Antimicrobial Activity of a Novel Vascular Access Film Dressing Containing Chlorhexidine Gluconate.

Covering insertion sites with chlorhexidine impregnated dressings has been proven to be clinically effective in reducing catheter related blood stream infections (CR-BSI). Two chlorhexidine gluconate (CHG)-impregnated dressings are commercially available, a polyurethane foam disk and a film dressing containing a chlorhexidine gluconate-impregnated gel pad. While both have demonstrated efficacy in clinical settings, the major drawback of high cost and impaired IV insertion site visibility limits their usage. A new, simple film dressing containing CHG within its adhesive layer is now available. The objective of this study was to test the in vitro antimicrobial efficacy of the new dressing in comparison to the CHG-impregnated gel dressing.Quantitative aliquots of suspensions (concentration of 1.0x106 to 5.0x106 cfu/sample) of clinically relevant challenge organisms (Staphylococcus species, gram-negative bacilli, Candida albicans) were incubated in contact with the new CHG-containing film dressing, a placebo version of the same (negative control) and the commercially available CHG-impregnated gel dressing (positive control). Serial dilutions of the surviving organisms were quantified using the pour plate after 1, 3, 5, and 7 days of incubation in order to calculate an antimicrobial log10 reduction for each organism/dressing combination at each point in time.The new CHG-containing film dressing delivered greater than 5.0 log10 reduction throughout the 7 days on all aerobic gram-negative bacilli and Staphylococcus species tested. As of day 1 the CHG-containing film dressing provided greater than 5.0 log10 reduction on Candida albicans. There were no statistically significant differences in the log10 reduction between the two dressings tested.The new CHG-containing film dressing was found to be as effective as the chlorhexidine gluconate-impregnated gel dressing on clinically relevant microbes

Bacterial and fungal strains tested.

<p>^#methicillin-susceptible</p><p>*multi-resistant</p><p>Bacterial and fungal strains tested.</p

<i>In vitro</i> microbial challenge over 7 days.

<p>CFU = colony forming units; MRSA = methicillin-resistant <i>staphylococcus aureus</i>; CRE = Carbapenem-resistant <i>enterobacteriaceae</i></p><p><i>In vitro</i> microbial challenge over 7 days.</p

Results from Chlorhexidine Gluconate neutralization assay.

<p>D = % Neutralizer Efficacy, E = % Neutralizer toxicity, F = % Microbial recovery</p><p>Results from Chlorhexidine Gluconate neutralization assay.</p

Dataset for "Development of a mixed-species biofilm model and its virulence implications in device related infections"

This dataset contains the data underlying the figures presented in "Development of a mixed-species biofilm model and its virulence implications in device related infections". The associated paper reports the development of a simple mixed-species biofilm model using strains of two clinically significant bacteria, Staphylococcus aureus and Pseudomonas aeruginosa, grown on nano-porous polycarbonate membranes on nutrient agar support. The following data tables are included: - Total number of viable cells (in colony forming units/biofilm) recovered from 8 selected single-species biofilms (Figure 3a). - Total number of viable cells (in colony forming units/biofilm) recovered from 5 mixed-species biofilms (Figure 3b). - Fluorescent response of lipid vesicles after incubation with planktonic culture of 20 S. aureus in tryptic soy broth and 10 P. aeruginosa strains in Luria broth (18 hours culture) for 24 hours (Figure 4a). - Fluorescent response of prototype diagnostic dressing to single-species biofilms after incubation at 33°C for 24 hours (Figure 4b). - Fluorescent response of prototype diagnostic dressing in triplicate to each mixed-species biofilm, based on positive control dressing with 250 µM 5,6-carboxyfluorescein (Figure 5a). - Time dependent variation of biofilm cells (colony forming units) and in situ fluorescent response of prototype diagnostic dressing throughout the biofilm formation of S. aureus and P. aeruginosa in mixed-species biofilms (Figure 6a). - Reduction of viable biofilm cells (colony forming units) in single-species biofilms of S. aureus and P. aeruginosa using 2% octenidine hydrochloride containing hydrogel (Figure 6b)

COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study

International audienceBackground: Various observations have suggested that the course of COVID-19 might be less favourable in patients with inflammatory rheumatic and musculoskeletal diseases receiving rituximab compared with those not receiving rituximab. We aimed to investigate whether treatment with rituximab is associated with severe COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases.Methods: In this cohort study, we analysed data from the French RMD COVID-19 cohort, which included patients aged 18 years or older with inflammatory rheumatic and musculoskeletal diseases and highly suspected or confirmed COVID-19. The primary endpoint was the severity of COVID-19 in patients treated with rituximab (rituximab group) compared with patients who did not receive rituximab (no rituximab group). Severe disease was defined as that requiring admission to an intensive care unit or leading to death. Secondary objectives were to analyse deaths and duration of hospital stay. The inverse probability of treatment weighting propensity score method was used to adjust for potential confounding factors (age, sex, arterial hypertension, diabetes, smoking status, body-mass index, interstitial lung disease, cardiovascular diseases, cancer, corticosteroid use, chronic renal failure, and the underlying disease [rheumatoid arthritis vs others]). Odds ratios and hazard ratios and their 95% CIs were calculated as effect size, by dividing the two population mean differences by their SD. This study is registered with ClinicalTrials.gov, NCT04353609.Findings: Between April 15, 2020, and Nov 20, 2020, data were collected for 1090 patients (mean age 55·2 years [SD 16·4]); 734 (67%) were female and 356 (33%) were male. Of the 1090 patients, 137 (13%) developed severe COVID-19 and 89 (8%) died. After adjusting for potential confounding factors, severe disease was observed more frequently (effect size 3·26, 95% CI 1·66-6·40, p=0·0006) and the duration of hospital stay was markedly longer (0·62, 0·46-0·85, p=0·0024) in the 63 patients in the rituximab group than in the 1027 patients in the no rituximab group. 13 (21%) of 63 patients in the rituximab group died compared with 76 (7%) of 1027 patients in the no rituximab group, but the adjusted risk of death was not significantly increased in the rituximab group (effect size 1·32, 95% CI 0·55-3·19, p=0·53).Interpretation: Rituximab therapy is associated with more severe COVID-19. Rituximab will have to be prescribed with particular caution in patients with inflammatory rheumatic and musculoskeletal diseases