An alternative approach for daily perineal care of patients with indwelling urinary catheterization: Photodynamic inactivation with cationic porphyrin derivatives

Ayşe Akbıyık; Selçuk Kaya; Nermin  Topaloğlu Avşar; Hüseyin  Taşlı; Vildan  Alptüzün; Sülünay  Parlar Çoşkun

doi:10.14687/jhs.v20i3.6395

Authors

Ayşe Akbıyık İzmir Katip Çelebi University https://orcid.org/0000-0003-0513-5433
Selçuk Kaya İzmir Katip Çelebi University https://orcid.org/0000-0002-8637-6345
Nermin Topaloğlu Avşar İzmir Katip Çelebi University https://orcid.org/0000-0001-7001-8327
Hüseyin Taşlı Ege University https://orcid.org/0000-0003-0216-1740
Vildan Alptüzün Ege University https://orcid.org/0000-0002-1477-4440
Sülünay Parlar Çoşkun Ege University https://orcid.org/0000-0002-2892-5932

DOI:

https://doi.org/10.14687/jhs.v20i3.6395

Keywords:

Indwelling urinary catheterization, catheter-associated urinary tract infections, daily perineal care, antiseptic, antimicrobial photodynamic inactivation, MDR, E.coli, K. pneumoniae, MRSA, C. albicans

Abstract

Background: Catheter-associated urinary tract infections (CAUTI) constitute a significant portion of healthcare-associated infections. Using antiseptic for routine daily perineal care of patients with IUC may reduce CAUTIs.

Aim: This study aimed to examine antimicrobial photodynamic inactivation (aPDI) against clinical isolates for use in the daily perineal care of patients with IUC. In addition, it was also aimed to compare the antimicrobial activities of aPDI and 0.1% chlorhexidine gluconate.

Methods: In this in-vitro study, cationic porphyrin derivatives (CPDs) were used as photosensitizers in the experiments. CPDs, named PM, PE, PN, and PL were synthesized by the researchers. A diode laser device emitting light with a wavelength of 450 nm (blue light) was used as the light source. Methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli and Klebsiella pneumoniae with multidrug-resistant (MDR) properties and Candida albicans were used. Photosensitizer (PS), aPDI, light (L), and control (C) groups in aPDI experiments; control (C) and chlorhexidine gluconate 0.1% groups were used in the chlorhexidine gluconate experiments. Survival was calculated based on CFU/mL in the control group.

Results: In experiments, combinations of 25 J/cm² with 6.25 and 3.125 µM PM, PE reduced E. coli, K. pneumoniae, MRSA, and C. albicans survival in the range of 8.70 to 11.53 log₁₀. In aPDI experiments performed with 6.25 and 3.125 µM PN and PL concentrations at the same energy density, reductions in the range of 4.41 to 0.17 log₁₀ were observed in all four clinical isolates. In experiments where 1.5625 µM concentration was used, survival decreased in the range of 8.29 to 10.87 log₁₀ in PM and PE, while antimicrobial activity was limited in PN and PL. In the 0.1% chlorhexidine gluconate experiments, the survival reduction in all four clinical isolates ranged from 8.87 to 10.24 log₁₀.

Conclusion: For PM and PE, a very strong aPDI was obtained in C. albicans, E.coli, K. pneumoniae, and MRSA at low concentrations and energy density. The same antimicrobial activity was found in experiments using 0.1% chlorhexidine gluconate. In this context, we would like to inform you that aPDI to be performed with a combination of 25 J/cm² at 6.25 and 3.125 µM concentrations of PM and PE has the potential to be an antiseptic in the daily perineal care of patients with IUC.

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Author Biographies

Ayşe Akbıyık, İzmir Katip Çelebi University

Assist. Prof., Izmir Katip Çelebi University, Faculty of Health Sciences, Department of Nursing, Fundamental of Nursing

Selçuk Kaya, İzmir Katip Çelebi University

Prof. Dr., İzmir Katip Çelebi University, Faculty of Medicine, Department of Microbiology

Nermin Topaloğlu Avşar, İzmir Katip Çelebi University

Assoc. Prof. Dr., İzmir Katip Çelebi University, Faculty of Engineering, Department of Biomedical Engineering

Hüseyin Taşlı , Ege University

Prof. Dr., Ege University, Faculty of Pharmacy, Department of Pharmaceutical Microbiology

Vildan Alptüzün, Ege University

Prof. Dr., Ege University, Faculty of Pharmacy, Department of Pharmaceutical Chemistry

Sülünay Parlar Çoşkun, Ege University

Assist. Prof. Dr., Ege University, Faculty of Pharmacy, Department of Pharmaceutical Chemistry

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