John’s Alwyn Gifted University

The proposed John Alwyn Gifted University will set up its first campus in Bali, Indonesia in collaboration with IBU Tree Limited, the developer of the International Bali University. Further details on this project can be found at www.ibutree.com.

 AFFILIATIONS:

The maiden program for the John’s Alwyn Gifted University is the M.Sc. in Regenerative Medicine, which details are as follows:

John Alwyn’s  M.Sc. in Regenerative Medicine

Regenerative Medicine aims to generate therapeutics for repair and regeneration of damaged and diseased organs. These therapeutics are based on stem cells, gene therapy and engineered tissues.

John Alwyn’s  M.Sc. in Regenerative Medicine , aims to provide students with the skills necessary for a career in this emerging discipline or within other areas of biomedical research. Taught modules will address the science behind regenerative medicine, its application to human disease and its importance to modern society. Students will then undertake a laboratory-based individual research project for four-5 months.

MSc (Regenerative Medicine)

College of Medicine, Nursing, & Health Sciences

* Course description

* Why choose this course?

Key facts

Entry requirements

Successful applicants will have at least an MBBS or a Second Class Honours degree in an appropriate biological science, life science, medicine or nursing. Students who have a degree without Honours in a related area and have three or more years of practical experience in the subject area will also be eligible to apply.

Duration: 1 year, full-time, 3 years part time ^ correspondence

Estimated start date: September 2012

Closing date: August 15th , 2012

Course overview- Main Focus to Human Safety in Choice of Aesthetic Medical treatments especially the misuse of Stemcells and Placenta extracts in certain beauty treatments.

This Johns Alwyn 12 month MSc programme aims to provide graduates in the life sciences, nursing or medicine with an understanding of Regenerative Medicine and to equip them with the skills necessary for a career in this emerging discipline. This course will integrate information, technologies and skills from biological sciences, engineering, legal and ethical disciplines. Modules will address the science behind Regenerative medicine, its application to human disease and its importance to modern society.

Course outline

The first two semesters will consist of taught courses to train students in the scientific principles of stem cells, gene therapy, biomaterials, tissue engineering, immunology, and pharmacology.   In addition there will be extensive training on the regulatory issues involved in translating a research observation to an approved and licensed regenerative treatment for patients. Training in scientific concepts and techniques important to biomedical research will occur in the second semester via a series of laboratory-based practicals. Training in scientific writing and data presentation will occur in the Introduction to Biomedical Research module. After the end of the second semester students will embark on individual thesis research projects for the remainder of the course.

Applications and selections

Applications are made online via The Postgraduate Applications Centre (PAC) at Johns Alwyn Bali University in collaboration with IBU- International Bali University & Polnas in bali.

Selection is based on the candidate’s academic record , and mostly on the applicants’ experienceat undergraduate level and their aptitude for the programme.

Modes of Study

Our courses fit your lifestyle.  Find out what all the different modes of study are and what they mean: full time, part time, distance, and more.

Full time study

Full time means you spend the full amount of hours per week on your programme of study.  Almost all courses are available full time.

Part time study

Part time means you spend fewer hours per week on your programme of study.  Sometimes part time hours are during nights and/or weekends to accommodate those who work full time.  Many courses are available both full time and part time, so you can get the same degree if you wish to study only part time hours.

Distance Learning

Distance learning is for students who perfer to study on their own at home.  At the beginning of the course, you receive self-paced, self-instructional learning materials, either hard copies or via the internet. You meet their tutor and other students occasionally for workshops and tutorials.

Classroom Based Learning

Classroom based programmes take place both at Bali Resort based campus and at our outreach locations.  Classroom based learning is part time and combines time in the classroom with time spent alone studying and doing project work.

Blended Learning

Blended learning is an extension of distance learning. It’s a combination of self-instructional learning materials , traditional face-to-face lectures and workshops, online discussions, self-assessment activities, assignments and formal examinations.

Returning to Learning

Returning to learning is for students starting late on their education or who have had an interruption in their education.

Addition of Natechnology in Johns Alwyn’s MSc Regenerative Medicine

SURGICAL ASPECT

MSc in Nanotechnology and Regenerative Medicine

Nanotechnology and regenerative medicine are rapidly expanding fields with the potential to revolutionise medicine.

    * About the MSc

    * How to Apply

    * Course Structure

    * Projects

    * Fees/Funding

    * Staff

    * News

About the MSc

PhD Students        Synthetic artery     Marterial testing

This unique MSc aims to equip students with fundamental knowledge in these interdisciplinary subjects, provide an overview of the exciting applications of nanotechnology in regenerative medicine and develop the students transferable research skills.

Based within the Division of Surgery and Interventional Science ensures that this MSc retains a clinical focus and addresses real medical needs. Indeed, in addition to world-leading research scientists, guest lecturers on this MSc include eminent surgeons (e.g. Prof Dr Andrew Christopher and Prof. Dr David Ralph) and regenerative medicine industry leaders in jakarta & Bali as well as Asean Experts

Course Structure & Modules

An MSc will be awarded for satisfactory completion of 180 credits, a Diploma for completion of 120 credits and PG certificate awarded for the completion of 60 credits.

Taught modules include: Nanotechnology in Medicine; Applied Tissue Engineering (including the use of stem cells ); Biomaterials in Regenerative Medicine; the Translation of Nanomedicne and a laboratory based module entitled Practical Bio-Nanotechnology & Regenerative Medicine.

 

JOURNAL 

JOHNS ALWYN MEDICAL JOURNAL also known as JMJ
JMJ is one of the most exclusive tournals whereby only Medical Research Papers involving human safety aspects are selected to be published in Johns Alwyn Medical Journal.

 

Selection Committee is headed by:

Prof Dr Menaka Hari Haran

Dr GK Kogelen Govvin

Dr Olubayode Awosika

 

Aaride AGT-1 Liquid Glove –an anti-MRSA disinfectant

 

Salmah S1 , Suresh K, Mahmood , Christopher A3 and Ralph D3

 

Department of Molecular Medicine1 and Department of Parasitology2,

Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur,

University College London Hospitals, NHS Foundation Trust.

Running title : Effective disinfectant against MRSA

Corresponding author

Prof Dr Suresh Kumar

Department of Parasitology

Faculty of Medicine

University of Malaya

 

Key words : Liquid Glove, MRSA , disinfectant ,

Introduction
In recent years hospitals and nursing homes have increasingly reported multi-resistant pathogens, particularly methicillin-resistant Staphylococcus aureus (MRSA) which has become a global problem. The first regional cross-sectional study in Germany detected S. aureus in 319 out of 1083 patients (2.5%) which provides supportive data for MRSA surveillance in Germany to take additional preventative measures (Woltering et al . 2008). In another study in the UK , variation in MRSA prevalence in the hospital was reported to correlate with similar variations in MRSA prevalence in the surrounding community (MacKenzie et al. 2007) suggesting that unless hygiene measures are seriously taken hospital outbreaks may become a source for the transmission of MRSA in the surrounding community. In a 6-y study period in Sweden, 1 to 4 household contact(s) connected to a MRSA patient were positive for MRSA. In the 22 families, 42 of 60 (70%) household contacts were positive for MRSA (Johansson, Gustafsson and Ringberg, 2007) again suggesting the seriousness to institute better hygiene practices with effective disinfectants and other measures to prevent transmission within the community. The high prevalence of MRSA colonization in emergency/transfer patients reported (Muralidha et al .2007) apart from implying the need for pre-operative antibiotic prophylaxis also suggest that effective disinfectants are needed to upkeep the cleanliness of operating theaters.

MRSA reports in Malaysian hospitals have shown strain differences with differing PFGE types (Alfizah et al. 2002) and highlighted the important finding of the presence of a single predominant PFGE type which suggests that inter-hospital spread of MRSA do occur frequently and regularly (Norazah et al 2003).

It therefore become imperative to assess the effectiveness of new disinfectants against bacteria especially MRSA. We have previously reported that Aaride AGT-1 Liquid Glove have shown to better than two other common disinfectants used in hospitals in eliminating 5 different bacteria strains namely Staphylococcus aureus, Enterococcus fecalis, E. coli, Pasteurella multocida and Pseudomonas auroginosa ( Salmah et al 2008 ( in press) ). The bacterial loads of two strains of MRSA were significantly lowered as compared to the controls and the other two disinfectants. The present study uses transmission electron microscopy to asses if effects of the Aaride AGT-1 Liquid Glove disinfectant can be seen at the ultrastructural levels of MRSA bacteria.

Materials and Methods

Two strains of methicillin resistant Staphylococcus aureus were routinely maintained at Molecular Bacteriology Laboratory (MB Lab), Department of Molecular Medicine. The isolates were obtained from infected patients admitted at the University Malaya Medical Center (UMMC).

Disinfectants used

Three disinfectants were used namely Aaride AGT-1 Liquid Glove, Disinfectant ST and Disinfectant SF. SF and ST are local common disinfectants commonly used in hospitals. The two MRSA strains MRSA S. aureus 27625 and 27228 showed a CFU count of 530.7 x 103 and 858 x 103 respectively . The two strains were treated with 10 ul of the three disinfectants respectively for 5 min before subjecting them for transmission electron microscopy .

Transmission electron microscopy

The contents from culture of two methicillin resistant Staphylococcus aureus (MRSA) strains namely 27625 and 27228 were centrifuged at 500 g for 5 min. The pelleted cells were re-suspended overnight in 4% glutaraldehyde in 0.1 M sodium cacodylate buffer, pH 7.3 at 4oC, washed thoroughly with cacodylate buffer and post-fixed for 30 min in 1% osmium tetroxide in cacodylate buffer. The fixed cells were dehydrated in ascending series of ethanols and embedded in epoxy resin. Semi-thin sections were stained with toluidine blue. Ultrathin sections were cut using an ultramicrotome, contrasted with uranyl acetate and lead citrate and viewed using a transmission electron microscope (LEO Libra 120).

Results and Discussion

The MRSA bacteria strain 27625 in control culture tubes were extremely heterogeneous with pleomorphic shape and size. Some of the bacteria showed no or less electron-dense amorphous dark material with intact cell wall (Plate 1 Fig 1). Bacteria in control tubes also showed dense homogenous electron-dense material occupying most of the cell contained within clear intact wall ( Plate 2 Fig 2) .

Aaride AGT-1 Liquid Glove ruptured the cell wall (Plate 1 Figs 3 and 4) causing the contents to leak. Partial or complete structural alteration including loss of a portion of electron dense core as well as irregular condensation and clumping of electron dense core materials was seen .

However disinfectant SF (Plate 1 Fig 5) did not cause any change. The ultrastructure of the bacteria was almost similar to that seen in the controls. Disinfectant ST (Plate 1 Fig 6) however did show some effect on few of the bacteria. However most of the bacteria however still showed the intact cell wall containing the electron dense material.

Similar results were seen for the MRSA bacteria strain 27228 (Plate 2). The intact wall containing the condensed electron dense material of the bacteria was seen in the controls (Plate 2 Fig 1) became ruptured with the electron dense material withdrawn (Plate 2 Fig 2) when treated with Aaride AGT-1 Liquid Glove. However there was no effect seen on the bacteria with disinfectants SF (Plate 2 Fig 3) and ST (Plate 2 Fig 4) F were used.

MRSA is an important cause of nosocomial infections and is a growing global concern. The difficulty in clinical management posses problems to control of MRSA infection (de Lancastre et al 1994)

One of the most commonly used methods to prevent the occurrence of bacterial infection in hospitals is still the use of disinfectants. Hence there have been a resurgence of new range of disinfectants containing different formulas. We strongly feel that hospital managements must continue to seek for newer products developed by evolving technologies as disinfectants seem to be the most practical first line of defense against microbes.

In the present study Aaride AGT -1 Liquid Glove showed the maximum cell destruction (Plate 1 Figs 3 and 4 and Plate 2 Fig 2) for both strains of MRSA. The cell wall was completely destroyed forcing the electron dense material out (Plate 1 Fig 4). The electron dense material seems to also have withdrawn leaving many of the bacterial cells empty. The solutions of disinfectants used to treat the bacteria prior to the TEM processing were direct from their respective dispenser containers. This is to avoid interference from the solution used to dilute as well as to provide an opportunity to simulate real time effect of the disinfectant. Using transmission electron microscopy to study the bactericidal effects of disinfectants is an effective method and has been used previously by others for the same purpose ( Richards & Cavill 1979, Gelinas & Goulet 1983; Bobichon & Bouchet 1987).

Aaride AGT-1 Liquid Glove contains phytoserum as a base. Apart from the very strong destructive ability of the disinfectant against bacteria, the disinfectant is known to regenerate surface epidermis of skin. The fact the treatment with the disinfectants was only for 5 minutes, the destruction of the cell wall and the total alteration of the bacterial structure within the stipulated time period makes AGT-1 a suitable disinfectant to be recommended in hospital settings.

References

Alfizah H. Norazah A. Nordiah AJ. Lim VK. (2002). DNA fingerprinting of methicillin-resistant Staphylococcus aureus (MRSA) by pulsed-field gel electrophoresis (PFGE) in a teaching hospital in Malaysia. Medical Journal of Malaysia. 57(3):319-28.

Bobichon, H., Bouchet, P. (1987) Action of chlorhexidine on budding Candida albicans: scanning and transmission electron microscopic study. Mycopathologia 100: 27±35

de Lancastre, H., Couto, I., Santos, I., Melo-Cristino, J., Torres-Psreira, A., Tomasz, A. (1994) Methicillin-resistant Staphylococcus aureus disease in a Portuguese hospital: characterization of clonal types by a combination of DNA typing method. Eur. J. Clin. Microbiol. Infect. Dis. 13:64±73

Gelinas, P., Goulet, J. (1983) Efficacy of 8 disinfectants on 3 types of surfaces contaminated by Pseudomonas aeruginosa. Can. J. Microbiol. 29: 1715±1730

Johansson PJ. Gustafsson EB. Ringberg H. (2007) High prevalence of MRSA in household contacts. Scandinavian Journal of Infectious Diseases. 39(9):764-8.

Muralidhar B. Anwar SM. Handa AI. Peto TE. Bowler IC. (2006) Prevalence of MRSA in emergency and elective patients admitted to a vascular surgical unit: implications for antibiotic prophylaxis. European Journal of Vascular & Endovascular Surgery. 32(4):402-7.

Norazah A. Lim VK. Rohani MY. Alfizah H. Koh YT. Kamel AG. (2003) A major methicillin-resistant Staphylococcus aureus clone predominates in Malaysian hospitals. Epidemiology & Infection. 130(3):407-11

R Woltering R. Hoffmann G. Daniels-Haardt I. Gastmeier P. Chaberny IF. (2008) Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in patients in long-term care in hospitals, rehabilitation centers and nursing homes of a rural district in Germany. Medizinische Wochenschrift.133(19):999-1003.

Richards, R. M. E., Cavill, R. H. (1979) Electron-microscope study of the effect of chlorhexidine on Pseudomonas aeruginosa. Microbios 26: 85±93

Yusof MI. Yusof AH. (2004) Orthopaedic infections: organisms and antibiotic sensitivity. Journal Medical Journal of Malaysia. 59(5):574-7

Plate 1 MRSA bacteria strain 27625

Figs 1 and 2 Control without disinfectants

Fig 1 Bacteria heterogeneous with pleomorphic shape and size. Some of the bacteria showed no or less electron-dense amorphous dark material with intact cell wall.

Fig 2 . Note the dense homogenous electron-dense material occupying most of the cell contained within clear intact wall .

Fig 3 and 4 bacteria treated for 5 mins with Aaride AGTI- Liquid Glove

Fig 3 Ruptured cell wall with contents leaked and irregular condensation of electron dense material

Fig 4 Partial or complete structural alteration including loss of a portion of electron dense core as well as irregular condensation and clumping of electron dense core materials was seen .

Fig 5 treated with SF. Ultrastructure of bacteria similar to that seen in the controls

Fig 6 treated with ST. Partial destruction in a few however most of the bacteria still showed the intact cell wall containing the electron dense material.

Plate 2 MRSA bacteria strain 27228

Fig1 The intact wall containing condensed electron dense material of the bacteria was seen in the controls.

Fig 2 with Aaride AGT 1 Liquid Glove . The intact wall was seen to rupture and the electron dense material withdrawn

Fig 3 with SF . similar to control

Fig 4 with ST similar to control
Aaride AGT-1 Liquid Glove –an effective disinfectant against bacteria

Salmah S1 , Suresh K2, Christopher A3 and Ralph D3
Department of Molecular Medicine1 and Department of Parasitology2,

Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur ,

University College London Hospitals, NHS Foundation Trust.
Corresponding author

Prof Dr Suresh Kumar

Department of Parasitology

Faculty of Medicine

University of Malaya

Introduction

Disinfectants continue to play an important role in preserving hospital hygiene and controlling the spread of infections especially when nosocomial infections have been shown to be an important cause of morbidity and mortality all over the world (Wenzel 1995). Hand hygiene therefore has become more important in community medicine especially with the increasing rise of antibiotic resistant bacteria such as Methicillin resistant Staphylococcus aureus (MRSA). Furthermore hands continuously engaged at a stretch in providing medical care are known to increase the number of microorganisms (Kamp 2003). In another study hands scrubbed with disinfectants for three minutes have been shown to produce lower mean log bacterial counts than scrubbing for two minutes (Wheelock and Lookinland 1997). However scrubbing for long periods have shown to remove barrier lipids by detergent cleaning and alcohol antisepsis as well as contribute to loss of moisturizers and stratum corneum (Kownatzki 2003). The only additional barrier for health personnel against the transfer of blood borne pathogens, chemical substances or any mutagenic material will be the gloves they wear. The two way protection system fails more often due to the holes and cuts left in the gloves by heavy scrubbing or sometimes the demands of heavy operative procedures ( Palmer and Rickett 1992). The risk for occupationally acquired bacterial infection among heath care workers with frequent occupational blood contact, including percutaneous injuries continue to pose a risk (Korniewicz and Rabussay 1997).

Furthermore hospital-acquired infections are also associated with increased attributable mortality, length of hospital stay and costs (Mahieu, Buitenweg, Beutels and De Dooy 2001). Therefore it is inevitable that the search for more effective disinfectants showing favorable barrier conferring properties as well affecting a wide range of microorganisms be made .

In this study, Aaride AGT-1 Liquid Glove , a disinfectant containing plant based phytoserum, known to not only confer protection by forming a thin liquid barrier on the surface of the skin but also possess a epidermis regenerative ability, is compared with two other disinfectants used commonly in hospitals for its anti-bacterial property.

Materials and Methods

Bacterial isolates

Five bacterial strains namely Staphylococcus aureus, Enterococcus fecalis, E. coli, Pasteurella multocida and Pseudomonas auroginosa were routinely maintained at Molecular Bacteriology Laboratory (MB Lab), Department of Molecular Medicine. All the isolates for Staphylococcus aureus, Enterococcus fecalis, E. coli and Pseudomonas auroginosa were obtained from infected patients admitted at the University Malaya Medical Center (UMMC) whereas, Pasteurella multocida was isolated from an infected cow at the Veterinary Research Institute (VRI) Ipoh

.

Disinfectants used

Three disinfectants were used namely Aaride AGT-1 Liquid Glove, Disinfectant ST and Disinfectant SF were local common disinfectants commonly used in hospitals .

Disinfectants susceptibility testing

The effect of disinfectants on the bacterial count was evaluated using the colony forming unit (CFU) technique. The theory behind the technique of CFU is that a single bacteria can grow and form a colony, via binary fission. A measure of viable cells from a colony represents an aggregate of cells derived from a single progenitor cell.

Each strain was inoculated in 3 ml of Brain-Heart Infusion (BHI) broth and incubated overnight at 37oC. The suspension containing 109 colony forming unit (CFU) per ml was used as a test inoculum. 0.1 ml (100 ul) from each of the strain was added to 1 ml (1000 ul) of physiologic saline (dilution factor = 1 ml/0.1 ml = 10). The test inoculum, 0.01 ml (10 ul), was mixed with 0.01 ml (10 ul) of Solution Aaride AGT-1 Liquid Glove, ST and SF respectively (diluted in to half; dilution factor = 2). After the exposure of inocula to the disinfectants for 10 min at room temperature, 0.001 ml (1 ul) from each inocula was transferred to BHI agar plates in triplicate and were incubated overnight at 37oC for colony count.

Control suspension was prepared by adding the 0.1 ml (100 ul) inoculum to 1 ml (1000 ul) of physiologic saline for each of the strain (dilution factor = 1 ml/0.1 ml = 10). 0.001 ml (1 ul) from each inocula was transferred to BHI agar plates in triplicate and were incubated overnight at 37oC for colony count.

Antimicrobial activity was considered to be inactive when a decrease in the colony counts, as compared with the control was seen. Data were presented in number of colony count and CFU/ml value, respectively. The differences in number of colony count and CFU/ml value between the disinfectants were statistically analysed.

Statistical test

All comparisons were performed using Yates chi-square tests

Results and Discussion

The results showed that Aaride AGT-1 Liquid glove significantly reduced CFU counts compared to the controls and the other two disinfectants. The two MRSA strains namely MRSA S. aureus 27625 and 27228 showed a CFU count of 530.7 x 103 and 858 x 103 respectively. The remaining 4 bacterial strains showed 0 counts in two out of three plates respectively. Disinfectant B and C showed positive growth for all bacterial strains with E.coli and P.multocida showing higher CFU counts than the controls .

Disinfections, including glutaraldehyde, formaldehyde and chloride-releasing agents compounds reduce the risk of endemic and epidemic nosocomial infections in patients.

There have been numerous studies assessing disinfectants potential to be anti-bacterial (Rutala et al. 1997; Shiraishi et al. 1993; Miner et al.2007; Grzybowska et al 2007).

Many of these studies show considerable differences in the efficiency of disinfectants to kill bacteria. However Ossia-Ongagna and Sabatier (1993) showed no significant differences of susceptibility to disinfectants appear between wild bacterial strains and reference strains when tested against seventeen bacterial strains and two suspensions including reference strains and wild strains from water of hospital environment,. In another study resistance of disinfectants against bacteria was shown to depend upon where these organisms grew. In close association with solid surface, they constitute a microbial community tight included in the exopolymer glycocalyx which then confers bacteria up to 10 to 100 folds more resistant to disinfectants than the bacteria of the same strain in suspension (Vidal, Ragot and Thibault 1997) .

In the present study Aaride AGT-1 Liquid Glove disinfectant significantly lowered the CFU counts compared to controls and the other two disinfectants. Studies have shown the presence of bacteria in contaminated disinfectants /antiseptics do pose a health risk to patients, particularly in the pediatric and surgical wards. Of the 180 samples studied, 11 of them (6.1%) were contaminated by Pseudomonas spp. (Gajadhar et al 2003) . 2 out of 3 plates in the present study had 0 CFU for E. fecalis, E.coli , P.aerouginasa and P.multocida respectively . The one plate positive for bacteria respectively had only 5 x 103 CFU .

Aaride AGT-1 Liquid Glove uses a plant base phytoserum as the base and is devoid of cations . Studies have shown that the involvement of plasmids in the resistance to some disinfectants, such as heavy metals and formaldehyde could contribute to cross-resistance between quaternary ammonium compounds (QACs) and aminoglycosides, codified by plasmids, has been reported in MRSA strains, implying the extensive use of cationic agents in the hospital environment could contribute to the emergence of resistant strains to antibiotic agents (Brumfitt, Dixson, Miller 1985: Towsend et al 1984).

P.aeruginosa continues to be an important hospital acquired infection especially so when the bacterium has been implicated in the contamination of medical-surgical instruments and respiratory apparatus ( Climo, Pastor and Wong , 1997) . The bacterium’s is also known to be highly resistant to antibiotic agents, antiseptics and disinfectants. Fernandéz-Astorga et al (1995) have reported that the high resistance of Pseudomonas spp to cationics agents which seems to be associated with the chemical composition of the external membrane. In the present study the CFU counts were significantly reduced compared to the controls and the other two disinfectants.

The high colonization rate of in patients with Enterococcus strains resistant to several antibiotic agents, especially ampicillin and aminoglycosides, represents a challenge to the therapy of these nosocomial infections. In another study when 35 commercially available disinfectants against vancomycin-resistant enterococci (VRE) and vancomycin-sensitive enterococci (VSE) were investigated under both clean and dirty (albumin added) conditions using a microtitration plate method, the results suggested that the use of a disinfectant with activity against VRE may be one appropriate method for preventing infections caused by this micro-organism ( Sakagami and Kajimura 2002). Our results concur with the suggestion made and it is vital that appropriate disinfectant be used in hospital settings to generate a healthy and safe place.

Resistance to disinfectants has increasingly become a problem. Disinfectants with mainly quaternary ammonium compounds and phenols ( Hammond, Morgan, Russell 1987; Russell, Hammond, Morgan 1986) and phenols (Navajas et al. 1992) have shown to be resistant against some strains of bacteria. 15% of strains of Gram-negative bacteria isolated from urinary tract infection have shown to be more resistant to QACs (Stickler and Thomas 1980) .

Plant based phytoserum in AGT-1 also appears to be advantageous over the other two disinfectants as it possess a barrier protection and epidermis generating ability. Herbal disinfectants have been used since 533 AD in China (Chen 2004) and judging from the growing concern of isolate resistance against disinfectants , it is timely that investigations using disinfectants from alternative bases conferring possibly better er protection should be carried out more extensively.

References

Brumfitt W, Dixson S. Hamilton Miller JMT. (1985) . Resistance to antiseptics

in methicillin and gentamicin resistant Staphylococcus aureus. Lancet i:

1442-1443.

Chen ZB. (2004) . Study and application of herbal disinfectants in China. Biomedical & Environmental Sciences. 17(4):492-8.

Climo, MW, Pastor A, Wong ES. (1997). An outbreak of Pseudomonas

aeruginosa related to contaminated urodynamic equipment. Infect. Control

Hosp. Epidemiol. 18: 509-510.

Fernández-Astorga A, Hijarrubia MJ, Hernández M, Arana I, Suñen

E. (1995) Disinfectant tolerance and antibiotic resistance in psychrotrophic Gramnegative

bacteria isolated from vegetables. Lett. Appl. Microbiol. 20: 308-311

Gajadhar T, Lara A, Sealy P, Adesiyun AA. (2003) Microbial contamination of disinfectants and antiseptics in four major hospitals in Trinidad. Pan American Journal of Public Health. 14(3):193-2003.

Grzybowska W, Mlynarczyk G, Mlynarczyk A, Bocian E, Luczak M, Tyski S. (2007). Estimation of activity of pharmakopeal disinfectants and antiseptics against Gram-negative and Gram-positive bacteria isolated from clinical specimens, drugs and environment. Medycyna Doswiadczalna i Mikrobiologia. 59(1):65-73.

Hammond SA, Morgan JR, Russell AD. (1987) Comparative susceptibility of

hospital isolates of Gram-negative bacteria to antiseptics and disinfectants. J.

Hospital. Infection. 9: 255-264.

Kampf G. (2003). State-of-the-art hand hygiene in community medicine. International Journal of Hygiene & Environmental Health. 206(6):465-72.

Korniewicz M, Rabussay DP (1997), “Surgical glove failures in clinical practice settings,” AORN Journal 66, 660-673.

Mahieu LM, Buitenweg N, Beutels P, De Dooy JJ. (2001), Additional hospital stay and charges due to hospital-acquired infections in a neonatal intensive care unit. Journal of Hospital Infection 47 . 223–229.

Miner N, Harris V, Ebron T, Cao TD. (2007). Sporicidal activity of disinfectants as one possible cause for bacteria in patient-ready endoscopes. Gastroenterology Nursing. 30(4):285-90.

Navajas RFC, Diaz RM, Del Castillo AS, Marín MAI. (1992)

Concentraciones mínimas inhibitorias y bactericidas de algunos antisépticos

y desinfectantes frente a cepas de origen hospitalario. Rev. Latino Am.

Microbiol. 34: 1-6

Ossia-Ongagna Y, Sabatier R. (1993) Comparison of in vitro activity of six disinfectants on bacteria from contamination in hemodialysis water. Journal de Pharmacie de Belgique. 48(5):341-51,

Palmer JD, Rickett JWS. (1992) The mechanisms and risks of surgical glove perforation, Journal of Hospital Infection 22 279- 286.

Russell AD, Hammond SA, Morgan JR. (1986) Bacterial resistance to antiseptics

and disinfectants. Journal of . Hospital Infection 7: 213-225.

Rutala WA, Stiegel MM, Sarubbi FA, Weber DJ. (1997) . Susceptibility of antibiotic-susceptible and antibiotic-resistant hospital bacteria to disinfectants. Infection Control & Hospital Epidemiology. 18(6):417-21.

Shiraishi T, Nakagawa Y. (1993). Review of disinfectant susceptibility of bacteria isolated in hospital to commonly used disinfectants. Postgraduate Medical Journal. 69 Suppl 3:S70-7.

Sakagami Y, Kajimura K. (2002) Bactericidal activities of disinfectants against vancomycin-resistant enterococci. Journal of Hospital Infection. 50(2):140-4.

Stickler DJ, Thomas B. (1980) Antiseptic and antibiotic resistance in Gramnegative

bacteria causing urinary tract infection. Journal of Clinical Pathology . 33: 288-296.

Towsend DE, Ashdow N, Greed LC, Grubb WB. (1984) Transposition of gentamicin resistance to staphylococcal plasmids encoding resistance to cationic agents. Journal of. Antimicrobial . Chemotheraphy. 14: 115-124.

Vidal DR. Ragot C. Thibault F. (1997) Bacterial biofilms and resistance to disinfectants. Annales Pharmaceutiques Francaises. 55(2):49-54

Wenzel RP. (1995) The economics of nosocomial infections. The Journal of Hospital Infection 31 79-87;

Wheelock SM, Lookinland S. (1997) Effect of surgical hand scrub time on subsequent bacterial growth. AORN Journal. 65(6):1087-92; 1094-8

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