Cotton textiles modified with citric acid as efficient anti-bacterial agent for prevention of nosocomial infections

AIM: 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. METHOD: 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 the 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 log(10) treated by conventional drying and 6.46 log(10) treated by microwave drying before washing, and 6.90 log(10) and 7.86 log(10), respectively, after 1 cycle of home domestic laundering washing [HDLW]). Antibacterial activity was also remarkable against S. aureus (4.25 log(10) by conventional drying, 4.58 log(10) by microwave drying) and against P. aeruginosa (1.93 log(10) by conventional and 4.66 log(10) by microwave drying). Antibacterial activity against P. aeruginosa was higher in samples subjected to microwave drying/curing than in those subjected to conventional drying/curing. As expected, 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. CONCLUSION: 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.