不同商业次氯酸钠/次氯酸溶液（NaClO/HClO）的安全性和疗效特征：体外抗菌功效、细胞毒性影响和理化参数。

Safety and efficacy profiles of different commercial sodium hypochlorite/hypochlorous acid solutions (NaClO/HClO): antimicrobial efficacy, cytotoxic impact and physicochemical parameters in vitro.

机构信息

Institute for Translational Wound Research, Centre for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Germany.

出版信息

J Antimicrob Chemother. 2019 Feb 1;74(2):365-372. doi: 10.1093/jac/dky432.

DOI:10.1093/jac/dky432

PMID:30388236

Abstract

BACKGROUND

Sodium hypochlorite (NaClO, SHC)/hypochlorous acid (HClO, HCA) wound irrigation solutions have experienced a renaissance in the prevention and treatment of low-level wound infections. They are attributed with lower cytotoxicity and have therefore gained increasing attention in daily clinical practice.

OBJECTIVES

To determine the cytotoxicity and antimicrobial efficacy of six NaClO/HClO wound irrigation solutions.

METHODS

For cytotoxicity evaluation (based on DIN EN 10993-5), human keratinocytes (HaCaT) and human skin fibroblasts (BJ) were used. Staphylococcus aureus and Pseudomonas aeruginosa were used for antimicrobial efficacy evaluation (based on DIN EN 13727). Solutions were evaluated after 1, 5 and 15 min of exposure. Additionally, physicochemical properties (pH and oxidation-reduction potential values) were investigated.

RESULTS

Efficacy and cytotoxicity varied significantly between solutions. Generally, increasing antimicrobial activity was associated with decreasing cell viability. Furthermore, a concentration- and time-dependent impact on pathogens and cells was observed: cytotoxic and antimicrobial activity increased with rising NaClO/HClO solution concentrations and extended exposure times. Based on these in vitro evaluations, the following ranking (lowest to highest microbicidal effect and cytotoxic impact) was found: Microdacyn60® (SHC/HCA-M) < Granudacyn® (SHC/HCA-G) < Veriforte™ (SHC/HCA-V) < KerraSol™ (SHC-K) < Lavanox® (SHC-L) ≪ ActiMaris®forte (SHC/SM-A).

CONCLUSIONS

The presented results indicate that microbicidal effects are almost always associated with certain negative side effects on cell proliferation. Efficacy and biocompatibility of NaClO/HClO solutions depend on their specific formulation and physicochemical properties. The investigations also underline the necessity for exact product- and application-specific efficacy profiles.

摘要

背景

次氯酸钠（NaClO，SHC）/次氯酸（HClO，HCA）伤口冲洗液在预防和治疗低水平伤口感染方面经历了复兴。它们的细胞毒性较低，因此在日常临床实践中越来越受到关注。

目的

确定六种 NaClO/HClO 伤口冲洗液的细胞毒性和抗菌功效。

方法

对于细胞毒性评估（基于 DIN EN 10993-5），使用人角质形成细胞（HaCaT）和人皮肤成纤维细胞（BJ）。使用金黄色葡萄球菌和铜绿假单胞菌进行抗菌功效评估（基于 DIN EN 13727）。在暴露 1、5 和 15 分钟后评估溶液。此外，还研究了物理化学性质（pH 值和氧化还原电位值）。

结果

溶液之间的功效和细胞毒性差异很大。通常，抗菌活性的增加与细胞活力的降低相关。此外，还观察到对病原体和细胞的浓度和时间依赖性影响：随着 NaClO/HClO 溶液浓度和暴露时间的增加，细胞毒性和抗菌活性增加。基于这些体外评估，发现以下排名（最低至最高杀菌效果和细胞毒性影响）：Microdacyn60®（SHC/HCA-M）<Granudacyn®（SHC/HCA-G）<Veriforte™（SHC/HCA-V）<KerraSol™（SHC-K）<Lavanox®（SHC-L）≪ActiMaris®forte（SHC/SM-A）。