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PMB 341.1 Anti Microbial Agents
PMB 341.1 Anti Microbial Agents
• Mycobacterium
• Bacteria endospores
• Prions
Factors affecting antimicrobial activities of chemical
antimicrobial agents
Generally classified based on:
• Organisms
• Chemical agents
• Environments/host
1. Organism-based factors:
• The nature:
• G+ve and G-ve bacteria have varied sensitivities to antimicrobial agents.
• Vegetative cells more susceptible than spores.
Spores possess rigid protective structures and/or capsules, spore coats and cortex.
• Possession of unusually high lipid/waxy cell wall leading to hydrophobic nature by
mycobacteria
• Biofilm formers are more resistant than planktonic/free-living ones.
• Vegetative forms of fungi are most susceptible than the spores e.g chlamydiospores, conidia
spores etc.
• Protozoa are resistant to most antimicrobial agents.
• Inoculum size (number): The larger the number of microbes, the more time or higher
concentration a germicide needs to destroy all of them, all other conditions remain
constant.
• E.g 10 B. atrophaeus spores were killed in 30 minutes while 100,000 Bacillus
atrophaeus spores took 3 hours.
• aggregated or clumped cells are more difficult to inactivate than monodispersed cells
• Mixture of resistant, non-resistant groups and dead cells in a mixed, large microbial
population
• Location of the organism: organisms inhabit aqueous environment just as chemical
antimicrobial agents.
• Intracellularly located microorganisms
• Presence of organic matter (pus, excreta, blood, milk etc) may impair penetration of
antimicrobial agents.
• Surface application, cracks and uneven surface application of chemical agents do not affect
deep-seated resident flora of the skin.
• Age of microorganisms:
• Susceptibility of organisms at log phase than those in other phases.
• May be due to the content of lipid, nucleic acid, protein and cell wall
permeability of the organisms.
2. Chemical agents:
• A. Concentration: Higher concentration have greater efficiency in
killing microorganism.
• Rate of kill of bacteria population varies directly with concentration of
the agent between the MIC and maximal concentration of agent.
• Below the MIC, exist only sub-inhibitory concentration of the agent at
the reactor site.
• Above the maximal concentration, no significant ↑ in the
antimicrobial action occurs.
• May be due to saturation of chemical agent at the reactors and
receptor sites or due to steric interference due to accumulation of the
agent at the reactor site.
• Plot of log death time(Time to kill a standard inoculum) against Log
concentration gives a straight line.
• Slope = concentration exponent (ⴄ).
•ⴄ=
• =
Log death time
Log concentration
• ⴄ is a characteristic of each type of antimicrobial agent.
• It indicates the activity of the agent on dilution.
• Examples:
Concentration
Dilution Disinfection
Agent coefficient (ⴄ) factor (d.F) effect (d.f ^ⴄ) dilution effect
Mercuric Chloride 1 3 3 3 times as long
Rapid inactivation
Phenol 6 3 729 by dilution
Mercuric Chloride 1 2 2 Twice as long
Phenol 6 2 64
Ethanol 9 2 512
Ethanol 9 3 19683
formaldehyde 1 2 2
formaldehyde 1 3 3
• 1. For mercuric chloride, ⴄ = 1 means its activity will be reduced by
the power of 1. thus a 3-fold dilution implies that its disinfection
activity will be reduced by 31 which is 3 .
• Interpretation= Disinfection activity will be 3 times as long.
• 2. Phenol ⴄ = 6; activity will be reduced by power of 6. A 3-fold
dilution implies that its disinfection activity will be reduced by 36
which is 729
• Similar interpretation applies to other antimicrobial agents.
• NB: agents with low conc. Coefficient/dilution exponent cannot easily be
inactivated by dilution but require use of chemical inactivator.
• B. Solubility:
• The more aqueous soluble an agent, the higher its penetration into
microbial cells and higher the antimicrobial action.
• C. Partition coefficient:
• The ratio of concentration of a solute in 2 immiscible or slightly miscible
liquids when in equilibrium across the interface between them.
• Especially important with preservatives
• The more an antimicrobial agent partitions into an aqueous environment,
the higher its antimicrobial action.
• Preservatives that favour partition into oily phase e.g chlorocresol will
require an ↑in their concentration.
• C. Formulation: considerations in formulation include the nature of
solvent or vehicles, solubility etc.
• Some agents are more active in alcoholic solvents than aqueous
solvents.
• Low soluble agents could be prepared using soaps, hydrocarbon
carriers and protective coverings.
• Nature of solvents affects the partition coefficient of disinfectants
• Partitioning in favour of oily phase will reduce concentration of most
antimicrobial agents.
• Some Preservatives easily adsorb unto finely divided particles in
suspension thus negatively affects antimicrobial action
• Interaction between preservatives and other components of the
formulation and/or packaging containers.
• 3. ENVIRONMENT-RELATED FACTORS
• A. pH: Changes in pH can affect the growth rate of inoculum, potency of
agent and its ability to combine with the sites on the cell surface.
• Bacterial growth is optimal at pH 6-8, fungi and yeast thrive at <6 thus on
either side, growth declines.
• Effect of pH on potency of agent: antimicrobial agents demonstrate activity
in different forms viz undissociated form (phenols, Benzoic acids,
nitrophenols, salicylic and acetic acids); cationic or anionic forms (QACs e.g
cetrimide) and acridine dyes.
• Active forms are affected by the pH of the environment
• Best activity is obtained at the pH that favours the formation of active
species.
• Weakly acidic agents are effective at low pH.
• Cationic agents are active at alkaline regions .
• Non-ionic and ampholytic agents are not affected by pH changes.
• Effect of pH on cell surface:
• Bacterial cell surface have increased negatively charged ions.
• Alkaline (-ve) pH will favour interactions with positively charged ions of antimicrobial
agents whereas negatively charged (anions) will be facilitated under acidic or +ve
conditions.
• Intercation of AMA with cell surface follows adsorption process thus increased
adsorption increases activity.
• B. Presence of organic matter or interfering substances:
• Organic matter include: Pus, blood, serum, faecal matter, food residues, organic
wastes ets.
• Presence of organic matter may interfere with AMA’s efficacy via:
• Microbial Coating with increase in the viscosity of the environment and ↓diffusion of the agent
• Adsorption of and reaction with organic matter. This reduces the concentration of AMA to the
organisms.
• Interaction and degradation of organic matter releasing metabolites (may be inactive or alter
physicochemical properties of the agent).
• Such interactions include:
• Phospholipids in serum, milk and faeces will reduce the AM activity of QACs.
• Phenolic compounds with cetomacrogols will give inactive complex
• Materials like rubber, fabrics, corks and plastics adsorb AMA resulting to loss of activity.
• Other environment-related factors include:
• Temperature, packaging materials (corks, rubbers, bottles etc), surface activity etc.
• Temperature:
• An ↑ in temperature ↑s AM activity of an agent.
• Generally, as temperature ↑s arithmetically, the rate of kill ↑s geometrically.
• The effect of temperature ↑ on the rate of bactericidal activity at fixed concentration of
AMA and inoculum size is expressed quantitatively by means of temperature coefficient
(Ꝋ).
Poor
penetration of
as skin disinfectants; to organic matter.
Intermediate level of disinfection; Bactericidal form tinctures of They quickly Ethyl alcohol,
including mycobacterium, fungicidal, not sporicidal. denaturation of volatilize; can Ethanol,
Alcohols Activity enhanced by presence of water. Readily proteins; interference antiseptics (used with leave particle Trichlorobutanol,
available and inexpensive. Have cleansing and with metabolism; lysis acetone); cleaning of
clinical thermometers and residues not Phenyl ethanol,
detergent action leading tto mechanical removal of (dissolving of organism) general instrument disintinguishabl Isopropanol,
microorganisms. disinfection. e from other Benzylalcohol etc
undesirable
particulate
matter.
irritation action and
carcinogenic
high level disinfectant; highly antimicrobial and chemical sterilant in possibilities with
sporicidal; 34-38% aqueous solution of equipment sterilization; in formaldehydes; little
protein inactivation; fumigation; soil and air penetrating power
formaldehyde is known as formalin; potent interaction with amino- and disinfection; viral vaccine for other organic
bactericide affecting vegetative bacteria, viruses hydroxyl groups of nucleic preparation e.g polio and materials order than Glutaraldehyde
Aldehydes and many spores (at 8%); 2% glutaraldehyde kills s;
acid, carboxyl and sulphydryl influenza,; production of serum; antimicrobial
non-sporing bacteria within 2 minutes; spores of groups in proteins leading to toxoids from toxins; dilute activity is affected formaldehydes
bacilli and clostridium in 3 hours;
cell death. solution (0.1-0.2%) of by temperature and
mycobacterium, viruses and fungi in 10 mins;
formalin may be used as humidity; toxic to
activity is not affected in the presence of serum
gargles. skin causing
hardening and
wrinkling of skin.
Ease of inactivation
by other chemicals; Hydrogen
pproduction of peroxides,
High level disinfectant; broad spectrum activity hydrogen peroxide is pungent odour; acts Peracetic acids
Peroxygenes with efficacy aginst viruses, bacteria, yeasts and Attacks the enzymes with widely used as biocides as oxidant by and ozones,
and thiol groups; affects the for disinfection, producing/releasing benzyl
permangates fungal spores; environmentally friendly with ribosomes and nucleic acids. sterilization and hydroxyl (OH-) free peroxides,
degradation into water and oxygen.
antiseptics radicals which potassium
attack cell essential permanganate
elements like s
proteins and DNA.
Agents Properties Mode of action Uses limitations Examples
penetration and
disruption of cell
Low level membrane; exhibit
disinfectants; Active rapid cytocidal
against bacteria at action at high instrument Activity reduces by
5% and inactive concentration; cell disinfection; mucous dilution (n=6); Chlorxylenols,
Phenols and against spores; protein precipitation. membrane and skin activity is affected by Bisphenols,
fungicidal and kills At low surfaces at low presence of organic Chlorocresols,
phenolic compounds
some viruses;are concentration, they concentration; matter, increase in Hexachlorophene,
corrosive and can inactivate essential environmental pH reduces the Cresols (e.g Lysol) etc
damage tissues enzymes, disrupts surfaces. activity
causing systemic cytoplasmic
poisoning. membrane and
leakage of cellular
content.
Agents Properties Mode of action Uses limitations Examples
mercuric compounds
Heavy metals have are used as topical
Most ancient of strong affinity for
antiseptics,
antiseptics and proteins combining preservatives and
disinfectants; mercuric with the thiol (SH)
disinfectants;
compounds have static groups leading to organomercurials are
activity against inactivation; forms used as fungicides and
vegetative bacteria complexes and renders Mercury (Hg), Silver
and molds; Phenyl them metabolically preservatives at 0.01- Toxicity to animals; (Ag), Copper (Cu),
0.02 %; cupric salts are activity reduction in
mercuric salts are inactive; high used as potent the presence of phenylmercuric nitrate
Heavy metals and their relatively non-toxic, concentration of Siver (PMN),
salts non-irritant and non- and copper fungicides and organic matter; phenylmercuric
algacides in reservoirs corrosive action;
corrosive; precipitates cell acetate (PMA),
organometallic are proteins; silver and swimming pools; possible pollution to thiomersals,
0.001% phenyl environment
effective against Gram compounds act as nitromesals etc
mercuric salts are used
positive cocci, spore- protoplasmic poison as preservatives for
forming rods, forming silver
tuberculosi, mycosis proteinates(a complex multidose injections
and some ophthalmic
and not Gram positive with sustained solutions and at
rods. antiseptic action
0.002% in sterilization
through slow release) with bactericide.
Approximate
Agents concentration used Mode of action Uses
(percent)
in disinfection of
dwellings, ships, storage
Aldehydes (e.g., general microorganism
formaldehyde) 1–5 poison houses, utensils, clothing;
in hospital-instrument
sterilization
as disinfectants; in
cell-membrane
Oligodynamic metals ointments and salves; in
traces destruction; coagulation of
(silver, copper, mercury) cell materials cement (e.g., in shower
rooms)
Approximate
Agents concentration used Mode of action Uses
(percent)
as disinfectants; in
Oligodynamic metals traces cell-membrane destruction; ointments and salves; in
(silver, copper, mercury) coagulation of cell materials cement (e.g., in shower
rooms)
in cosmetics and
deodorants;
Heavy metals 0.1–1 precipitation of cell proteins
antiperspirants; skin
antiseptics
in dentistry as mucous
inhibition of cell function;
Dyes (e.g., acridine) 0.1–1 combination with essential antiseptics; in laboratory
media to inhibit growth of
metabolites
unwanted bacteria
Approximate
Agents concentration used Mode of action Uses
(percent)
Antibiotics and
interference with cell in chemotherapy of
chemotherapeutic drugs
(e.g., penicillin, 0.001–1 metabolism; synergistic action in disease; in ointment and
body to counteract infection salves as skin antiseptics
sulfonamides)
Cetrimides/QACs Lubrol W
• Example:
Disinfectant REACTION TIME (mins)
Dilutions
2.5 5 7.5 10
Phenol + + - -
1 : 95
Test Disinfectant
1 : 200 - - - -
1 : 250 + - -
1 : 300 + - - -
1 : 350 + + - -
• Rideal Walker phenol coefficient =
= = 3.68
Interpretation: Test disinfectant is more effective disinfectant than
phenol
2. Chick- Martin PCT
• Proposed by H. Chick and Martin 5 years after RW PCT
• A modification of Rideal Walker PCT as follows:
• Addition of organic matter (5% yeast)
• Use of Staphylococcus aureus in addition to Salmonella Typhi
• Use of 30 mins as time of sub-culture from reaction mixture to
recovery medium
• Use of 10 ml recovery medium
• Chick Martin PCT is calculated with the formular:
Mean of highest concentration of phenol showing growth (in both
tubes) and lowest concentration for growth inhibition divided by the
same mean for the test disinfectant.
Example:
Phenol (%) Tubes Disinfectant (%) Tubes
1 2 1 2
2.0 - - 0.47 - -
1.8 - - 0.41 - -
1.62 + - 0.37 + -
1.45 + + 0.33 + +
1.31 + + 0.31 + +
PC = = 4.15
Limitations of Phenol coefficient test
• Used only for phenolic disinfectants
• Except for chick martin PC, it does not consider the effect of organic
matters on disinfectant efficacy.
• Use of only an organism. This does not represent a wide spectrum of
activity of phenolic disinfectants
• Use of fixed temperature which precludes the disinfectant assessment
under different temp. conditions.
• Varied disinfection times for different methods which don not consider
slow acting disinfectants that may be efficient with broad spectrum.
• A possibility of picking dead cells during sampling
• Difficulty with reproducibility due to variations in inoculum
concentration, age or metabolic states, different diluents, suspending
agents or recovery media.
EVALUATION OF ANTISEPTICS
• Categories of antiseptics:
• Oral antiseptics: mouthwashes and gargles; lozenges, pastilles and paints.
• Skin antiseptics: used in other parts of the body as in wound cleaning and pre-surgery
procedures.
• Skin antiseptics evaluation methods:
• Skin penetration test e.g in acne where skin penetration is needed.
• Skin infection test
Skin antisepsis test: Applicable to antiseptics for bathing, hand washing and pre-surgery
procedures.
• Skin penetration test methods
i. Glove test using spread plate techniques
• Procedure:
• Apply antiseptics over two hands and cover with sterile rubber gloves for 2hrs
• Carefully remove the gloves without turning inside out
• Shake with 100 ml of sterile normal saline
• Spread plate 1 ml of the rinse and incubate for 48hours
• Check for presence or absence of growth.
• Repeat produce using control and compare the differences
ii. Skin biopsy test.
Skin infection test procedure:
- Inflict the skin with an open cut and inoculate the wound with virulent
strain of a test organism
- After the establishment of infection, clean the wound with solution of test
antiseptic
- Perform viable cell count
- Repeat procedure without antiseptics and compare count.
- Survival level is a measure of activity of the antiseptic
Evaluation method for oral antiseptics:
- Extinction time test: it determines the shortest interval required to kill a
given population of a test microorganaism.
- Procedure:
- Inoculate about 10 ml saliva with 1 ml culture of S. aureus or Strep.
pyogenes
• Withdraw a loopful of organism-saliva reaction mixture at 0 and 1
minute intervals
• Subculture into a nutrient broth and incubate at 37OC for 48 hrs
• Determine the extinction time as follows:
• Mouth washes and gargles ≤ 15 seconds
• Lozenges, pastiles and paints ≤ 15 minutes
• Skin antiseptics ≤ 5 minutes
• NB: An effective antiseptic is that which exerts lethal action against
test microorganism within the given period of time as stated.
EVALUATION OF PRESERVATIVES
• Best undertaken in the final product container.
• Preservative efficacy is determined using the microbial challenge test
• A preserved preparation is exposed to a wide variety of organisms most
likely to encountered during production and use
• In microbial challenge test, the following is considered wit respect to the
organism:
• microbial association with the product,
• high level of resistance to preservatives,
• capacity to opportunistic contamination,
• ability to elicit a particular health hazard if present in a product
• Use of organisms at the optimal growth levels
• Incubation temp. similar to product storage and use temperature.
• Procedure: Refer to Laboratory practical manual
Aseptic techniques – Principles and processes, etc
Good manufacturing practice (GMP)