Self-disinfecting plastics for intravenous catheters and prosthetic inserts

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Abstract
SUMMARY: A disinfectant (2,4,4′-trichloro-2′-hydroxydiphenyl ether: Irgasan, Ciba-Geigy) was incorporated into plastic washers fabricated from ethylvinyl acetate (EVA), polyethylene, polypropylene or TPX. Plastics containing 0·2 and 2% Irgasan gave zones of inhibition on nutrient and blood agar plates seeded with micro-organisms (Staphylococcus aureus, Staph, epidermidis Escherichia coli, Proteus mirabilisorCandida albicans) even after thorough washing. Exceptionally,C. albicanswas inhibited only by 2% Irgasan, and EVA gave good inhibition only against the staphylococci. Similar washers of each plastic were implanted subcutaneously into the flanks of rabbits; before insertion each was washed, had thread woven into it and was surrounded by a plasma clot containing 2 × 108Staph. aureus. All the plastics without Irgasan gave rise to abscesses, none of the plastics impregnated with 2% Irgasan did, though from 2 out of 12 sites small numbers ofStaph. aureuswere isolated atpost mortem. Using either clinical or bacteriological criteria, the results were highly significant (P< 0.00001 andP<0.001 respectively), demonstrating the effectiveness of this technique in preventing plastic-associated infection.