, such that ER = Zone max / Zone min. This ratio determines the most effective treatment for each bacterium and its comparative effectiveness against rest of antiseptics and disinfectants. For instance, the highest most effective daily mouthwash against S. aureus is ‘Colgate Plax Mouthwash.’ The number of experimental observations is n = 3
  • Figure 8. The putative immunomodulatory/anti-inflammatory, anti-microbial and bactericidal mechanisms are estimated by determining the probable effective ratios. The maximal effective ratio (ER) of Class B (Toilet Bowl Cleaners/Bleaches/Sanitizers) on gram-positive bacteria. ER was calculated as the ratio of each bacterium with maximal zone of inhibition against the minimum zone of inhibition (set as 1) within the same category, such that ER = Zone max / Zone min. This ratio determines the most effective treatment for each bacterium and its comparative effectiveness against rest of antiseptics and disinfectants. For instance, the highest most effective daily mouthwash against S. aureus are ‘Carrefour Nettoyant Disinfectant’ and ‘Harpic Power Plus Disinfectant.’ The number of experimental observations is n = 3
  • Figure 9. The putative immunomodulatory/anti-inflammatory, anti-microbial and bactericidal mechanisms are estimated by determining the probable effective ratios. The maximal effective ratio (ER) of Class C (Surface and Floor Mopping Cleaners/Detergents) on gram-positive bacteria. ER was calculated as the ratio of each bacterium with maximal zone of inhibition against the minimum zone of inhibition (set as 1) within the same category, such that ER = Zone max / Zone min. This ratio determines the most effective treatment for each bacterium and its comparative effectiveness against rest of antiseptics and disinfectants. For instance, the highest most effective daily mouthwash against S. aureus is ‘Ajax Fete des Fleurs.’ The number of experimental observations is n = 3
  • Figure 10. The putative immunomodulatory/anti-inflammatory, anti-microbial and bactericidal mechanisms are estimated by determining the probable effective ratios. The maximal effective ratio (ER) of Class D (Hand and Body Wash Gels) on gram-positive bacteria. ER was calculated as the ratio of each bacterium with maximal zone of inhibition against the minimum zone of inhibition (set as 1) within the same category, such that ER = Zone max / Zone min. This ratio determines the most effective treatment for each bacterium and its comparative effectiveness against rest of antiseptics and disinfectants. For instance, the highest most effective daily mouthwash against S. aureus is ‘HiGeen Hand and Body Wash Gel.’ The number of experimental observations is n = 3
  • Figure 11. Typical microbial growth of gram-positive bacteria in the presence of commercially available disinfectants and antiseptics in culture. (A) Bacillus subtilis + ‘HiGeen Hand and Body Wash Gel’ at various concentrations (undiluted, 1/2, 1/4, 1/8, 1/16, and 1/32 + negative control, methanol), noting zones of inhibition. (B) Group D Streptococcus (GDS; E. faecalis)+ ‘Carrefour Nettoyant Disinfectant’ at various concentrations (undiluted, 1/2, 1/4, 1/8, 1/16, and 1/32 + positive control, novobiocin (30 μg)), noting zones of inhibition. (C) Staphylococcus aureus + ‘Spartan Max WC Lavender’ at various concentrations (undiluted, 1/2, 1/4, 1/8, 1/16, and 1/32 + positive control, novobiocin (30 μg)), noting zones of inhibition.(D) Group A Streptococcus (GAS)+ ‘La Croix Sans Javel’ at various concentrations (undiluted, 1/2, 1/4, 1/8, 1/16, and 1/32 + negative control, methanol), noting zones of inhibition.(E) Group B Streptococcus (GBS)+ ‘Clorox Bleach Rain Clean’at various concentrations (undiluted, 1/2, 1/4, 1/8, 1/16, and 1/32 + positive control, novobiocin (30 μg)), noting zones of inhibition.The number of experimental observations is n = 3. DF = Dilution factor
  • Figure 12. Descending order of resistance to antiseptics and disinfectants. This map may resemble a variation of an order in that the conclusions are not yet universally agreed upon. (Adapted, courtesy of reference [33])
  • Figure 13. Bacterial intrinsic resistance mechanisms to antiseptics and disinfectants. (Adapted, courtesy of reference [33])
  • Figure 14. Typical examples on the effect of disinfectants containing chlorine on Bacillus mycoides. (A) Acridine orange staining of Bacillus mycoides in sterile saline buffer (without chlorine) observed by epifluorescence microscopy. (B) Acridine orange staining of Bacillus mycoidesin sterile saline buffer (after 60 min. of contact with 1 mg/L of chlorine) observed by epifluorescence microscopy. (Adapted, courtesy of reference [19])
  • Figure 15. Typical examples on the effects of EO (essential oil rinse), CHX (0.12% chlorhexidine rinse), CPC/CHX (0.05% cetyl pyridinium chloriderinse/CHX), AFSF (amine fluoride/stannous fluoride rinse), and CPC2 (0.07% cetyl pyridinium chloride rinse) mouthrinses on saliva-derived biofilms (two 30-second treatments, vital staining, batch biofilm model).For abbreviations used in this illustration, please refer to abbreviations list. (Adapted, courtesy of reference [113])