Analysis of povidone iodine, chlorhexidine acetate and polyhexamethylene biguanide as wound disinfectants: in vitro cytotoxicity and antibacterial activity

• Published in: BMJ nutrition, prevention & health Vol. 6; no. 1; pp. 21 - 27
• Main Authors: Zhang, Mingshi, Jin, Jian, Liu, Yingying, Ben, Chi, Li, Haihang, Cheng, Dasheng, Sun, Yu, Guang-Yi, Wang, Zhu, Shihui
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01-06-2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Apoptosis; Bacteria; Clinical medicine; Cytotoxicity; Disinfection & disinfectants; Fibroblasts; Infectious disease; Iodine; Original Research; Ozone; Skin disorders; Wound healing; China; Infectious disease; Skin disorders
• ISSN: 2516-5542; 2516-5542
• DOI: 10.1136/bmjnph-2022-000431

ObjectivesEven though disinfectants are commonly used in clinical practice and daily life, there are few studies on their antibacterial ability and cytotoxicity, which are closely related to the safety and effectiveness of their use. To provide a basis for the use of disinfectants, the cytotoxicity and antibacterial activity of three most commonly used disinfectants, povidone-iodine, chlorhexidine acetate and polyhexamethylene biguanide (PHMB), were investigated.DesignA CCK-8 assay was used to measure the activities of human fibroblasts (HF) and keratinocytes (HaCat), the two most important cells in wound healing, following their exposure to disinfectants. The effects of different times and concentrations were included. The antibacterial activity of disinfectants against Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae was reflected by their minimum inhibitory concentration and minimum bactericidal concentration.ResultsAll three disinfectants showed strong cytotoxicity in direct contact with HF and HaCat cells. Cytotoxicity increased with increasing exposure time and concentration. S. aureus, A. baumannii and K. pneumoniae comprised 70%, 55% and 85% of the strains sensitive to povidone iodine; 50%, 45% and 80% of the strains sensitive to chlorhexidine acetate; and 60%, 45% and 80% of the strains sensitive to PHMB, respectively.ConclusionsAll three disinfectants were cytotoxic; therefore, it is necessary to pay attention to the use time and concentration in the clinical setting. All three disinfectants were cytotoxic, with povidone-iodine being the most cytotoxic even at low concentrations. PHMB had better antibacterial efficacy against S. aureus and is suitable for the treatment of shallow wounds primarily. All three tested bacteria were significantly more sensitive to PHMB than to the other disinfectants.