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Howard Thomas Citroxx All plants have some form of defense mechanism against damage or injury Smell Colour Taste Seville Orange What is Citroxx? Citroxx is a patented combination of small & large flavonoids molecules with known anti-microbial / viral activity: Neohesperidin Narangin Poncirin Rhiofolen Enhanced activity by addition of natural fruit acids: Malic Citric Ascorbate Approvals Citroxx has been developed over a number of years and has been approved by the British Government’s MAFF (now DEFRA) to control the onset of various diseases such as:Newcastle’s Disease found in chickens Foot and Mouth Disease Tuberculosis Swine Fever Approvals Citroxx is also approved by the Department of Health (HPA) for use as a disinfectant. Citroxx is also approved to decontaminate fresh produce for Britain’s leading supermarkets. Conforms to EU Organic Farming Regulations for the treatment of fresh produce. Effectiveness Citroxx has been independently tested and found to be effective (i.e. killing pathogens with an efficiency rate of 5 logs-up to 99.999*%) The list of organisms against which Citroxx has been tested and found to be effective is long: Bacteria Alternaria spp Aspergillus flavus Aspergillus niger Aspergillus oizae Aspergillus terrus Campylobacter jejuni Candida albicans Chaetomium golbosum Dipiodia natalensis Escherichia coli F. sp. tuberosa Fusarium sambucinum Geotrichum candidium Klebsiella pneumonia Lactobacillus pentoaceticus Legionella pneumophila (NCTC11192) Effectiveness Listeria monocytogenes MRSA (clinical strain) Mycobacterium fortutium (NCTC 8573 for indication of tuberculocidal activity) Penicillium digitatum Penicillium funiculosum Penicillium italicum Penicillium roqueforti Penicillium sp. Phomopsis ortl Proteus vulgaris Pseudomonas aeruginosa (ATCC 15442) Pullularia pullulans Salmonella chloreraesuis Salmonella typhimurium (DT004) Scerotinia laxa Staphylococcus aureus (NCTC 6571) Staphylococcus pyogenes Staphylococcus sp. Sterptococcus faecalis Trichophyton iterdigitale Effectiveness Viruses H5N1 (Avian Influenza A) Human Rhinovirus Influenza A Human Immunodeficiency Virus (HIV) Urbani SARS African swine fever Foot & mouth disease Gumboro virus Herpes virus type 1 Herpes virus type 2 Herpes zoster Hepatitis A & B Effectiveness Yeast and Fungi Aspergillus flavus Aspergillus niger Aspergillus terreus Botrytis cinerea Candida albicans Candida glabrata Chaetonium globosum Cladosporium Collectotricum sp. Fusarium sp. Mucor sp. Penicillium sp. Pullularia pullulans Pythium sp. Trichophyton interdigitale Trichophyton mentagrophytes Protozoa Histomonas meleagradis Giardia lamblia Entamoeaba histolytica Blastocystis hominis Broth Micro Dilution MIC values for each micro organism in the presence of Citrox BC30. BC30 A odontolyticus 1.000 A viscosus C albicans 0.800 C glabrata C krusei 0.600 C parapsilosis C tropicalis 0.400 C difficile P gingivalis 0.200 P buccae P intermedia 0.000 0 0. 00 7 0. 01 5 0. 03 1 0. 06 2 0. 12 5 0. 25 0 0. 50 0 1. 00 0 2. 00 0 4. 00 0 8. 00 0 Absorbance (Turbidity) 1.200 % Citrox (v/v) S gordonii S sanguinis Broth Micro Dilution Candida albicans 1.200 Absorbance 1.000 0.800 BC30 MDC30 0.600 0.400 0.200 0.000 0 0.007 0.015 0.031 0.062 0.125 0.250 0.500 1.000 2.000 4.000 8.000 % Citrox (v/v) Broth Micro Dilution Candida glabrata 1.200 Absorbance 1.000 0.800 BC30 0.600 MDC30 0.400 0.200 0.000 0 0.007 0.015 0.031 0.062 0.125 0.250 0.500 1.000 2.000 4.000 8.000 % Citrox Broth Micro Dilution Candida krusei 0.900 Absorbance 0.800 0.700 0.600 0.500 BC30 MDC30 0.400 0.300 0.200 0.100 0.000 0 0.007 0.015 0.031 0.062 0.125 0.250 0.500 1.000 2.000 4.000 8.000 % Citrox (v/v) Broth Micro Dilution Candida parapsilosis 1.200 Absorbance 1.000 0.800 BC30 MDC30 0.600 0.400 0.200 0.000 0 0.007 0.015 0.031 0.062 0.125 0.250 0.500 1.000 2.000 4.000 8.000 % Citrox (v/v) Broth Micro Dilution Candida tropicalis 1.000 0.900 Absorbance 0.800 0.700 0.600 BC30 0.500 MDC30 0.400 0.300 0.200 0.100 0.000 0 0.007 0.015 0.031 0.062 0.125 0.250 0.500 1.000 2.000 4.000 8.000 % Citrox (v/v) Broth Micro Dilution Porphyromonas gingivalis 0.700 Absorbance 0.600 0.500 0.400 BC30 MDC30 0.300 0.200 0.100 0.000 0 0.007 0.015 0.031 0.062 0.125 0.250 0.500 1.000 2.000 4.000 8.000 % Citrox (v/v) Broth Micro Dilution Clostridium difficile 0.800 0.700 Absorbance 0.600 0.500 BC30 MDC30 0.400 0.300 0.200 0.100 0.000 0 0.007 0.015 0.031 0.062 0.125 0.250 0.500 1.000 2.000 4.000 8.000 % Citrox (v/v) Biofilm Assay Biofilm assay - BC30 2.00 Actinomyces odontolyticus Actinomyces viscosus 1.50 Candida albicans Candida glabrata 1.00 Candida krusei Candida parapsilosis Candida tropicalis 0.50 Clostridium difficile Porphyromonas gingivalis 0.00 Prevotella buccae 0. 00 0% 0. 00 7% 0. 01 5% 0. 03 2% 0. 06 2% 0. 12 5% 0. 25 0% 0. 50 0% 1. 00 0% 2. 00 0% 4. 00 0% 8. 00 0% Relative growth Candida dubliniensis -0.50 Citrox BC30 concentration (v/v) Prevotella intermedia Streptococcus gordonii Streptococcus sanguinis Biofilm Assay Porphyromonas gingivalis 2.50 1.50 1.00 0.50 Citrox BC30 concentration (v/v) 8. 00 0% 4. 00 0% 2. 00 0% 1. 00 0% 0. 50 0% 0. 25 0% 0. 12 5% 0. 06 2% 0. 03 2% 0. 01 5% -0.50 0. 00 7% 0.00 0. 00 0% Relative growth 2.00 Biofilm Assay Clostridium difficile 1.20 Relative growth 1.00 0.80 0.60 0.40 0.20 0.00 % -0.20 00 0 0. -0.40 7 % 15 % 32 % 62 % 25 % 50 % 00 % 00 % 00 % 00 % 00 % 0 0 0 0 0 1 2 5 0 0 0 0 0. 0. 0. 0. 0. 0. 0. 1. 2. 4. 8. Citrox BC30 concentration (v/v) Biofilm Assay Citrox BC30 concentration (v/v) 8. 00 0% 4. 00 0% 2. 00 0% 1. 00 0% 0. 50 0% 0. 25 0% 0. 12 5% 0. 06 2% 0. 03 2% 0. 01 5% 0. 00 7% 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 -0.10 -0.20 0. 00 0% Relative growth Candida glabrata Biofilm Assay Candida parapsilosis 1.20 0.80 0.60 0.40 0.20 -0.40 Citrox BC30 concentration (v/v) 8. 00 0% 4. 00 0% 2. 00 0% 1. 00 0% 0. 50 0% 0. 25 0% 0. 12 5% 0. 06 2% 0. 03 2% 0. 01 5% -0.20 0. 00 7% 0.00 0. 00 0% Relative growth 1.00 Biofilm Assay Candida tropicalis 1.40 1.00 0.80 0.60 0.40 0.20 Citrox BC30 concentration (v/v) 8. 00 0% 4. 00 0% 2. 00 0% 1. 00 0% 0. 50 0% 0. 25 0% 0. 12 5% 0. 06 2% 0. 03 2% -0.40 0. 01 5% -0.20 0. 00 7% 0.00 0. 00 0% Relative growth 1.20 Biofilm Assay Candida krusei 1.40 1.00 0.80 0.60 0.40 0.20 Citrox BC30 concentration (v/v) 8. 00 0% 4. 00 0% 2. 00 0% 1. 00 0% 0. 50 0% 0. 25 0% 0. 12 5% 0. 06 2% 0. 03 2% 0. 01 5% 0. 00 7% 0.00 0. 00 0% Relative growth 1.20 Use of Citrox as an antimicrobial agent Elaine Waters UCD School of Biomolecular and Biomedical Science Staphylococcus aureus Gram+ cocci with many virulence factors (including biofilm formation) Important hospital pathogen Drug resistant Citrox is an effective antimicrobial agent against S. aureus Very low MIC 0.008% (tested 15 S. aureus clinical isolates) Effect of Citrox on biofilms 1. 2. 3. 4. 5. 6. Sub-inhibitory concentrations of Citrox does not inhibit biofilm production 0.25% Citrox solution kills biofilm cells in <10 mins Control Tetracycline (200µg/ml) Citrox (0.1%) Citrox (0.25%) Citrox (0.5%) Citrox (1%) 1 2 3 4 56 Biofilm susceptibility assay (Alamar blue) • Pink-metabolically active • Blue – metabolically inactive Future Work: Effect of Citrox on mature biofilms – Examine against more clinical strains and compare to other classes of antimicrobial drug (b-lactams, nucleic acid synthesis inhibitors) Clostridium difficile Anaerobic, spore forming bacteria Healthcare associated infection (ethanol doesn’t inhibit spores) High mortality rate Collaborating with Prof. Séamus Fanning and Dr. Katie Solomon to examine the effect of Citrox on C. diff spores Use of Citrox to decontaminate a room using the nebulair system Prevent infections spreading Disperses citrox as a 'dry' mist to “fog” the room Area bacteria are found in a hospital room Citrox is effective at cleaning a microbial contaminated room using the Nebulair Use of Nebulair in Beaumont Hospital In collaboration with Prof. Hilary Humphreys and Dr Anthony Dolan Use of Citrox/nebulair remove known concentrations of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin resistant Enterococcus faecalis (VRE) from mattress cover Compare with fogging a room with Hydrogen Peroxide Use of Nebulair in Beaumont Hospital 105 colony forming units (CFU) per 100cm2 killed in 3 hours using a 5% Citrox solution Impressed with the size and convenience of Nebulair Future work with the Nebulair Continue experiments with the Nebulair – test on different surfaces with a known number of bacteria – MRSA, VRE and C. diff spores (in collaboration with Dr. Katie Soloman) Using Citrox to coat surfaces In collaboration with Dr Denis Dowling and Dr Maria Katsikogianni (UCD Engineering surface group) -currently looking at coating food packaging surfaces (PET Film) -In the future hopefully use the technology to coat medical devices Lab line system Try to increase Citrox attachment to surface Establish how long Citrox will be still active on the attached surface pre-treating film with He/O2 Non pre-treated 100 passes He/O2 pre-treated 100 passes Citrox remaining attached after 1 hour in water Optical Microscope Citrox coating is more active against S. aureus after 21 days on He/02 pre-treated film than untreated film 6000 5000 4000 Pre-treated film (plantonic cells) 3000 Untreated film (plantonic cells) Pre-treated film (Attached cells) 2000 Untreated film (Attached cells) 1000 0 Control 50 Passes 100 Passes 150 Passes Future Work: Continue work with PET Film – currently examining S. aureus, Salmonella and E. coli over a 35 day period Future work: EnBIO Use Co-blast system Potential coat Hip replacements/titanium surfaces with citrox to prevent infection Acknowledgments Dr Jim O’Gara Sarah Rowe Brian Conlon Sarajane McTiernan Shunyao Yang Patrick Houston Dr Linda Holland Dr Clarissa Pozzi Collaborators: Dr Denis Dowling Dr Maria Katsikogianni Dr Katie Soloman Liam Mannion Citrox Dr Howard Thomas Funding: Irish Research Council for Science Engineering and Technology (IRCSET) Citrox Thank You Howard Thomas