title: Cotton textiles modified with citric acid as efficient anti-bacterial agent for prevention of nosocomial infections.
abstract: OBJECTIVE
  To study the antimicrobial activity of citric acid (CA) and sodium hypophosphite monohydrate (SHP) against gram-positive and gram-negative bacteria, and to determine the influence of conventional and microwave thermal treatments, on the effectiveness of antimicrobial treatment of cotton textiles.
  
  
  METHODS
  Textile material was impregnated with CA and SHP solution and thermally treated by either conventional or microwave drying/curing treatment. Antibacterial effectiveness was tested according to ISO 20743:2009 standard, using absorption method. The surfaces were morphologically observed by scanning electron microscopy, while physical characteristics were determined by wrinkle recovery angles method (DIN 53 891), tensile strength (DIN 53 837), and whiteness degree method (AATCC 110-2000).
  
  
  RESULTS
  Cotton fabric treated with CA and SHP showed significant antibacterial activity against MRSA (6.38 log10 treated by conventional drying and 6.46 log10 treated by microwave drying before washing, and 6.90 log10 and 7.86 log10, respectively, after 1 cycle of home domestic laundering washing [HDLW]). Antibacterial activity was also remarkable against S. aureus (4.25 log10 by conventional drying, 4.58 log10 by microwave drying) and against P. aeruginosa (1.93 log10 by conventional drying and 4.66 log10 by microwave drying). Antibacterial activity against P. aeruginosa was higher in samples subjected to microwave than in conventional drying. Antibacterial activity was reduced after 10 HDLW cycles but the compound was still effective. The surface of the untreated cotton polymer was smooth, while minor erosion stripes appeared on the surfaces treated with antimicrobial agent, and long and deep stripes were found on the surface of the washed sample.
  
  
  CONCLUSIONS
  CA can be used both for the disposable (non-durable) materials (gowns, masks, and cuffs for blood pressure measurement) and the materials that require durability to laundering. The current protocols and initiatives in infection control could be improved by the use of antimicrobial agents applied on cotton carbohydrate polymer.
authors.affiliation: Faculty of Textile Technology, University of Zagreb, Zagreb, Croatia. sbischof@ttf.hr
authors.forename: Sandra
authors.initials: S
authors.lastname: Bischof Vukušić
authors.forename: Sandra
authors.initials: S
authors.lastname: Flinčec Grgac
authors.forename: Ana
authors.initials: A
authors.lastname: Budimir
authors.forename: Smilja
authors.initials: S
authors.lastname: Kalenić
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002241:Carbohydrates / Q000494:pharmacology; D019343:Citric Acid / Q000494:pharmacology / Q000627:therapeutic use; D032561:Cotton Fiber; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D004337:Drug Carriers / Q000494:pharmacology; D016503:Drug Delivery Systems; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006801:Humans; D017053:Infection Control / Q000379:methods; D008422:Materials Testing; D019999:Pharmaceutical Solutions / Q000494:pharmacology / Q000627:therapeutic use; D010721:Phosphinic Acids / Q000494:pharmacology / Q000627:therapeutic use; D011108:Polymers / Q000494:pharmacology; D013678:Technology, Pharmaceutical / Q000379:methods; D013784:Textiles / Q000032:analysis / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002241:Carbohydrates; D004337:Drug Carriers; D019999:Pharmaceutical Solutions; D010721:Phosphinic Acids; D011108:Polymers; D019343:Citric Acid; C009287:sodium hypophosphite