Nicoletti G, Boghossian V, Gurevitch F, Borland R, Morgenroth P
Department of Applied Biology & Biotechnology, Royal Melbourne Institute of Technology, Victoria, Australia.
J Hosp Infect. 1993 Feb;23(2):87-111. doi: 10.1016/0195-6701(93)90014-q.
Chlorehexidine, two 4% chlorhexidine antiseptic handwashes ('Bioprep' and 'Hibiclens'), cetyl trimethyl ammonium bromide (CTAB) and isothiazolinones ('Kathon') were tested against Staphylococcus aureus, Micrococcus luteus, Escherichia coli, Serratia marcescens, Pseudomonas aeruginosa, Proteus vulgaris and Candida albicans. The activities measured were the minimum inhibitory concentration (MIC), minimum microbicidal concentration (MMC), rate of kill in water and broth, effect of organic soil, the development of microbial resistance on continuous exposure and agent bioavailability in media and formulation. 'Kathon' was the most active microbistatic agent showing maximal activity at low concentration, least inactivation by organic soil and media components and the lowest level of development of bacterial resistance. It was synergistic with chlorhexidine against S. marcescens and P. aeruginosa. Media, formulation components and organic soil affected the performance of chlorhexidine and CTAB. Chlorhexidine was more broadly active than CTAB but showed a greater reduction in activity in the presence of soil and engendered a greater level of bacterial resistance. It was more rapidly bactericidal to P. aeruginosa and S. marcescens than to S. aureus. Stable resistance to chlorhexidine and CTAB was developed by P. aeruginosa and S. marcescens, the latter showing the higher level of resistance. Chlorhexidine-resistant strains were also resistant to CTAB. The antiseptic formulations were more rapidly bactericidal than chlorhexidine alone but were otherwise of comparable activity. Mixtures of disinfectants, in particular a combination of chlorhexidine and a preservative level of 'Kathon', were more active than single disinfectants. The importance of standardization of media and test conditions and the use of chemically defined media for accurate and reproducible in-vitro testing of disinfectant activity is emphasized. Disinfection kinetics, expressed as time-kill curves, log reduction factors or decimal reduction times were shown to be valuable in differentiating microbistatic from microbicidal activity, showing the effects of dilution and soil on activity and indicating possible different mechanisms of action.
对洗必泰、两种4%的洗必泰消毒洗手液（“Bioprep”和“Hibiclens”）、十六烷基三甲基溴化铵（CTAB）和异噻唑啉酮（“Kathon”）进行了针对金黄色葡萄球菌、藤黄微球菌、大肠杆菌、粘质沙雷氏菌、铜绿假单胞菌、普通变形杆菌和白色念珠菌的测试。所测量的活性包括最低抑菌浓度（MIC）、最低杀菌浓度（MMC）、在水和肉汤中的杀菌速率、有机污垢的影响、持续暴露时微生物耐药性的发展以及在培养基和制剂中的药剂生物利用度。“Kathon”是最具活性的抑菌剂，在低浓度时显示出最大活性，受有机污垢和培养基成分的失活作用最小，细菌耐药性发展水平最低。它与洗必泰对粘质沙雷氏菌和铜绿假单胞菌具有协同作用。培养基、制剂成分和有机污垢会影响洗必泰和CTAB的性能。洗必泰的活性比CTAB更广泛，但在有污垢存在时活性降低幅度更大，且产生的细菌耐药性水平更高。它对铜绿假单胞菌和粘质沙雷氏菌的杀菌速度比对金黄色葡萄球菌更快。铜绿假单胞菌和粘质沙雷氏菌对洗必泰和CTAB产生了稳定的耐药性，后者显示出更高的耐药水平。耐洗必泰菌株对CTAB也耐药。消毒制剂的杀菌速度比单独的洗必泰更快，但在其他方面活性相当。消毒剂混合物，特别是洗必泰和“Kathon”防腐剂量的组合，比单一消毒剂更具活性。强调了培养基和测试条件标准化以及使用化学定义培养基进行消毒剂活性准确且可重复的体外测试的重要性。以时间 - 杀灭曲线、对数减少因子或十进制减少时间表示的消毒动力学在区分抑菌和杀菌活性、显示稀释和污垢对活性的影响以及表明可能不同的作用机制方面被证明是有价值的。
