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(Scientific American)   Staph bacteria would like to thank you for using antimicrobial soap   (scientificamerican.com) divider line 32
    More: Scary, bacteria, Soap Ingredient, soaps, disinfectants, mucus, mBio, Staphylococcus aureus, staph  
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1965 clicks; posted to Geek » on 10 Apr 2014 at 6:23 PM (20 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



32 Comments   (+0 »)
   
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2014-04-10 06:25:09 PM
Antimicrobial soap would also like to say that it thinks it's had enough skin contact for one lifetime and declares celibacy. More at eleven.
 
2014-04-10 06:31:16 PM
"That which does not kill me makes me stronger."
-Staph. Nietzsche
 
2014-04-10 06:35:52 PM
Jokes on you, staph! I don't bathe!


www.sevendaysvt.com
"Let me tell you a true story about immunization ok. When I was a little boy in New York city in the nineteen-forties, we swam in the Hudson river. And it was filled with raw sewage! OK? We swam in raw sewage, you know, to cool off. And at that time the big fear was polio. Thousands of kids died from polio every year. But you know something? In my neighborhood no one ever got polio. No one! EVER! You know why? Cause WE SWAM IN RAW SEWAGE! It strengthened our immune system, the polio never had a prayer. We were tempered in raw shiat!"
 
2014-04-10 06:51:13 PM
Phage > antibiotics

and neither one belongs in hand soap
 
2014-04-10 06:53:19 PM
The article itself actually makes some much less sweeping statement:

http://mbio.asm.org/content/5/2/e01015-13.full.pdf+html

In people:  there was a moderate correlation between  concentrations of triclosan (the antibacterial agent) in the nose and whether there was carriage of Staph aureus.  They got this to be significant by picking a partiuclar cutoff concentration -- 175 nanomolar -- without explaining why.

In rats:  After forcefeeding them an enormous amount of triclosan in corn oil [!] through their noses, then injecting Staph aureus in their noses, the mice who got triclosan+oil were more susceptible to a small amount of Staph aureus colonizing, when compared to the mice who got oil without triclosan.

In Petri dishes:  promotes aherence of Staph aureus to various surfaces and connective tissue proteins.

This is all about adherence and colonization.  This is the first step towards getting sick with Staph aureus, but by no means the whole pathway.

Hand hygiene is still key.  The washing probably much more important than the antibacterial agent that goes along with it.

Remember, this is not the stuff in Purell or other antimcrobial hand foams or gels.  That is alcohol, and that works.  It's probably more important to get the stuff off of our hands than out of our noses.

That being said, not sure that we need triclosan as an additive for hand hygiene.  It's been somewhat controversial for lots of reasons like this.
 
2014-04-10 06:54:37 PM
I don't really get antibacterial soap. Don't soaps already destroy cell walls and membranes of bacteria because the polarity of their medium changes?
 
2014-04-10 06:56:06 PM
That's why I rub my hands down with feces after I use anti microbial soap.
 
2014-04-10 06:56:24 PM

AlgaeRancher: Phage > antibiotics


How very Arrowsmith of you.  Old idea is old.

Once we've designed the perfect phage to kill a particular bacterium, great.  Then it has to kill the bacterium better and faster than traditional antibiotics to be deemed superior, and if you have pneumococcal pneumonia, you really want good old penicillin.  (Yeah, ceftriaxone, ampicillin/sulbactam, levofloxacin, whatever.)

There's plenty of money to be made doing it, but phage are expensive to tweak, test, and produce.
 
2014-04-10 06:59:36 PM

Phaeon: I don't really get antibacterial soap. Don't soaps already destroy cell walls and membranes of bacteria because the polarity of their medium changes?


Not perfectly.  The detergent should solubilize the cell membranes, but some are surprisingly hardy, or even form spores.  (C. difficile is a good example.)  People do a crappy job of washing their hands, anyway.

Check out this (out-of-date) slide set form the CDC.
http://www.cdc.gov/handhygiene/download/hand_hygiene_core.pdf

Alcohol based handrubs still overall superior.
 
2014-04-10 07:06:18 PM
I take this to mean I should start snorting hand sanitizer to kill the staph in my nose.
 
2014-04-10 07:09:10 PM
Thy rot and thy staff they come for me
 
2014-04-10 07:09:26 PM

AlgaeRancher: Phage > antibiotics

and neither one belongs in hand soap


Is money the reason why phages aren't used in the USA? I figure the smallest scalpel is the best one for getting into those bacterial nooks and crannies.
 
2014-04-10 07:17:25 PM
Just drink more. When you're good and pickled, bacteria can't getcha.
 
2014-04-10 07:20:20 PM
Is money the reason why phages aren't used in the USA? I figure the smallest scalpel is the best one for getting into those bacterial nooks and crannies.

I have heard our medical system really does not have a way to regulate a living medical treatment like phage. It could be done, maybe treat them like vaccines.

However there has not been much push to do it in the US and yes the money is on antibiotics which are very profitable. They just don't work very well anymore.

So if you are dying of MSRA take comfort in the fact that the our medical system is keeping effective and relatively safe treatments away from you because approving them requires thinking and work.
 
2014-04-10 07:29:35 PM

lake_huron: Phaeon: I don't really get antibacterial soap. Don't soaps already destroy cell walls and membranes of bacteria because the polarity of their medium changes?

Not perfectly.  The detergent should solubilize the cell membranes, but some are surprisingly hardy, or even form spores.  (C. difficile is a good example.)  People do a crappy job of washing their hands, anyway.

Check out this (out-of-date) slide set form the CDC.
http://www.cdc.gov/handhygiene/download/hand_hygiene_core.pdf

Alcohol based handrubs still overall superior.


Is ethyl alcohol as effective as isopropyl alcohol, I noticed the data in the slides was for isopropanol
 
2014-04-10 07:34:00 PM
To dream the impossible dream! To reach that unreachable star! 41 AII-One, All-One we are! To fight that unbeatable foe! To go where the brave dare not go! To right the unrightable wrong! To love pure, chaste, from afar! To try when your arms are too weary! 'Til All- One, AII4ne we are! For this is my goal! To reach that unreachable star. No matter how hopeless, no matter how far! To fight for the right without question or pause, to be willing to march into hell for a heavenly cause! For I know that if I follow this glorious quest, my heart will lie peaceful & calm when I'm laid to my rest! And I know that the world will be better for this, that one man, tortured, blinded, covered with scars, still strove with his last ounce of courage, to reach that unreachable star 'til united All-one, All-one we are!
 
2014-04-10 07:34:29 PM
I can't understand the obsession with anti-bacterial soap.  The main thing that soap does is get the stuff OFF your body so it is rinsed down the drain.  Who cares if it's alive or dead when it's going through the sewer?  As long as it's not on your hands, mission accomplished, right?
 
2014-04-10 07:36:39 PM

cefm: I can't understand the obsession with anti-bacterial soap.  The main thing that soap does is get the stuff OFF your body so it is rinsed down the drain.  Who cares if it's alive or dead when it's going through the sewer?  As long as it's not on your hands, mission accomplished, right?


People usually don't wash their hands well enough to achieve the intended goal.
 
2014-04-10 07:39:17 PM
I don't use antimicrobial soap, I just piss on my hands.
 
2014-04-10 07:53:22 PM

AbiNormal: I don't use antimicrobial soap, I just piss on my hands.


Well, as long as you don't have a UTI...
 
2014-04-10 08:17:33 PM
That's alright, I went off of soap years ago when I found out bathing in menstrual blood would make me irresistible to women.
 
2014-04-10 08:36:21 PM

Phaeon: I don't really get antibacterial soap. Don't soaps already destroy cell walls and membranes of bacteria because the polarity of their medium changes?


I'm not sure why it's so hard to find nonantibacterial soap at the grocery store now. At least for hand soap.
 
2014-04-10 08:47:45 PM

lake_huron: Phaeon: I don't really get antibacterial soap. Don't soaps already destroy cell walls and membranes of bacteria because the polarity of their medium changes?

Not perfectly.  The detergent should solubilize the cell membranes, but some are surprisingly hardy, or even form spores.  (C. difficile is a good example.)  People do a crappy job of washing their hands, anyway.


Hand soap's primary sterilizing effect isn't direct sterilization, it's that it's  soap.  It doesn't matter whether the bacteria it comes into contact with die or not, because unless you suck terribly at washing your hands both the bacteria themselves and the substrate they're reproducing in are  removed from your hands when you wash.

Putting antibacterial (in the sense of reproduction-inhibiting, alcohol is fine) stuff in soap is sort of like tying some spears to your nuclear missile.  Sure, technically spears can hurt people too but it doesn't really matter if you're nuking the site from orbit.
 
2014-04-10 09:44:00 PM

sprawl15: To dream the impossible dream! To reach that unreachable star! 41 AII-One, All-One we are! To fight that unbeatable foe! To go where the brave dare not go! To right the unrightable wrong! To love pure, chaste, from afar! To try when your arms are too weary! 'Til All- One, AII4ne we are! For this is my goal! To reach that unreachable star. No matter how hopeless, no matter how far! To fight for the right without question or pause, to be willing to march into hell for a heavenly cause! For I know that if I follow this glorious quest, my heart will lie peaceful & calm when I'm laid to my rest! And I know that the world will be better for this, that one man, tortured, blinded, covered with scars, still strove with his last ounce of courage, to reach that unreachable star 'til united All-one, All-one we are!


Hello Dr. Bronner, I thought you were dead.
 
2014-04-10 10:08:02 PM
This is why I wash my hands with molten steel. Bastards don't stand a chance.
 
2014-04-10 10:58:36 PM

lake_huron: The article itself actually makes some much less sweeping statement:

http://mbio.asm.org/content/5/2/e01015-13.full.pdf+html

In people:  there was a moderate correlation between  concentrations of triclosan (the antibacterial agent) in the nose and whether there was carriage of Staph aureus.  They got this to be significant by picking a partiuclar cutoff concentration -- 175 nanomolar -- without explaining why.

In rats:  After forcefeeding them an enormous amount of triclosan in corn oil [!] through their noses, then injecting Staph aureus in their noses, the mice who got triclosan+oil were more susceptible to a small amount of Staph aureus colonizing, when compared to the mice who got oil without triclosan.

In Petri dishes:  promotes aherence of Staph aureus to various surfaces and connective tissue proteins.

This is all about adherence and colonization.  This is the first step towards getting sick with Staph aureus, but by no means the whole pathway.

Hand hygiene is still key.  The washing probably much more important than the antibacterial agent that goes along with it.

Remember, this is not the stuff in Purell or other antimcrobial hand foams or gels.  That is alcohol, and that works.  It's probably more important to get the stuff off of our hands than out of our noses.

That being said, not sure that we need triclosan as an additive for hand hygiene.  It's been somewhat controversial for lots of reasons like this.


Wouldn't it also be true that, by wiping out other bacteria that are less capable of resistance, we are more likely to have the specific species (that is capable of developing resistance) they chose to test for?  We're reducing the biodiversity of the region, and providing a more competition-free growing space for S. aureus.  We may have the same bacterial load, but more S. aureus.
 
2014-04-11 12:09:57 AM

Jim_Callahan: Hand soap's primary sterilizing effect isn't direct sterilization, it's that it's  soap.  It doesn't matter whether the bacteria it comes into contact with die or not, because unless you suck terribly at washing your hands both the bacteria themselves and the substrate they're reproducing in are  removed from your hands when you wash.


It is amazing how much of it isn't soap at all.  Some of them have none of those nice ionic forced need to work like soap.
 
2014-04-11 06:16:54 AM

DON.MAC: It is amazing how much of it isn't soap at all.  Some of them have none of those nice ionic forced need to work like soap.


There are a lot of hand-washes that aren't technically soap as such, but the mechanism is the same, just using a different surfactant chemistry (usually one that'll less aggressively exfoliate/dry out your skin, since dehyration/chemical cracking from full-strength regular soap, especially lye soap, can actually be a source of new infection).  You don't actually have to be literally a fatty acid salt to promote the dissolution of accumulated nonpolar chemicals and the removal of particulate matter, plenty of full synthetics work just fine-- the stuff used by dove and zest and so on does the same stuff.

There's a balancing of different factors in wash chemistry, but the underlying mechanism's always the same-- remove the oil that's essentially a food-slurry for bacteria and then replace it with something else without the contaminants in it so your body doesn't have to overdrive on the oil production to replace it immediately.  The most blatant example of step 2 being conditioner - shampoo is soap, it removes the oil from your hair that prevents it from fracturing (and also accumulates to hold bacteria and just kinda look disgusting), the conditioner basically adds less-disgusting oil back in to do what the original nasty oil was doing before it got washed out.

Disinfectants are a different deal, they rely on continual contact and staying in place to actually kill off the whatever.  This is the main reason that adding them to soap is kind of stupid-- soap's whole deal is to carry everything you scrub with the soap-water mix away with the water.  Since that  includes the disinfectant, all you're accomplishing is to dump disinfectant down the sink, since it's not staying on your hands in overwhelming quantity it's not actually doing anything for you.  It's releasing a bunch of insufficient-dose triclosan into the environment (exactly how you  intentionally create resistant strains in the lab) without actually benefitting the user at all.  Which is why it kinda frustrates us scientists, and probably the doctors too.
 
2014-04-11 07:24:16 AM

Jim_Callahan: DON.MAC:

 Which is why it kinda frustrates us scientists, and probably the doctors too

Oh, its past the point of frustration.  I am a scientist, but it should piss off anyone who is able to think for a minute beyond: "whats better than soap... hmm, I know, lets add ANTIBIOTICS to soap because why not?"  Its the same reasoning as people who mix bleach and ammonia together for super cleaner, only that reaction at least has a culling effect on the idiocy.

/well, overuse of antibiotics have a culling effect too, but its much less immediate.  We are definitely getting there though...
 
2014-04-11 08:41:33 AM

Jim_Callahan: lake_huron: Phaeon: I don't really get antibacterial soap. Don't soaps already destroy cell walls and membranes of bacteria because the polarity of their medium changes?

Not perfectly.  The detergent should solubilize the cell membranes, but some are surprisingly hardy, or even form spores.  (C. difficile is a good example.)  People do a crappy job of washing their hands, anyway.

Hand soap's primary sterilizing effect isn't direct sterilization, it's that it's  soap.  It doesn't matter whether the bacteria it comes into contact with die or not, because unless you suck terribly at washing your hands both the bacteria themselves and the substrate they're reproducing in are  removed from your hands when you wash.

Putting antibacterial (in the sense of reproduction-inhibiting, alcohol is fine) stuff in soap is sort of like tying some spears to your nuclear missile.  Sure, technically spears can hurt people too but it doesn't really matter if you're nuking the site from orbit.


That is not actually true.  Antibacterial soap is better at decreasing bacterial loads on hands than soap without the same antibacterial agents.  Again, this is an immediate short-term effect, and this study is looking at onger-term ecologic effects.

Slide 12 in this slide set summarizes one study
http://www.cdc.gov/handhygiene/download/hand_hygiene_core.pdf 

The particular agent in this slide is chlorhexidine, which is probably the best topical antiseptic we have now that is safe on human skin.  Also, it does not generate the same controversial data that triclosan has.
 
2014-04-11 09:04:26 AM
Here's a 2009 publication from Townsend, Daltrey, Entwistle, and Moon on hand hygiene.  When you go to page 31, they review the data on handwashing with different preparations, and effects on bacterial load.  Plain handwashing not so hot, better with various additives.

One of the points is that leftover antibacterial compounds on the skin may have a persistent effect, continuing the kill bugs even after the handwashing is done.

http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf

Triclosan is discussed on p 36, and has more space devoted to it because of resistance concerns.  My personal favorite remains chlorhexidine.

Sorry, all.  Adding antimicrobial agents to soaps does improve bug-killing.

/Why yes, I used to be the Medical Director of Infection Control at a small academic medical center, why do you ask?
 
2014-04-11 07:37:32 PM
Oh, it's 2014 and we need a new scare article about the danger of ani-bacterial soap.

If it kills C. Diff, Norovirus, E. Coli and Salmonella, I don't care about the rest.  Knock out the big stuff, and we are friends.

Oh, BTW, it actually takes real soap and hot water to remove the real threats that I listed.  15-20 seconds of handwashing.  Sing "Happy Birthday" twice and you are good.
 
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