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Biocidal agents used for disinfection are usually not suspected to enhance cross-resistance to antibiotics. The aim of this review was therefore to evaluate the effect of 13 biocidal agents at sublethal concentrations on antibiotic resistance in Gram-negative species. A medline search was performed for each biocidal agent on antibiotic tolerance, antibiotic resistance, horizontal gene transfer, and efflux pump. In cells adapted to benzalkonium chloride a new resistance was most frequently found to ampicillin (eight species), cefotaxime (six species), and sulfamethoxazole (three species), some of them with relevance for healthcare-associated infections such as Enterobacter cloacae or Escherichia coli. With chlorhexidine a new resistance was often found to ceftazidime, sulfamethoxazole and imipenem (eight species each) as well as cefotaxime and tetracycline (seven species each). Cross-resistance to antibiotics was also found with triclosan, octenidine, sodium hypochlorite, and didecyldimethylammonium chloride. No cross-resistance to antibiotics has been described after low level exposure to ethanol, propanol, peracetic acid, polyhexanide, povidone iodine, glutaraldehyde, and hydrogen peroxide. Taking into account that some biocidal agents used in disinfectants have no health benefit (e.g., in alcohol-based hand rubs) but may cause antibiotic resistance it is obvious to prefer products without them.

Polyhexamethylene biguanide (PHMB) is one of the many antiseptics available in the medicine. It stands out from the others with its numerous advantages. It has a low toxicity factor, chemical stability, and bactericidal effect on most microorganisms. PHMB is used in many areas of medicine, veterinary medicine, gastronomy, and industry. The application of polyhexanide in the treatment of chronic wounds allows for fast regeneration and reduced time of wound treatment and hospitalization. According to the Recommendations of the Polish Wound Treatment Society, PHMB is recommended in treatment of critically colonized wounds, wounds at risk infection, burns, and decontamination of acute and chronic wounds, and as second choice in infected wounds. DOI: http://dx.doi.org/10.5281/zenodo.3956819

To compare the efficacy of Negative Pressure Wound Therapy (NPWT) with and without irrigation with 0.1% polyhexanide-betaine. We randomized 150 subjects in a 16-week RCT to compare healing in patients with diabetic foot infections. NPWT delivered at 125 mm Hg continuous pressure. NPWT-I were administered at 30 cc per hour. There were no differences clinical treatment or outcomes: wound area after surgery (18.5 ± 19.0 vs. 13.4 ± 11.1 cm2, p = 0.50), duration of antibiotics (39.7 ± 21.0 vs. 38.0 ± 24.6 days, p = 0.40), number of surgeries (2.3 ± 0.67 vs. 2.2 ± 0.59, p = 0.85), duration of NPWT (148.1 ± 170.4 vs. 114.5 ± 135.1 h, p = 0.06), healed wounds (58.7% vs. 60.0%, p = 0.86), time to healing (56.3 ± 31.7 vs. 50.7 ± 27.8, p = 0.53), length of stay (13.8 ± 6.4 vs. 14.5 ± 11.2 days, p = 0.42), re-infection (20.0% vs. 22.7%, p = 0.69, and re-hospitalization (17.3% vs. 18.7, p = 0.83). The addition of irrigation to NPWT did not change clinical outcomes in patients with diabetic foot infections. NCT02463487, ClinicalTrials.gov. •Negative pressure wound therapy is common in treatment of diabetic foot infections•No current comparison between NPWT with or without irrigation in foot infections•Addition of irrigation to NPWT did not change clinical outcomes in these patients

The spread of COVID-19 has brought about huge losses around the world. This study aims to investigate the applicability of PHMB used for developing antiviral spandex clothing against coronavirus. PHMB was qualitatively determined on the surface of spandex fabrics by using BPB. The antiviral analysis shows that the PHMB-treated spandex fabric can kill 99% of the coronavirus within 2 h of contact, which suggests that the spandex fabric treated with PHMB could be used for developing antiviral clothing against coronaviruses for containing the transmission of COVID-19 in high-risk places. Furthermore, PHMB-treated spandex fabrics were shown excellent antibacterial activity against gram-positive S. aureus and gram-negative K. pneumoniae. The hand feel properties of Spandex fabric were not significantly affected by the PHMB coating in addition to the wrinkle recovery, which was obviously improved after PHMB coating.

Periprosthetic joint infection (PJI) is one of the most frequent reasons for painful shoulder arthroplasties and revision surgery of shoulder arthroplasties. Cutibacterium acnes (Propionibacterium acnes) is one of the microorganisms that most often causes the infection. However, this slow growing microorganism is difficult to detect. This paper presents an overview of different diagnostic test to detect a periprosthetic shoulder infection. This includes nonspecific diagnostic tests and specific tests (with identifying the responsible microorganism). The aspiration can combine different specific and nonspecific tests. In dry aspiration and suspected joint infection, we recommend a biopsy. Several therapeutic options exist for the treatment of PJI of shoulder arthroplasties. In acute infections, the options include leaving the implant in place with open debridement, septic irrigation with antibacterial fluids like octenidine or polyhexanide solution, and exchange of all removable components. In late infections (more than four weeks after implantation) the therapeutic options are a permanent spacer, single-stage revision, and two-stage revision with a temporary spacer. The functional results are best after single-stage revisions with a success rate similar to two-stage revisions. For single-stage revisions, the microorganism should be known preoperatively so that specific antibiotics can be mixed into the cement for implantation of the new prosthesis and specific systemic antibiotic therapy can be applied to support the surgery.

Poly(hexamethylene biguanide) (PHMB) has been extensively studied as an antiseptic and a disinfectant for various areas. However, little attention has been paid to the flocculation performance of PHMB as a cationic polyelectrolyte. The present manuscript investigates the applicability of PHMB as a cationic flocculant for removal of anionic dyes from aqueous solution. It was found that the optimal dosage of 50 ~ 70 mg/L PHBM can effectively remove two model anionic dyes over a wide range of pH value with both rather higher color removal efficiency and lower turbidity. The effect of pH value on the flocculation performance of PHMB mainly lies in the lower dosage (< 60 mg/L), whereas it does not affect the higher dosage of PHMB (> 60 mg/L), suggesting that PHMB is pH-tolerant in the removal of anionic dyes at higher dosage. More interestingly, the addition of inorganic salts was found to enhance the flocculation performance of PHMB, particularly sodium chloride and sodium sulphate, which indicates that the flocculation performance of PHMB increases with increasing ionic strength, i.e., salt-intensive effect. Compared to traditional polymeric flocculants, the present study shows that PHMB has an excellent and comparable flocculation performance in the removal of anionic dyes from aqueous solution, which may extend the application of PHMB in the treatment of dye wastewater. PHMB used as flocculant for decolorization of dyeing wastewater.

The surface modification of cellulose nanofibers (CNFs) using a 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO)/sodium bromide (NaBr)/sodium hypochlorite (NaClO) system was successful in improving their hydrophilicity. Following that, we fabricated hydrogels containing carboxylated cellulose nanofibers (c-CNFs) and loaded them with polyhexamethylene biguanide (PHMB) using a physical crosslinking method, aiming for efficient antimicrobial uses. The morphological and physicochemical properties of all hydrogel formulations were characterized, and the results revealed that the 7% c-CNFs-2 h loaded with PHMB formulation exhibited desirable characteristics such as regular shape, high porosity, good mechanical properties, suitable gel content, and a good maximum swelling degree. The successful integration of PHMB into the c-CNF matrix was confirmed by FTIR analysis. Furthermore, the 7% c-CNFs-2 h loaded with the PHMB formulation demonstrated PHMB contents exceeding 80% and exhibited a prolonged drug release pattern for up to 3 days. Moreover, this formulation displayed antibacterial activity against S. aureus and P. aeruginosa. In conclusion, the novel approach of c-CNF hydrogels loaded with PHMB through physical crosslinking shows promise as a potential system for prolonged drug release in topical drug delivery while also exhibiting excellent antibacterial activity.

Traditional wound and burn treatments often fall short in balancing antimicrobial efficacy, patient comfort, and ease of application. This study introduces a novel, transparent, thermoresponsive sol–gel formulation incorporating polyhexamethylene biguanide (PHMB) for advanced topical therapy. Utilizing Poloxamer 407 as a biocompatible carrier, the formulation remains a sprayable liquid at room temperature and instantly gels upon contact with body temperature, enabling painless, pressure-free application on sensitive, injured skin. Comprehensive in vitro and in vivo evaluations confirmed the formulation’s broad-spectrum antimicrobial efficacy (≥5 log10 reduction in 30 s), high biocompatibility (viability > 70% in fibroblasts), non-irritancy (OECD 425-compliant), and physical stability across three months. Importantly, the formulation maintained fibroblast migration capacity—crucial for wound regeneration—while exhibiting rapid sol-to-gel transition at ~34 °C. These findings highlight the system’s potential as a next-generation wound dressing with enhanced user compliance, transparent monitoring capability, and rapid healing support, particularly in disaster or emergency scenarios.

Poly(hexamethylene biguanide) (PHMB) is a polycationic antimicrobial polymer exhibiting broad-spectrum activity against bacteria, fungi, and viruses, and is widely used in medical settings for infection prevention and control. However, the relationship between chemical structure and antimicrobial activity remains unclear. In this study, we synthesised and characterised a series of polymeric biguanides with systematically varied alkyl chain lengths to examine the effects of structural variation on physicochemical properties and antimicrobial activity. H NMR spectroscopy and FTIR confirmed successful polymerisation. Solubility measurements revealed a progressive decrease in aqueous solubility with increasing alkyl chain length, consistent with increased hydrophobicity. Dynamic light scattering indicated reversible folding and unfolding of polymer chains in aqueous solution, with stabilisation at higher concentrations. Diffusion-ordered spectroscopy was used to calculate hydrodynamic diameters and polydispersity indices. Antimicrobial assays against Staphylococcus aureus and Pseudomonas aeruginosa showed that polymers containing heptamethylene and octamethylene chains exhibited the highest antibacterial activity, whereas tetramethylene- and pentamethylene-containing polymers showed greater fungicidal activity against Candida albicans. Highly hydrophobic polymers showed increased aggregation, resulting in reduced antimicrobial efficacy. Overall, these results indicate that both charge density and alkyl chain length are key determinants of antimicrobial activity. This polymeric biguanide series provides a platform for further investigation of structure–activity relationships and mechanisms of action against pathogenic microorganisms and their biofilms.