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Pediatric Allergy, Immunology, and... Jun 2024Povidone, a synthetic polymer commonly used in various products such as antiseptics, cosmetics, and medications, has been associated with allergic reactions, including... (Review)
Review
Povidone, a synthetic polymer commonly used in various products such as antiseptics, cosmetics, and medications, has been associated with allergic reactions, including anaphylaxis. Despite its widespread use, cases of povidone-induced anaphylaxis, especially in children, are under-recognized. This case report aims to highlight the importance of considering povidone allergy in pediatric patients presenting with anaphylaxis. We describe a 3-year-old boy who experienced anaphylaxis following the application of povidone-iodine antiseptic solution to a leg wound. He presented with generalized urticaria, angioedema, dyspnea, and cough. Prompt diagnosis and management were initiated in the emergency department. He experienced the second anaphylaxis with povidone-containing eye drops prescribed during an ophthalmology visit. Povidone allergy should be considered in pediatric patients presenting with anaphylaxis, especially those with idiopathic reactions or multiple drug allergies. Clinicians should emphasize patient education on label reading and the provision of adrenaline autoinjectors to prevent life-threatening reactions associated with povidone exposure.
Topics: Humans; Anaphylaxis; Male; Child, Preschool; Povidone-Iodine; Anti-Infective Agents, Local; Drug Hypersensitivity; Epinephrine; Ophthalmic Solutions
PubMed: 38864768
DOI: 10.1089/ped.2024.0036 -
Carbohydrate Polymers Sep 2024Iodine (I) as a broad-spectrum antiseptic has been widely used for treating bacterial infections. However, I has low water-solubility and sublimes under ambient...
Iodine (I) as a broad-spectrum antiseptic has been widely used for treating bacterial infections. However, I has low water-solubility and sublimes under ambient conditions, which limits its practical antibacterial applications. The highly specific and sensitive reaction between I and starch discovered 200 years ago has been extensively applied in analytical chemistry, but the antibacterial activity of the I-starch complex is rarely investigated. Herein, we develop a novel type of iodine-based antiseptics, iodine-soluble starch (I-SS) cryogel, which can dissolve in water instantly and almost completely kill bacteria in 10 min at 2 μg/mL of I. Although KI and the commercially available povidone‑iodine (I-PVP) solutions show similar antibacterial efficacy, the high affinity of I to SS largely enhances the shelf stability of the I-SS solution with ∼73 % I left after one-week storage at room temperature. In sharp contrast, ∼8.5 % and ∼2.5 % I are detected in KI and I-PVP solutions, respectively. Mechanistic study reveals that the potent antibacterial effect of I-SS originates from its attack on multiple bacterial targets. The outstanding antibacterial activity, capability of accelerating wound healing, and good biocompatibility of I-SS are verified through further in vivo experiments. This work may promote the development of next-generation iodine-based antiseptics for clinical use.
Topics: Iodine; Starch; Anti-Bacterial Agents; Anti-Infective Agents, Local; Solubility; Water; Cryogels; Animals; Staphylococcus aureus; Mice; Microbial Sensitivity Tests; Povidone-Iodine; Escherichia coli; Wound Healing
PubMed: 38857997
DOI: 10.1016/j.carbpol.2024.122217 -
Antimicrobial Resistance and Infection... Jun 2024Although uncommon, infections associated with peripheral intravenous catheters (PIVCs) may be responsible for severe life-threatening complications and increase... (Randomized Controlled Trial)
Randomized Controlled Trial
Insertion site and risk of peripheral intravenous catheter colonization and/or local infection: a post hoc analysis of the CLEAN 3 study including more than 800 catheters.
AIM
Although uncommon, infections associated with peripheral intravenous catheters (PIVCs) may be responsible for severe life-threatening complications and increase healthcare costs. Few data are available on the relationship between PIVC insertion site and risk of infectious complications.
METHODS
We performed a post hoc analysis of the CLEAN 3 database, a randomized 2 × 2 factorial study comparing two skin disinfection procedures (2% chlorhexidine-alcohol or 5% povidone iodine-alcohol) and two types of medical devices (innovative or standard) in 989 adults patients requiring PIVC insertion before admission to a medical ward. Insertion sites were grouped into five areas: hand, wrist, forearm, cubital fossa and upper arm. We evaluated the risk of risk of PIVC colonization (i.e., tip culture eluate in broth showing at least one microorganism in a concentration of at least 1000 Colony Forming Units per mL) and/or local infection (i.e., organisms growing from purulent discharge at PIVC insertion site with no evidence of associated bloodstream infection), and the risk of positive PIVC tip culture (i.e., PIVC-tip culture eluate in broth showing at least one microorganism regardless of its amount) using multivariate Cox models.
RESULTS
Eight hundred twenty three PIVCs with known insertion site and sent to the laboratory for quantitative culture were included. After adjustment for confounding factors, PIVC insertion at the cubital fossa or wrist was associated with increased risk of PIVC colonization and/or local infection (HR [95% CI], 1.64 [0.92-2.93] and 2.11 [1.08-4.13]) and of positive PIVC tip culture (HR [95% CI], 1.49 [1.02-2.18] and 1.59 [0.98-2.59]).
CONCLUSION
PIVC insertion at the wrist or cubital fossa should be avoided whenever possible to reduce the risk of catheter colonization and/or local infection and of positive PIVC tip culture.
Topics: Humans; Female; Male; Catheterization, Peripheral; Catheter-Related Infections; Middle Aged; Aged; Chlorhexidine; Adult; Disinfection; Povidone-Iodine; Risk Factors; Anti-Infective Agents, Local; Equipment Contamination; Wrist
PubMed: 38840171
DOI: 10.1186/s13756-024-01414-4 -
Journal of International Society of... 2024To determine whether rinsing with preprocedural mouthrinses against coronavirus disease before acid etching affects resin-based sealant microleakage.
AIM
To determine whether rinsing with preprocedural mouthrinses against coronavirus disease before acid etching affects resin-based sealant microleakage.
MATERIALS AND METHODS
A presented experimental study was performed on 15 extracted permanent third molars. Samples were randomly allocated into five groups: Group 1-distilled water (control); Group 2-1% hydrogen peroxide; Group 3-1.5% hydrogen peroxide; Group 4-0.5% povidone-iodine; and Group 5-1% povidone-iodine. After the teeth were immersed in the assigned mouth rinses for 60 s, they were sealed with Concise™ white sealant. Subsequently, the teeth were thermocycled for 500 cycles, immersed in 2% methylene blue solution for 24 h, and sectioned with two parallel cuts in the buccolingual direction. Sixty surfaces (12 surfaces in each group) were examined for microleakage under a 40× light microscope and scored as described by Zyskind . Welch's one-way analysis of variance test and the Games-Howell test were used to analyze the results at a significance level of < 0.05 for all tests.
RESULTS
The intergroup comparisons indicated that the 0.5% povidone-iodine group and the 1% povidone-iodine group had significantly higher microleakage compared with the control group. The 1% and 1.5% hydrogen peroxide groups demonstrated no significant difference in mean microleakage scores compared with the control group. There was no significant difference between the povidone groups and the hydrogen peroxide groups.
CONCLUSIONS
Preprocedural rinsing with 0.5% and 1% povidone-iodine before acid etching caused higher microleakage of resin-based sealant, while hydrogen peroxide rinsing gave comparable microleakage compared with the control group.
PubMed: 38827349
DOI: 10.4103/jispcd.jispcd_188_23 -
Surgery Jun 2024The irrigation efficacy of a povidone-iodine solution to prevent surgical site infection is still controversial. We assessed the irrigation effect with a povidone-iodine...
BACKGROUND
The irrigation efficacy of a povidone-iodine solution to prevent surgical site infection is still controversial. We assessed the irrigation effect with a povidone-iodine solution on the incidence of surgical site infection after gastroenterological surgery.
METHODS
This study is a single-center, prospective, randomized, blinded-end point superiority trial for surgical wound irrigation. Patients undergoing gastroenterological surgery were randomly assigned in a 1:1 replacement ratio using computer-generated randomization. Patients were grouped according to their surgical wound treatment into the control group using the normal sterile saline and the povidone-iodine group using 10% povidone-iodine solution after the NS solution. The main finding was 30-day surgical site infections assessed in the full analysis set.
RESULTS
From November 2020 to December 2022, 697 of 894 patients were eligible for the study, among which 347 were in the povidone-iodine group and 350 in the control group. Thirty-day surgical site infections occurred in 100 (14%) patients-54 (16%) in the povidone-iodine group and 46 (13%) in the control group (odds ratio, 1.229; 95% CI, 0.800-1.889; P = .406). Superficial incisional surgical site infections occurred in 30 (9%) and 15 (4%) patients, respectively (odds ratio, 2.154; 95% CI, 1.134-4.090; P = .026). Only 3 patients (1%) in the control group developed adverse skin reactions.
CONCLUSION
This study examined the irrigation efficacy of povidone-iodine for surgical site infection prevention compared to control in gastroenterological surgery. Povidone-iodine wound irrigation has shown no additional beneficial effect on the occurrence of surgical site infections.
PubMed: 38825398
DOI: 10.1016/j.surg.2024.04.034 -
Heliyon May 2024It is important to accurately determine the blood ethanol concentration (BEC) to ensure appropriate diagnosis and treatment of patients in the emergency department (ED)...
BACKGROUND
It is important to accurately determine the blood ethanol concentration (BEC) to ensure appropriate diagnosis and treatment of patients in the emergency department (ED) and protect their legal rights. This study aimed to determine whether sterilization of venipuncture site with ethanol, which is frequently used in practice in the ED would affect BEC.
METHODS
Venous blood samples were collected by two consecutive techniques from 94 individuals who were admitted to the ED, had an indication for BEC measurement, and volunteered to participate in the study. The reference technique involved applying 3 cc of 10 % povidone-iodine solution to a gauze pad, cleaning the right arm antecubital region, and performing phlebotomy. The index technique used 3 cc of alcohol-based antiseptic (89 % ethanol) on another gauze for cleaning the left arm antecubital region. Both techniques allowed the antiseptic to air-dry for 30 s before phlebotomy. Two blood sample tubes per patient were sent to the laboratory, and BEC were measured using the alcohol dehydrogenase enzymatic method.
RESULTS
94 patients were included in the study. The mean age was 37.8 years (±15.7), with 77 % (n = 72) of them were male. The median BEC levels measured by both the reference and index techniques were 2 mg/dL (IQR: 0.97-16.25) and 2 mg/dL (IQR: 0.90-15.22), respectively, with no significant statistical difference (p = 0.536). 72 (77 %) of the patients had a BEC level below the legal driving limit of 20 mg/dL. Bland-Altman analysis, performed on these patients, revealed a small negative bias, -0.116 mg/dL with a standard deviation of 1.13 mg/dL. The upper and lower limit of the agreement was 2.092 and -2.323 respectively.
CONCLUSION
In patients with a BEC level of less than 20 mg/dL, using ethanol-containing antiseptics before blood sampling does not lead to erroneously elevated BEC levels.
PubMed: 38813189
DOI: 10.1016/j.heliyon.2024.e31517 -
International Journal of Retina and... May 2024The use of povidone-iodine for ocular surface asepsis is widespread for intravitreal injections. They became frequent procedures, leading to serial exposure of patients'...
BACKGROUND
The use of povidone-iodine for ocular surface asepsis is widespread for intravitreal injections. They became frequent procedures, leading to serial exposure of patients' eyes to iodinated solutions. In this study, we investigate the changes in the ocular surface in patients submitted to repeated use of povidine for intravitreal injection of anti-VEGF asepsis, analyzing Ocular Surface Disease Index, non-invasive break up time, blinking quality, lipid layer, meniscus height and osmolarity.
METHODS
This case-control study included 34 individuals (68 eyes), 14 males, 20 females aged 48 to 94. Inclusion criteria were individuals who received application of 2% povidone-iodine eyedrops for intravitreal injections treatment with the non-treated contralateral eye used as control. Ocular surface examinations were performed at a single occasion. A pre-intravitreal injection asepsis protocol with povidone-iodine was applied. All statistical analysis was performed using the STATA® 18.0 Software and a p-value = 0.05 was considered as the statistical significance value in all tests.
RESULTS
The median number of IVIs in treated eyes was 12 (range 6-20). The results in treated eyes compared with untreated eyes were respectively : median OSDI 16 (IQR 6-39) and 12.5 (IQR 8-39) (p = 0.380); mean NIBUT 10.30 (SD ± 2.62) and 10.78 (SD ± 2.92) ( s, p = 0.476); median blinking quality 100 (IQR 100) and 100 (IQR 100 ) (%, p = 0.188); median lipid layer 87 (IQR 77-90) and 86 (IQR 74-100) (nm, p = 0.451); median meniscus height 0.22 (IQR 0.19-0,31) and 0.24 (IQR 0.20-0.27) (mm, p = 0.862), median Meibomian gland atrophy 33 (IQR 24-45) and 31.5 (IQR 25-39) (%, p = 0.524); and mean osmolarity 306.6 (SD ± 21.13) and 313.8 (SD ± 29) (mOsm, p = 0.297). There was no statistically significant relationship between the repetitive use of 2% iodinated solution and signs or symptoms compatible with dry eye syndrome in this group of patients.
CONCLUSIONS
The findings suggest that 2% povidone iodine is a safe and efficacious agent for ocular surface antisepsis during intravitreal injections, not leading to substantial ocular surface modifications. This conclusion supports the continued use of povidone iodine in routine ophthalmic procedures without increased risk of inducing dry eye syndrome.
PubMed: 38812063
DOI: 10.1186/s40942-024-00557-1 -
Aquatic Toxicology (Amsterdam,... Jul 2024The gut microbiome is crucial in maintaining fish health homeostasis. Disinfectants can kill important pathogens and disinfect fish eggs, yet their effect on the immune...
The gut microbiome is crucial in maintaining fish health homeostasis. Disinfectants can kill important pathogens and disinfect fish eggs, yet their effect on the immune pathways and intestinal microbiome in healthy fish remains unknown. In this study, we investigated the effects of two disinfectants on the transcriptome profiles, immunological response, and gut microbiota dynamics of grass carp over a four-week trial. In particular, aquatic water was disinfected with 80 μg/L glutaraldehyde or 50 μg/L povidone-iodine. We found that glutaraldehyde and povidone-iodine induced gut antioxidant system and depressed the function of grass carp digestive enzymes. The results of the 16S rDNA high-throughput sequencing identified a reduction in the diversity of grass carp gut microbiota following the disinfectant treatment. Moreover, transcriptome profiling revealed that disinfectant exposure altered the immune-related pathways of grass carp and inhibited the expression of inflammation and tight junction related genes. Finally, the histopathological observation and apoptosis detection results suggested that the long-term diet of disinfectant destroyed intestinal structural integrity and promoted apoptosis. In conclusion, long-term exposure to disinfectants was observed to reduce oxidation resistance, suppress the immune response, dysbiosis of the intestinal flora, and resulted in increasing the apoptosis in intestinal of grass carp.
Topics: Animals; Carps; Gastrointestinal Microbiome; Disinfectants; Water Pollutants, Chemical; Intestines; Transcriptome
PubMed: 38788458
DOI: 10.1016/j.aquatox.2024.106942 -
Dentistry Journal May 2024In severe stages of periodontitis, conventional periodontal therapy and maintenance care are usually insufficient due to the viral and bacterial etiology; thus, a...
A Low-Cost Protocol Using the Adjunctive Action of Povidone-Iodine Irrigations and Sodium Hypochlorite Rinsing Solution in Step 2 of Periodontal Therapy for Patients with Stage III-IV Periodontitis: A Single-Blind, Randomized Controlled Trial.
In severe stages of periodontitis, conventional periodontal therapy and maintenance care are usually insufficient due to the viral and bacterial etiology; thus, a mechanical approach alone may not be sufficient to eliminate a substantial portion of subgingival pathogens, especially in deep periodontal sites. : This single-blind, randomized clinical trial aimed to compare the clinical and microbiological efficacy of a low-cost protocol using povidone-iodine and sodium hypochlorite formulations as adjuncts to non-surgical therapy for patients with stage IV periodontitis when compared with chlorhexidine, the most commonly employed substance to date for antimicrobial regimens in periodontal therapy. : Forty-five patients were randomly divided into two groups: control (subgingival instrumentation, chlorhexidine-assisted) and test (antiviral medication, subgingival instrumentation with povidone-iodine, sodium hypochlorite rinsing solution, and antibiotics). Clinical measurements and microbiological analyses were performed at baseline and after three months. : After three months, notable differences were found in the bacterial detection scores for (a significant reduction in detection frequency was observed in the test compared to the control ( = 0.021)), and there were significant reductions in detection in the test group for and , showing undetectable levels ( < 0.0001 for both). In the test group, the pocket probing depth median value was reduced significantly ( = 0.0005); similarly, bleeding on probing showed a marked decrease ( < 0.0001). However, changes in clinical attachment loss and full-mouth plaque score were not statistically significant. : Using the proposed protocol, substantial improvements in clinical and microbiological parameters were obtained when compared with the current antimicrobial recommendations.
PubMed: 38786542
DOI: 10.3390/dj12050144 -
Journal of Ophthalmic Inflammation and... May 2024Intravitreal injections are a common ophthalmologic procedure. While infections following these injections are rare, they can lead to endophthalmitis, with potentially...
BACKGROUND
Intravitreal injections are a common ophthalmologic procedure. While infections following these injections are rare, they can lead to endophthalmitis, with potentially serious consequences. Various methods have been proposed to prevent endophthalmitis, including the use of antisepsis and antibiotics in patient preparation.
PURPOSE
To evaluate the antiseptic efficacy of aqueous chlorhexidine (CHX) and povidone-iodine (PI) when used alone and in combination with lidocaine gel (LG) in vitro.
METHODS
Two independent experimental trials were conducted. The first trial determined the minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs) of CHX and PI against six bacterial strains. The second trial evaluated the bactericidal efficacy of the antiseptic agents (CHX 0.1% and PI 5%) and their combination with LG against the same bacterial strains.
RESULTS
CHX was more effective than PI in reducing the number of colonies forming units (cfus) of the tested bacteria. The order in which the antiseptic and LG were administered affected their effectiveness, with CHX administered before LG resulting in greater reduction of bacterial growth.
CONCLUSIONS
CHX 0.1% is more effective than PI 5% as an antiseptic agent. Application of CHX and PI prior to the use of lidocaine gel results in a more effective reduction of microorganisms.
PubMed: 38782819
DOI: 10.1186/s12348-024-00404-2