. Ecotoxicol Environ Saf. 2013 Apr;90:98-102. doi: 10.1016/j.ecoenv.2012.12.017. Epub 2013 Jan 18.
Nakano T 1 , Hirose J , Kobayashi T , Hiro N , Kondo F , Tamai H , Tanaka K , Sano K .
Author information:
 1 Project Team for Medical Application of Electrolysis (Nakano Project), Central Research Center,
Osaka Medical College, Takatsuki-shi, Osaka, Japan. tnakano@art.osaka-med.ac.jp
Abstract
Contamination of surface water by antibacterial pharmaceuticals (antibacterials) from clinical settings may affect aquatic organisms, plants growth, and environmental floral bacteria. One of the methods to decrease the contamination is inactivation of antibacterials before being discharged to the sewage system. Recently, we reported the novel method based on electrolysis for detoxifying wastewater containing antineoplastics. In the present study, to clarify whether the electrolysis method is applicable to the inactivation of antibacterials, we electrolyzed solutions of 10 groups of individual antibacterials including amikacin sulfate (AMK) and a mixture (MIX) of some commercial antibacterials commonly prescribed at hospitals, and measured their antibacterial activities. AMK was inactivated in its antibacterial activities and its concentration decreased by electrolysis in a timedependent manner. Eighty to ninety-nine percent of almost all antibacterials and MIX were inactivated within 6h of electrolysis. Additionally, cytotoxicity was not detected in any of the electrolyzed solutions of antibacterials and MIX by the Molt-4-based cytotoxicity test.
Copyright © 2012 Elsevier Inc. All rights reserved.
PMID: 23337489 [PubMed - indexed for MEDLINE]
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2. Med Mol Morphol. 2012 Dec;45(4):199-205. doi: 10.1007/s00795-011-0560-5. Epub 2012 Dec 7.
Yamamoto TM 1 , Nakano T , Yamaguchi M , Shimizu M , Wu H , Aoki H , Ota R , Kobayashi T , Sano K .
Author information:


1 Department of Microbiology and Infection Control, Osaka Medical College, 2-7 Daigaku-Machi,
Takatsuki, Osaka 569-8686, Japan.
Abstract
Electrolyzed acid water (EAW) has been studied for its disinfective potential against pathogenic microbes; however, the bactericidal process against Mycobacteria has not been clearly presented.
In this study, to clarify the disinfective process against Mycobacteria, EAW-treated bacteria were examined against laboratory strains of Mycobacterium bovis (M. bovis), Mycobacterium smegmatis
(M. smegmatis), and Mycobacterium terrae (M. terrae) by recovery culture and observation of morphology, enzymatic assay, and the detection of DNA. All experiments were performed with the use of EAW containing 30 ppm free chlorine that kills Mycobacteria, including three pathogenic clinical isolates of Mycobacterium tuberculosis (M. tuberculosis) and six isolates of other
Mycobacteria, within 5 min. In morphology, the bacterial surface became rough, and a longitudinal concavity-like structure appeared. The intrabacterial enzyme of EAW-contacted bacteria was inactivated, but chromosomal DNA was not totally denatured. These results suggest that the bactericidal effect of EAW against Mycobacteria occurs by degradation of the cell wall, followed by denaturation of cytoplasmic proteins, but degeneration of the nucleic acid is not always necessary.
PMID: 23224598 [PubMed - indexed for MEDLINE]
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3. PLoS One. 2012;7(9):e46392. doi: 10.1371/journal.pone.0046392. Epub 2012 Sep 28.
Mokudai T 1 , Nakamura K , Kanno T , Niwano Y .
Author information:

1 Tohoku University Graduate School of Dentistry, Sendai, Japan.
Abstract
Acid electrolyzed water (AEW), which is produced through the electrolysis of dilute sodium chloride
(NaCl) or potassium chloride solution, is used as a disinfectant in various fields because of its potent antimicrobial activity. The hydroxyl radical, an oxygen radical species, is often suggested as a putative active ingredient for AEW antimicrobial activity.
The aim of the present study is to detect hydroxyl radicals in AEW. The hydroxyl radicals in AEW prepared under different conditions were determined using an electron spin resonance (ESR) technique. A signal from 5,5-dimethyl-1-pyrroline N-oxide (DMPO)-OH, an adduct of DMPO and the hydroxyl radical, was detected in AEW prepared by double or triple electrolyses of 1% NaCl but not

of 0.1% NaCl solution. Then the presence of hydrogen peroxide as a proposed source of hydroxyl radicals was examined using a combination of ESR and a Fenton reaction. The DMPO-OH signal was clearly detected, even in AEW prepared by single electrolysis of 0.1% NaCl solution, when ferrous sulfate was added to induce a Fenton reaction, indicating the presence of hydrogen peroxide in the AEW. Since sodium formate, a hydroxyl radical scavenger, did not affect the bactericidal activity of AEW, it is concluded that the radical is unlikely to contribute to the antimicrobial activity of
AEW, although a small amount of the radical is produced from hydrogen peroxide. Dimethyl sulfoxide, the other hydroxyl radical scavenger used in the present study, canceled the bactericidal activity of AEW, accompanied by complete depletion of free available chlorine, suggesting that hypochlorous acid is probably a major contributor to the antimicrobial activity.
It is strongly suggested that although hydrogen peroxide is present in AEW as a source of hydroxyl radicals, the antimicrobial activity of AEW does not depend on these radicals.
PMCID: PMC3460889 Free PMC Article
PMID: 23029505 [PubMed - indexed for MEDLINE]
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4. Dent Mater J. 2012;31(4):662-8.
Ozaki M 1 , Ohshima T , Mukumoto M , Konishi H , Hirashita A , Maeda N , Nakamura Y .
Author information:

1 Department of Orthodontics, School of Dental Medicine, Tsurumi University, Tsurumiku,
Yokohama, Japan. cooldev-fd@m2.gyao.ne.jp
Abstract
The purpose of this study was to examine the biofilm removing and antimicrobial effects of microbubbled tap water and other functional water. The biofilm removal test showed that the activity of microbubbled tap water against the biofilm of Candida albicans and Streptococcus mutans was significantly higher than that of ordinary tap water (p<0.01). When the antimicrobial activities of two types of functional water were compared, the activity of electrolyzed hypochlorite water was significantly stronger than that of the ozonated water (p<0.01). The antimicrobial effect of the

electrolyzed hypochlorite water was increased in the microbubbled form, and was stronger than microbubbled tap water. The same results were obtained not only for biofilms, but also for planktonic microbes. Our results demonstrated that the microbubbled water showed strong biofilm removing effects. Moreover, the application of functional water, such as electrolyzed hypochlorite microbubbled water was effective for both removing and sterilizing biofilms.
Free Article
PMID: 22864222 [PubMed - indexed for MEDLINE]
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5. J Trauma Acute Care Surg. 2012 Jun;72(6):1584-7. doi: 10.1097/TA.0b013e318243a1dc.
Ge L 1 , Zhang X , Cao C , Gu Z , Liu Z , Liu L , Lin B .
Author information:

1 Chongqing Academy of Animal Sciences, Chongqing, China.
geliangpeng1982@163.com
Abstract
Neutral electrolyzed water (NEW) is considered to be a high-level biodegradable disinfectant with sporicidal, bactericidal, and virucidal activity. It has also been reported to accelerate wound healing; thus, it is particularly attractive for the elimination or minimization of the microbial population of skin grafts to be used as wound dressings.
Pigskins were sterilized with different concentrations of NEW and with different methods. The feasibility of pigskin sterilization by NEW was evaluated through microbiological analyses, viability assays, histologic assessments, contact cytotoxicity assays, and extract cytotoxicity assays.
NEW has strong bactericidal effects on pigskin microorganisms, does not change skin graft histologic properties, and has no cytotoxicity; however, skin viability was significantly reduced after
NEW treatment.
Although NEW treatment is a very safe and effective method for nonviable pigskin dressing sterilization, to obtain a complete sterilization of pigskin grafts, available chlorine concentration of

NEW as well as sterilization time and methods should be optimized.
Copyright © 2012 by Lippincott Williams & Wilkins.
PMID: 22695426 [PubMed - indexed for MEDLINE]
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6. J Food Sci. 2012 Apr;77(4):M182-7. doi: 10.1111/j.1750-3841.2012.02633.x.
Feliciano L 1 , Lee J , Pascall MA .
Author information:
 1 Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210,
USA.
Abstract
The effects of various sanitizers on the viability and cellular injury to structures of Escherichia coli and Listeria innocua were investigated. A food grade organic acidic formulation (pH 2.5) and acidic, neutral, and basic electrolyzed water [AEW (pH 2.7, oxidation reduction potential; ORP: 1100 mV, free available chlorine; FAC: 150 ppm), NEW (pH 6.9, ORP: 840 mV, FAC: 150 ppm), BEW (pH
11.6, ORP: -810 mV)] were used to treat E. coli and L. innocua cells. After 10 min of exposure to the sanitizers, changes to the bacterial numbers and cell structures were evaluated by plate counting and transmission electron microscopy (TEM), respectively. It was concluded from the results that the sanitizers reduced the E. coli cells between 2 and 3 log CFU/mL. Except for the BEW treatment, reductions in L. innocua population were greater (>1 log CFU/mL) than that of E. coli for all treatments. Data from the TEM showed that all sanitizers caused changes to the cell envelope and cytoplasm of both organisms. However, smaller changes were observed for L. innocua cells.
Decrease in the integrity of the cell envelope and aggregation of the cytoplasmic components appeared to be mainly because of exposure to the sanitizers. The organic acid formulation and AEW were the most effective sanitizers against bacterial cells, indicating that penetration of acidic substances effectively caused the cell inactivation.
An understanding of the method in which E-water and an acidic sanitizer cause injury to E. coli and
L. innocua would be helpful in selecting an effective chemical agent as a food safety tool. This will allow a scientist to target similar microorganisms such as food borne bacteria with structures that are vulnerable to the sanitizer.

© 2012 Institute of Food Technologists®
PMID: 22515246 [PubMed - indexed for MEDLINE]
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7. J Am Podiatr Med Assoc. 2011 Nov-Dec;101(6):484-96.
Landsman A 1 , Blume PA , Jordan DA Jr , Vayser D , Gutierrez A .
Author information:
 1 Podiatric Surgery, Harvard Medical School/Cambridge Health Alliance, Cambridge, MA,
USA. adamlandsman@aol.com
Abstract
This randomized, prospective, multicenter, open-label study was designed to test whether a topical, electrolyzed, superoxidized solution (Microcyn Rx) is a safe and effective treatment for mildly infected diabetic foot ulcers.
Sixty-seven patients with ulcers were randomized into three groups. Patients with wounds irrigated with Microcyn Rx alone were compared with patients treated with oral levofloxacin plus normal saline wound irrigation and with patients treated with oral levofloxacin plus Microcyn Rx wound irrigation. Patients were evaluated on day 3, at the end of treatment on day 10 (visit 3), and 14 days after completion of therapy for test of cure (visit 4).
In the intention-to-treat sample at visit 3, the clinical success rate was higher in the Microcyn Rx alone group (75.0%) than in the saline plus levofloxacin group (57.1%) or in the Microcyn Rx plus levofloxacin group (64.0%). Results at visit 4 were similar. In the clinically evaluable population, the clinical success rate at visit 3 (end of treatment) for patients treated with Microcyn Rx alone was
77.8% versus 61.1% for the levofloxacin group. The clinical success rate at visit 4 (test of cure) for

patients treated with Microcyn Rx alone was 93.3% versus 56.3% for levofloxacin plus saline-treated patients. This study was not statistically powered, but the high clinical success rate (93.3%) and the
P value (P = .033) suggest that the difference is meaningfully positive for Microcyn Rx-treated patients.
Microcyn Rx is safe and at least as effective as oral levofloxacin for mild diabetic foot infections.
PMID: 22106196 [PubMed - indexed for MEDLINE]
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8. Dis Colon Rectum. 2011 Jul;54(7):826-32. doi: 10.1007/DCR.0b013e318211b83a.
Takesue Y 1 , Takahashi Y , Ichiki K , Nakajima K , Tsuchida T , Uchino M , Ikeuchi H .
Author information:

1 Department of Infection Control and Prevention, Hyogo College of Medicine, Hyogo,
Japan. takesuey@hyo-med.ac.jp
Abstract
Electrolyzed strongly acidic aqueous solution which is produced by electrolysis of a sodium chloride solution has been used in Japan for the irrigation of wounds or body cavities even in the absence of particular evidence.
The purpose of this study is to investigate the efficacy or harmful effects of the disinfectant when applied before wound closure in colorectal surgery.
We performed a prospective, randomized study.
The study was conducted at Surgical Department of Hyogo College of Medicine

Patients who underwent elective colorectal surgery were randomly assigned to 2 groups. The surgical wound was irrigated with >500 mL of the disinfectant or saline solution after the completion of fascia closure. Patients with dirty/infected wounds were excluded from the study.
The primary end point of this study was comparison of the frequency of incisional surgical site infection. The secondary end point was the occurrence of wound dehiscence or wound hernia.
One hundred eighty patients in the disinfectant group and 183 patients in the saline solution group were analyzed. In multivariate analysis, IBD and contaminated wounds were independent risk factors for incisional surgical site infection. Application of the disinfectant tended to lower the risk of the infection (OR 0.457, 95% CI 0.206-1.013). In the analysis of poor wound healing, preoperative hospital stay of >2 weeks, stoma creation, and use of the disinfectant (OR 2.28, 95% CI 1.03-5.04) were independent risk factors.
This study was not a double-blind trial.
Application of electrolyzed strongly acidic aqueous solution to the wound impaired wound healing.
Routine use of electrolyzed strongly acidic aqueous solution is not recommended in patients undergoing elective colorectal surgery. As for the contribution of the disinfectant to preventing wound infections, further study is needed to make a definitive conclusion.
PMID: 21654249 [PubMed - indexed for MEDLINE]
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9. J Food Prot. 2010 Dec;73(12):2211-6.
Nan S 1 , Yongyu LI , Baoming LI , Wang C , Cui X , Cao W .

Author information:
 1 The Key Laboratory of Bio-environmental Engineering, China Agricultural University, P.O. Box
67, Beijing 100083, People's Republic of China.
Abstract
The use of different available chlorine concentrations (ACCs) of slightly acidic electrolyzed water
(SAEW; 0.5 to 30 mg/liter), different treatment times, and different temperatures for inactivating
Escherichia coli O157:H7 and Staphylococcus aureus was evaluated. The morphology of both pathogens also was analyzed with transmission electron microscopy. A 3-min treatment with SAEW
(pH 6.0 to 6.5) at ACCs of 2 mg/liter for E. coli O157:H7 and 8 mg/liter for S. aureus resulted in
100% inactivation of two cultures (7.92- to 8.75log reduction) at 25°C. The bactericidal activity of
SAEW was independent of the treatment time and temperature at a higher ACC (P > 0.05). E. coli
O157:H7 was much more sensitive than S. aureus to SAEW. The morphological damage to E. coli
O157:H7 cells by SAEW was significantly greater than that to S. aureus cells. At an ACC as high as
30 mg/liter, E. coli O157:H7 cells were damaged, but S. aureus cells retained their structure and no cell wall damage or shrinkage was observed. SAEW with a near neutral pH may be a promising disinfectant for inactivation of foodborne pathogens.
PMID: 21219738 [PubMed - indexed for MEDLINE]
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10. Anal Chem. 2011 Jan 1;83(1):231-9. doi: 10.1021/ac1022887. Epub 2010 Dec 3.
Prasad B 1 , Lewis AR , Plettner E .
Author information:
 1 Department of Chemistry, Simon Fraser University, 8888 University Drive, Burnaby, BC,
Canada - V5A 1S6.
Abstract
A low-abundance form of water, H(2)(17)O, was enriched from 0.04% to ∼ 90% by slow evaporation and fractional distillation of tap water. The density and refractive index for H(2)(17)O are reported.
Gas chromatography-mass spectrometry (GC-MS) of (16)O- and (17)O-1-hexanols and their trimethyl silyl ethers and of (16)O- and (17)O-hexamethyl disiloxanes was used to determine the percentage of (17)O enrichment in the H(2)(17)O. Furthermore, the chemical shifts of labeled and nonlabeled water dissolved in CDCl(3) differed sufficiently that we could verify the enrichment of
H(2)(17)O. (17)O hexanol was synthesized by the reaction of iodohexane with Na(17)OH. (17)O-
Labeled trimethylsilanol and (17)O-labeled hexamethyldisiloxane were prepared by the reaction of

H(2)(17)O with bis(trimethylsilyl)trifluoroacetamide (BSTFA). To generate standards for (17)O
NMR, H(2)(17)O(2), and (17)O camphor were prepared. H(2)(17)O was electrolyzed to form (17)Olabeled hydrogen peroxide which was quantified using two colorimetric assays. (17)O-Labeled camphor was prepared by exchanging the ketone oxygen of camphor using H(2)(17)O. The (17)Olabeled compounds were characterized using (17)O, (1)H, and (13)C NMR and GC-MS. While we were characterizing the labeled camphor, we also detected an unexpected oxygen exchange reaction of primary alcohols, catalyzed by electrophilic ketones such as camphor. The reaction is a displacement of the alcohol OH group by water. This is an example of the usefulness of (17)O
NMR in the study of a reaction mechanism that has not been noticed previously.
PMID: 21128590 [PubMed - indexed for MEDLINE]
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11. Arch Oral Biol. 2011 Apr;56(4):359-66. doi: 10.1016/j.archoralbio.2010.10.016. Epub 2010 Nov 24.
Morita C 1 , Nishida T , Ito K .
Author information:

1 Nihon University Graduate School of Dentistry, Tokyo, Japan.
Abstract
Acid electrolyzed functional water has been used in a variety of ways because of its antiseptic action. In the present study, we investigated both the systemic and gastrointestinal effects of ingesting acid electrolyzed functional water, from the perspective of its use in mouthwash.
Seventeen mice (three weeks old) were used in the experiment. Three of the mice (three-week-old group) were euthanized before having been given solid food, whilst the remaining 14 were divided into two groups, one given free access to acid electrolyzed functional water as drinking water (test group) and the other given free access to tap water as drinking water (control group). Changes in body weight, visual inspections of the oral cavity, histopathological tests, and measurements of surface enamel roughness and observations of enamel morphology were recorded after eight weeks.

The results showed no significant difference in changes in body weight between the test and control groups. No abnormal findings or measurements were observed for the test group in terms of visual inspections of the oral cavity, histopathological tests, or measurements of surface enamel roughness. In terms of enamel morphology, attrition was seen in the test group.
These findings suggest that the use of acid electrolyzed functional water has no systemic effect and is safe for use in mouthwash.
Copyright © 2010 Elsevier Ltd. All rights reserved.
PMID: 21109231 [PubMed - indexed for MEDLINE]
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12. Quintessence Int. 2010 Oct;41(9):e166-72.
Gomi K 1 , Makino T , Suzuki S , Hasegawa M , Maeda N , Arai T .
Author information:
 1 Department of Endodontics and Periodontics, Tsurumi University, School of Dental Medicine,
Yokohama, Japan. gomi-k@tsurumi-u.ac.jp
Abstract
Several kinds of functional water are used in the fields of food hygiene and medicine. The purpose of this study was to evaluate both the disinfection and cytotoxic effects of functional water in comparison with commonly used root canal irrigants such as sodium hypochlorite solution and hydrogen peroxide solution.
Three kinds of functional water were examined: alkaline electrolysis water (AEW), strong acid electrolyzed water (SAEW), and hypochlorous acid water (HAW). The disinfection effect was studied using Enterococcus faecalis and Candida albicans with or without organic substance. Each kind of functional water was applied to samples, and the colony formation was evaluated. The cytotoxic effect was evaluated by mitogenic assay (MTT) and alkaline phosphatase (ALPase) activity in pulp cells.

SAEW and HAW showed microbicidal effects in the presence of organic substance, with an effect almost similar to sodium hypochlorite solution. AEW did not show any microbicidal effect. SAEW,
AEW, and HAW at 10- and 1,000-times dilution did not inhibit the MTT assay and ALPase activity.
The cytotoxicity of SAEW and HAW against pulp cells was mild compared to that of sodium hypochlorite solution.
Functional water like SAEW and HAW have a good microbicidal effect under existing organic substance and are also mild to pulp cells.
PMID: 20806093 [PubMed - indexed for MEDLINE]
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13. J Biosci Bioeng. 2010 Sep;110(3):308-13. doi: 10.1016/j.jbiosc.2010.03.012. Epub 2010 Apr 18.
Issa-Zacharia A 1 , Kamitani Y , Tiisekwa A , Morita K , Iwasaki K .
Author information:
 1 Department of Environmental Science & Technology, Faculty of Agriculture, Kagoshima
University, 1-21-24 Korimoto, Kagoshima 890-0065, Japan. godson.issa@yahoo.co.uk
Abstract
In the current study, the effectiveness of slightly acidic electrolyzed water (SAEW) on an in vitro inactivation of Escherichia coli (E. coli), Staphylococcus aureus (S. aureus) and Salmonella spp. was evaluated and compared with other sanitizers. SAEW (pH 5.6, 23mg/l available chlorine concentration; ACC; and 940mV oxidation reduction potential; ORP) was generated by electrolysis of dilute solution of HCl (2%) in a chamber of a non-membrane electrolytic cell. One milliliter of bacteria suspension (ca. 10-11 log(10)CFU/ml) was mixed with 9ml of SAEW, strong acidic electrolyzed water (StAEW; ca. 50mg/l ACC), sodium hypochlorite solution (NaOCl; ca.120mg/l
ACC) and distilled water (DW) as control and treated for 60s. SAEW effectively reduced the population of E. coli, S. aureus and Salmonella spp. by 5.1, 4.8, and 5.2 log(10)CFU/ml. Although,
ACC of SAEW was more than 5 times lower than that of NaOCl solution, they showed no significant bactericidal difference (p>0.05). However, the bactericidal effect of StAEW was significantly higher (p<0.05) than SAEW and NaOCl solution in all cases. When tested with each individual test solution, E. coli, S. aureus and Salmonella spp. reductions were not significantly different (p>0.05). These findings indicate that SAEW with low available chlorine concentration can equally inactivate E. coli, S. aureus and Salmonella spp. as NaOCl solution and therefore SAEW shows a high potential of application in agriculture and food industry as an environmentally friendly disinfection agent.

Copyright 2010 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.
PMID: 20547336 [PubMed - indexed for MEDLINE]
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14. Int J Food Microbiol. 2010 Jan 31;137(1):67-75. doi: 10.1016/j.ijfoodmicro.2009.10.032. Epub 2009
Nov 6.
Xiong K 1 , Liu HJ , Liu R , Li LT .
Author information:
 1 College of Food Science and Nutritional Engineering, China Agricultural University, P. O. Box
40, No.17 Qing hua dong lu, Hai dian, Beijing 100083, PR China.
Abstract
Neutralized electrolyzed oxidizing water (NEW) and acidic electrolyzed oxidizing water (AcEW) are electrolyzed oxidizing waters (EOW) that have significantly different fungicidal efficiencies against
Aspergillus flavus (A. flavus) (The actuation durations of no survival population to NEW and AcEW were 90s and 120s, respectively.), even when used at the same available chlorine concentration
(30ppm). It has been verified by our previous research. This study hypothesized that this difference did not originate from the structure of water but based on the OH radical (OH). It was proved by the
UV spectroscopy, (17)O-NMR spectroscopy and electron spin resonance analysis. NEW contains more OH compared with AcEW in the same available chlorine concentration level. The OH that exists in NEW and AcEW was found to have an important fungicidal factor that destroys the cellular structures of the A. flavus conidia. It also damages the cellular normal function of A. flavus conidia that brought about K+ and Mg2+ leakages. The levels of OH that exist in NEW and AcEW could be the important reason that leads to significant fungicidal efficiencies against A. flavus.
Crown Copyright 2009. Published by Elsevier B.V. All rights reserved.
PMID: 19926156 [PubMed - indexed for MEDLINE]
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15. J Food Prot. 2009 Jun;72(6):1315-20.

Handojo A 1 , Lee J , Hipp J , Pascall MA .
Author information:
 1 Department of Food Science and Technology, The Ohio State University, 2015 Fyffe Road,
Columbus, Ohio 43210, USA.
Abstract
This study investigated residual bacteria and different food types left on tableware items after various washing and sanitization protocols. Escherichia coli K-12 and Staphylococcus epidermidis were inoculated into whole milk and soft cream cheese. The milk was used to contaminate regular drinking glasses and the cheese was used to contaminate plates and silverware. These tableware items were washed in manual (43 degrees C) and mechanical (49 degrees C) washers and sanitized with different sanitizers (24 degrees C) for 5 s. Quaternary ammonium compound, sodium hypochlorite, peroxyacetic acid, neutral electrolyzed water (NEW), and a combination of citric acid with sodium dodecylbenzene sulfonate (acidic formulation) were used as the chemical sanitizers.
Tap water was used as a control. Results showed that at least 5-log reductions in both bacterial numbers were achieved for all sanitizers in both types of washers, except for the control. With mechanical dishwashing, the NEW and acidic formulation treatments reduced bacterial populations by >6.9 and >6.0 log CFU per tableware item, respectively. With the manual operation, bacterial numbers were reduced by >5.4 and >6.0 log CFU per tableware item, respectively. This study revealed that NEW and the acidic formulation are as effective as the other chemical sanitizers for food contact surface sanitization in manual and mechanical ware washing.
PMID: 19610348 [PubMed - indexed for MEDLINE]
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16. Food Microbiol. 2009 Sep;26(6):629-37. doi: 10.1016/j.fm.2009.04.010. Epub 2009 May 7.

Smigic N 1 , Rajkovic A , Antal E , Medic H , Lipnicka B , Uyttendaele M , Devlieghere F .
Author information:
 1 Laboratory of Food Microbiology and Food Preservation, Department of Food Safety and Food
Quality, Ghent University, Ghent, Belgium.
Abstract
The utilization of sub-lethal decontamination treatments gains more and more interest due to the increased consumers' demand for fresh, minimally processed and convenient food products. These products rely on cold chain and hurdle (combination) technology to provide microbiological safety and quality during their shelf life. To investigate the ability of surviving cells to resuscitate and grow in a food simulating environment, sub-lethal decontamination treatments were coupled with subsequent storage under sub-optimal growth conditions. For this purpose chlorine dioxide (ClO2) and neutralized electrolyzed oxidizing water (NEW)-treated cultures of Escherichia coli O157:H7 were inoculated in TSB-YE of pH 5.8 and aw 0.99, and stored at 10 degrees C, 12.5 degrees C and 15 degrees C, under four different atmospheres (0%, 30% and 60% CO2 balanced with N2, and air). Due to the severity of injury, lactic acid-treated cells were inoculated in TSB-YE pH 7.0.
Data obtained reveal that the fraction of sub-lethally injured E. coli O157:H7 undergoes an additional inhibitory effect during the storage period under of sub-optimal conditions. Observed extension in the lag growth phase was a direct consequence prior sub-lethal injury. The effects of liquid ClO2 and NEW were less pronounced in comparison to lactic acid. The current study signifies the potential utilization of appropriate combination of different extrinsic and intrinsic factors in the elimination or growth inhibition of food-borne pathogens.
PMID: 19527839 [PubMed - indexed for MEDLINE]
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17. Hemodial Int. 2007 Jul;11(3):322-7.
Nakayama M 1 , Kabayama S , Terawaki H , Nakayama K , Kato K , Sato T , Ito S .
Author information:

1 Research Division of Dialysis and Chronic Kidney Disease, Tohoku University Graduate School of Medicine, Sendai, Japan.
mnakayama@mail.tains.tohoku.ac.jp

Abstract
Electrolyzed water (EW) generated on the cathode side reportedly displays anti-oxidative properties, and application of EW to hemodialysis (HD) systems supposedly suppresses oxidative markers in patients on HD. However, most of the chemical properties and biological effects of such solutions remain unclear. This study aimed to examine those issues to clarify the scientific background for the clinical use of EW solution. Reverse osmosis water comprising EW from the cathode side (e-RO) was prepared and used to process a test HD solution (e-HD). Chemical and biological properties of these solutions were compared with controls. Redox properties were examined by chemiluminescence (CL) of the luminol-H(2)O(2) system. Biological effects of e-RO on human polymorphonuclear leukocytes (PMNs) were tested with respect to the cellular protection against methylglyoxal, and with respect to the preservation of cellular function as to radical generation. Control HD solution presented the highest CL, followed by e-HD, control RO, suggesting a lower oxidative capacity for EW-based solutions. Increased levels of dissolved hydrogen were characteristic of e-RO and e-HD. Application of e-RO tended to be associated with less injury of PMNs by methylglyoxal, and with significantly higher levels of radical generation compared with the control. Compared with control HD, e-RO-based HD solution displays lessoxidative capacity in chemical terms, and may at least partly facilitate preservation of PMN viability.
These results appear to offer a scientific basis for supporting the clinical challenge of applying this technology to HD treatment.
PMID: 17576297 [PubMed - indexed for MEDLINE]
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18. Kansenshogaku Zasshi. 2007 May;81(3):249-55.
[Article in Japanese]
Mori K 1 , Hayashi Y , Akiba T , Noguchi Y , Yoshida Y , Kai A , Yamada S , Sakai S , Hara M .
Author information:

1 Department of Microbiology, Tokyo Metropolitan Institute of Public Health.
Abstract
As a preventive action plan against gastroenteritis caused by the Norovirus (NV), we studied hand hygiene effects using with three hand rubbing products, four wet wipe products, and two functional water types using Feline Calicivirus as a Norovirus surrogate. After treatment using antiseptic hand rubbing products containing chlorhexidine, quaternary ammonium, and povidone-iodine, high inactivation detected by TCID50 was observed compared to products containing povidone-iodine,

although no difference was seen in viral removal measured by the amount of viral genome copies in real-time-PCR. Among wet wipes soaked in chlorhexidine, quaternary ammonium, benzoic acid and PHMB, two groups showed viral inactivation and removal. Two products were more effective for functional water, viral decrease was seen in rinsing in running electrolyzed acid water and handwashing by soap. Results underscore the importance of selection in hand washing metheds
(alternative soap and also) in preventing viral gastroenteritis.
PMID: 17564112 [PubMed - indexed for MEDLINE]
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19. Curr Opin Infect Dis. 2005 Aug;18(4):326-30.
Nelson DB 1 .
Author information:

1 Minneapolis VA Medical Center, University of Minnesota, Minneapolis, Minnesota,
USA. douglas.nelson@med.va.gov
Abstract
This article reviews recent publications relevant to endoscope reprocessing and the potential for transmission of infection during gastrointestinal endoscopy.
There have been a number of established reprocessing failures of gastrointestinal endoscopes at various healthcare facilities across the US resulting in patient notifications. These episodes have been associated with user errors and reprocessing equipment failures, highlighting the need for increased compliance with established guidelines. Surveillance cultures may be useful to monitor the outcome of reprocessing, although their use is controversial. New technology to allow point-ofuse monitoring is promising. Biofilm accumulation may be an issue when reprocessing gastrointestinal endoscopes. Although peracetic acid has been promoted as superior to aldehydetype liquid chemical germicides with regard to soil fixation, it may only be a modest improvement.
Electrolyzed acid water is an emerging liquid chemical germicide that may be equivalent to currently accepted disinfectants. There appears to be no benefit to an additional reprocessing cycle before use for endoscopes that have been appropriately cleaned, disinfected, and stored.
With the recent media attention on gastrointestinal endoscope reprocessing failures, despite the absence of documented transmission of infection, increased compliance with existing guidelines and new initiatives to enhance endoscope reprocessing are increasingly important to maintain public confidence.

PMID: 15985829 [PubMed - indexed for MEDLINE]
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20. Arq Gastroenterol. 2005 Jan-Mar;42(1):60-2. Epub 2005 Jun 22.
[Article in Portuguese]
Machado AP 1 , Fischman O , Geocze S .
Author information:

1 Departamento de Microbiologia, Immunologia e Parasitologia, Escola Paulista de Medicina,
Universidade Federal de São Paulo, São Paulo, SP.
Abstract
The manual disinfection of endoscopes with glutharaldeyde is widely employed. The great routine in gastroenteroscopy services, low number of equipment and the lack of technical knowledge about the decontamination processes are factors that stimulate the inadequate endoscope disinfection, intensifying the risk of transmission of microorganisms. The electrolysed acid water has been effective in the inactivation and destruction of microorganisms.
The purpose of this investigation was to verify the microbicidal efficiency of electrolyzed acid water
(Cleantop WM-1) to decontaminate gastroscopes after their using in patients.
Samples from biopsy channel of flexible endoscopes collected after patient use (n = 20) and after disinfection (n = 20) were cultivated in tryptic soy agar, MacConkey agar and Sabouraud dextrose agar.
Seventeen of the 20 samples collected after patients examination yielded gram-negative bacilli, gram-positive coccus and yeast cells in contamination of 3 to 5 log10 ufc/mL. Microbial growth was not verified in samples collected after the decontamination process. Conclusion - In this preliminary study, the mechanical disinfection carried through the Cleantop device with electrolyzed acid water showed satisfactory results for the elimination of microorganisms and time optimization in the

reprocessing of gastroscopes.
Free Article
PMID: 15976913 [PubMed - indexed for MEDLINE]
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21. J Agric Food Chem. 2005 Jun 15;53(12):4906-10.
Stan SD 1 , Daeschel MA .
Author information:

1 Department of Food Science and Technology, Oregon State University, 100 Wiegand Hall,
Corvallis, Oregon 97331, USA.
Abstract
Electrolyzed oxidizing (EO) water has recently generated much interest as a disinfectant in the food industry. 5,5-Dimethyl-1-pyrroline-N-oxide (DMPO) is a spin trapping agent widely used in the electron spin resonance (ESR) characterization of oxygen-centered free radicals. The reaction between electrolyzed water, collected from the anode side of a two-chamber electrolyzer, and
DMPO was investigated by ESR spectroscopy. Addition of DMPO to EO water generated an ESR spectrum identical to that of 5,5-dimethyl-2-pyrrolidone-N-oxyl (DMPOX), suggesting that a compound from EO water oxidized DMPO with the formation of DMPOX. To further investigate the electrolytically generated compound that oxidized DMPO, aqueous solutions of different sodium salts (sodium chloride, sodium citrate, and sodium iodide) with similar conductivities were electrolyzed. The DMPOX signal was not detected in the electrolyzed sodium citrate sample, suggesting that DMPOX formation in the electrolyzed NaCl sample might be due to an electrolytically generated chlorine species. A low DMPOX signal was also observed from the electrolyzed NaI sample, suggesting that a similar species obtained through the electrolysis of I- can also oxidize DMPO. Hypochlorous acid is proposed to oxidize the spin trap DMPO with the formation of DMPOX. In a neutral pH environment, electrolyzed water also oxidized DMPO to
DMPOX. This is consistent with the DMPOX formation in the reaction of chlorine water (containing
HOCl and Cl2) or sodium hypochlorite with DMPO.
PMID: 15941334 [PubMed - indexed for MEDLINE]
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22. Kyobu Geka. 2004 Nov;57(12):1110-2.
[Article in Japanese]
Ichihara T 1 , Fujii G , Eda T , Sasaki M , Ueda Y .
Author information:

1 Department of Cardiovascular Surgery, Tosei General Hospital, Seto, Japan.
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infection after cardiac surgery has recently increased. We compared the anti-inflammatory effect of an electrolyzed strong acid solution and a warm saline solution in patients with open heart surgery. These solutions were used for mediastinal irrigation before closing the sternum. Group A patients were irrigated by a warm saline solution, and group B patients were irrigated by an electrolyzed strong acid solution, administration of this water is safe, feasible, and easy for the prevention of MRSA infection. Postoperative infection was significantly decreased in the group B as compared in the group A. An electrolyzed strong acid solution may be effective on postoperative infection, particularly MRSA infection following open heart surgery.
PMID: 15553026 [PubMed - indexed for MEDLINE]
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23. J Gastroenterol Hepatol. 2004 Aug;19(8):897-903.
Lee JH 1 , Rhee PL , Kim JH , Kim JJ , Paik SW , Rhee JC , Song JH , Yeom JS , Lee NY .

Author information:
 1 Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of
Medicine, 50 Ilwon-Dong. Kangnam-Ku, Seoul 135-710, Korea.
Abstract
Two percent glutaraldehyde, the most widely used liquid chemical germicide (LCG), may be hazardous to patients and medical personnel. Alternatives to glutaraldehyde, such as electrolyzed acid water (EAW), are being developed, but data from well-controlled studies with patient-used endoscopes are rare. The purpose of the present paper was to evaluate the high-level disinfection capability of EAW and compare it with glutaraldehyde.
A random sample of 125 endoscopes was collected immediately after upper endoscopic examination. After careful manual cleaning, endoscopes were divided into a glutaraldehyde and
EAW group. After the disinfection procedure, samples from working channel (S-1), insertion tube
(S-2), umbilical cord (S-3), and angulation knob (S-4) were taken and cultured. Another twenty endoscopes were experimentally contaminated with hepatitis B virus (HBV) and samples were collected after contamination (T-1), after manual cleaning (T-2), and after final disinfection (T-3).
Polymerase chain reaction (PCR) for HBV-DNA was performed.
In the EAW group, culture-positive rates were 3.2% in S-1, 9.5% in S-2, 3.2% in S-3, and 27.0% in the S-4 samples. There was no significant difference between the EAW and glutaraldehyde groups for all sampling sites. However, in both groups, disinfection of the angulation knobs (S-4) was less efficient than the others. For the T-1 site, HBV-DNA was detected from all of them, and in 95%
(19/20) of T-2. However, HBV-DNA was not detected from T-3 samples.
Electrolyzed acid water is as efficient as glutaraldehyde in eliminating bacteria from patient-used endoscopes. After disinfection procedures using both methods, HBV-DNA was not detected from any endoscopes experimentally contaminated with HBV-positive mixed sera. However, some bacteria may remain on the surface of the endoscopes. Therefore, more careful precleaning of the endoscopes may help achieve high-level disinfection in the clinical setting.
PMID: 15242493 [PubMed - indexed for MEDLINE]
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24. Artif Organs. 2004 Jun;28(6):590-2.

Vorobjeva NV 1 , Vorobjeva LI , Khodjaev EY .
Author information:
 1 Department of Physiology of Microorganisms, Biology Faculty, Moscow State University, Lenin
Hills 1/12, Moscow 119992, Russia.
nvvorobjeva@mail.ru
Abstract
The study is designed to investigate bactericidal actions of electrolyzed oxidizing water on hospital infections. Ten of the most common opportunistic pathogens are used for this study. Cultures are inoculated in 4.5 mL of electrolyzed oxidizing (EO) water or 4.5 mL of sterile deionized water
(control), and incubated for 0, 0.5, and 5 min at room temperature. At the exposure time of 30 s the
EO water completely inactivates all of the bacterial strains, with the exception of vegetative cells and spores of bacilli which need 5 min to be killed. The results indicate that electrolyzed oxidizing water may be a useful disinfectant for hospital infections, but its clinical application has still to be evaluated.
PMID: 15153153 [PubMed - indexed for MEDLINE]
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25. J Microbiol Methods. 2004 May;57(2):163-73.
Nakajima N 1 , Nakano T , Harada F , Taniguchi H , Yokoyama I , Hirose J , Daikoku E , Sano K .
Author information:
 1 Department of Microbiology, Osaka Medical College, 2-7 Daigaku-machi Takatsuki, Osaka 569-
8686, Japan.
Abstract
Tap water is one of the causative factors of hospital infections. We examined the disinfective potential of electrolysis and mechanism of disinfection, and clarified the disinfective effect of electrolysis on tap water contaminated with bacteria, and discussed its clinical applications. Tap waters artificially contaminated with Pseudomonas aeruginosa, Escherichia coli, Legionella pneumophila, and Staphylococcus aureus could be sterilized by electrolysis at 20-30 mA for 5 min.
A high-density suspension (10(6) CFU/ml) of a spore forming bacterium, Bacillus subtilis was not completely sterilized by electrolysis at 50 mA up to 30 min, but a low-density suspension (10(5)

CFU/ml) was totally sterilized by electrolysis at 50 mA for 5 min. Electrolyzed P. aeruginosa changed morphologically, that is, there was bleb formation on the cell wall and irregular aggregation of cytoplasmic small granules. Moreover, cytoplasmic enzyme, nitrate reductase, was inactivated by the electrolysis. On the other hand, genomic DNA of the electrolyzed bacteria was not degenerated, therefore, their DNA polymerase activity was not completely inactivated.
Consequently, the major agent in electrolysis for bactericidal action was considered to be free chlorine, and the possible bactericidal mechanism was by destruction of bacterial membranes, followed by the aggregation of peripheral cytoplasmic proteins. Electrolysis of tap water for both disinfecting contaminating bacteria and increasing the disinfectant capacity was considered effective with some limitations, particularly against high-density contamination by spore-forming bacteria. In clinical settings, electrolysis of tap water is considered effective to disinfect water for hand washing in operation theatres, and bathing water for immunocompromised hosts.
PMID: 15063056 [PubMed - indexed for MEDLINE]
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1. Ecotoxicol Environ Saf. 2013 Apr;90:98-102. doi: 10.1016/j.ecoenv.2012.12.017. Epub 2013
Jan 18.
Nakano T 1 , Hirose J , Kobayashi T , Hiro N , Kondo F , Tamai H , Tanaka K , Sano K .
Author information:

1 Project Team for Medical Application of Electrolysis (Nakano Project), Central Research
Center, Osaka Medical College, Takatsuki-shi, Osaka, Japan.
tnakano@art.osaka-med.ac.jp
Abstract
Contamination of surface water by antibacterial pharmaceuticals (antibacterials) from clinical settings may affect aquatic organisms, plants growth, and environmental floral bacteria. One of the methods to decrease the contamination is inactivation of antibacterials before being discharged to the sewage system. Recently, we reported the novel method based on electrolysis for detoxifying wastewater containing antineoplastics. In the present study, to clarify whether the electrolysis method is applicable to the inactivation of antibacterials, we electrolyzed solutions of 10 groups of individual antibacterials including amikacin sulfate (AMK) and a mixture (MIX) of some commercial antibacterials commonly prescribed at hospitals, and measured their antibacterial activities. AMK was inactivated in its antibacterial activities and its concentration decreased by electrolysis in a time-dependent manner. Eighty to ninety-nine percent of almost all antibacterials and MIX were inactivated within 6h of electrolysis.
Additionally, cytotoxicity was not detected in any of the electrolyzed solutions of antibacterials and MIX by the Molt-4-based cytotoxicity test.
Copyright © 2012 Elsevier Inc. All rights reserved.
PMID: 23337489 [PubMed - indexed for MEDLINE]
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2. Med Mol Morphol. 2012 Dec;45(4):199-205. doi: 10.1007/s00795-011-0560-5. Epub 2012 Dec
7.
Yamamoto TM 1 , Nakano T , Yamaguchi M , Shimizu M , Wu H , Aoki H , Ota R , Kobayashi
T , Sano K .
Author information:

1 Department of Microbiology and Infection Control, Osaka Medical College, 2-7 Daigaku-
Machi, Takatsuki, Osaka 569-8686, Japan.
Abstract
Electrolyzed acid water (EAW) has been studied for its disinfective potential against pathogenic microbes; however, the bactericidal process against Mycobacteria has not been clearly presented. In this study, to clarify the disinfective process against Mycobacteria, EAW-treated bacteria were examined against laboratory strains of Mycobacterium bovis (M. bovis),
Mycobacterium smegmatis (M. smegmatis), and Mycobacterium terrae (M. terrae) by recovery culture and observation of morphology, enzymatic assay, and the detection of DNA. All experiments were performed with the use of EAW containing 30 ppm free chlorine that kills
Mycobacteria, including three pathogenic clinical isolates of Mycobacterium tuberculosis (M. tuberculosis) and six isolates of other Mycobacteria, within 5 min. In morphology, the bacterial surface became rough, and a longitudinal concavity-like structure appeared. The intrabacterial enzyme of EAW-contacted bacteria was inactivated, but chromosomal DNA was not totally denatured. These results suggest that the bactericidal effect of EAW against Mycobacteria occurs by degradation of the cell wall, followed by denaturation of cytoplasmic proteins, but degeneration of the nucleic acid is not always necessary.
PMID: 23224598 [PubMed - indexed for MEDLINE]
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3. PLoS One. 2012;7(9):e46392. doi: 10.1371/journal.pone.0046392. Epub 2012 Sep 28.

Mokudai T 1 , Nakamura K , Kanno T , Niwano Y .
Author information:

1 Tohoku University Graduate School of Dentistry, Sendai, Japan.
Abstract
BACKGROUND:
Acid electrolyzed water (AEW), which is produced through the electrolysis of dilute sodium chloride (NaCl) or potassium chloride solution, is used as a disinfectant in various fields because of its potent antimicrobial activity. The hydroxyl radical, an oxygen radical species, is often suggested as a putative active ingredient for AEW antimicrobial activity.
METHODOLOGY/PRINCIPAL FINDINGS:
The aim of the present study is to detect hydroxyl radicals in AEW. The hydroxyl radicals in
AEW prepared under different conditions were determined using an electron spin resonance
(ESR) technique. A signal from 5,5-dimethyl-1-pyrroline N-oxide (DMPO)-OH, an adduct of
DMPO and the hydroxyl radical, was detected in AEW prepared by double or triple electrolyses of 1% NaCl but not of 0.1% NaCl solution. Then the presence of hydrogen peroxide as a proposed source of hydroxyl radicals was examined using a combination of ESR and a Fenton reaction. The DMPO-OH signal was clearly detected, even in AEW prepared by single electrolysis of 0.1% NaCl solution, when ferrous sulfate was added to induce a Fenton reaction, indicating the presence of hydrogen peroxide in the AEW. Since sodium formate, a hydroxyl radical scavenger, did not affect the bactericidal activity of AEW, it is concluded that the radical is unlikely to contribute to the antimicrobial activity of AEW, although a small amount of the radical is produced from hydrogen peroxide. Dimethyl sulfoxide, the other hydroxyl radical scavenger used in the present study, canceled the bactericidal activity of AEW, accompanied by complete depletion of free available chlorine, suggesting that hypochlorous acid is probably a major contributor to the antimicrobial activity.
CONCLUSIONS:
It is strongly suggested that although hydrogen peroxide is present in AEW as a source of hydroxyl radicals, the antimicrobial activity of AEW does not depend on these radicals.
PMCID: PMC3460889 Free PMC Article
PMID: 23029505 [PubMed - indexed for MEDLINE]
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4. Dent Mater J. 2012;31(4):662-8.

Ozaki M 1 , Ohshima T , Mukumoto M , Konishi H , Hirashita A , Maeda N , Nakamura Y .
Author information:

1 Department of Orthodontics, School of Dental Medicine, Tsurumi University, Tsurumiku,
Yokohama, Japan. cooldev-fd@m2.gyao.ne.jp
Abstract
The purpose of this study was to examine the biofilm removing and antimicrobial effects of microbubbled tap water and other functional water. The biofilm removal test showed that the activity of microbubbled tap water against the biofilm of Candida albicans and Streptococcus mutans was significantly higher than that of ordinary tap water (p<0.01). When the antimicrobial activities of two types of functional water were compared, the activity of electrolyzed hypochlorite water was significantly stronger than that of the ozonated water (p<0.01). The antimicrobial effect of the electrolyzed hypochlorite water was increased in the microbubbled form, and was stronger than microbubbled tap water. The same results were obtained not only for biofilms, but also for planktonic microbes. Our results demonstrated that the microbubbled water showed strong biofilm removing effects. Moreover, the application of functional water, such as electrolyzed hypochlorite microbubbled water was effective for both removing and sterilizing biofilms.
Free Article
PMID: 22864222 [PubMed - indexed for MEDLINE]
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5. J Trauma Acute Care Surg. 2012 Jun;72(6):1584-7. doi: 10.1097/TA.0b013e318243a1dc.
Ge L 1 , Zhang X , Cao C , Gu Z , Liu Z , Liu L , Lin B .

Author information:

1 Chongqing Academy of Animal Sciences, Chongqing, China. geliangpeng1982@163.com
Abstract
BACKGROUND:
Neutral electrolyzed water (NEW) is considered to be a high-level biodegradable disinfectant with sporicidal, bactericidal, and virucidal activity. It has also been reported to accelerate wound healing; thus, it is particularly attractive for the elimination or minimization of the microbial population of skin grafts to be used as wound dressings.
METHODS:
Pigskins were sterilized with different concentrations of NEW and with different methods. The feasibility of pigskin sterilization by NEW was evaluated through microbiological analyses, viability assays, histologic assessments, contact cytotoxicity assays, and extract cytotoxicity assays.
RESULTS:
NEW has strong bactericidal effects on pigskin microorganisms, does not change skin graft histologic properties, and has no cytotoxicity; however, skin viability was significantly reduced after NEW treatment.
CONCLUSION:
Although NEW treatment is a very safe and effective method for nonviable pigskin dressing sterilization, to obtain a complete sterilization of pigskin grafts, available chlorine concentration of NEW as well as sterilization time and methods should be optimized.
Copyright © 2012 by Lippincott Williams & Wilkins.
PMID: 22695426 [PubMed - indexed for MEDLINE]
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6. J Food Sci. 2012 Apr;77(4):M182-7. doi: 10.1111/j.1750-3841.2012.02633.x.

Feliciano L 1 , Lee J , Pascall MA .
Author information:

1 Department of Food Science and Technology, The Ohio State University, Columbus, OH
43210, USA.
Abstract
The effects of various sanitizers on the viability and cellular injury to structures of Escherichia coli and Listeria innocua were investigated. A food grade organic acidic formulation (pH 2.5) and acidic, neutral, and basic electrolyzed water [AEW (pH 2.7, oxidation reduction potential;
ORP: 1100 mV, free available chlorine; FAC: 150 ppm), NEW (pH 6.9, ORP: 840 mV, FAC:
150 ppm), BEW (pH 11.6, ORP: -810 mV)] were used to treat E. coli and L. innocua cells. After
10 min of exposure to the sanitizers, changes to the bacterial numbers and cell structures were evaluated by plate counting and transmission electron microscopy (TEM), respectively. It was concluded from the results that the sanitizers reduced the E. coli cells between 2 and 3 log
CFU/mL. Except for the BEW treatment, reductions in L. innocua population were greater (>1 log CFU/mL) than that of E. coli for all treatments. Data from the TEM showed that all sanitizers caused changes to the cell envelope and cytoplasm of both organisms. However, smaller changes were observed for L. innocua cells. Decrease in the integrity of the cell envelope and aggregation of the cytoplasmic components appeared to be mainly because of exposure to the sanitizers. The organic acid formulation and AEW were the most effective sanitizers against bacterial cells, indicating that penetration of acidic substances effectively caused the cell inactivation.
PRACTICAL APPLICATION:
An understanding of the method in which E-water and an acidic sanitizer cause injury to E. coli and L. innocua would be helpful in selecting an effective chemical agent as a food safety tool.
This will allow a scientist to target similar microorganisms such as food borne bacteria with structures that are vulnerable to the sanitizer.
© 2012 Institute of Food Technologists®
PMID: 22515246 [PubMed - indexed for MEDLINE]
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7. J Am Podiatr Med Assoc. 2011 Nov-Dec;101(6):484-96.

Landsman A 1 , Blume PA , Jordan DA Jr , Vayser D , Gutierrez A .
Author information:

1 Podiatric Surgery, Harvard Medical School/Cambridge Health Alliance, Cambridge, MA,
USA. adamlandsman@aol.com
Abstract
BACKGROUND:
This randomized, prospective, multicenter, open-label study was designed to test whether a topical, electrolyzed, superoxidized solution (Microcyn Rx) is a safe and effective treatment for mildly infected diabetic foot ulcers.
METHODS:
Sixty-seven patients with ulcers were randomized into three groups. Patients with wounds irrigated with Microcyn Rx alone were compared with patients treated with oral levofloxacin plus normal saline wound irrigation and with patients treated with oral levofloxacin plus Microcyn Rx wound irrigation. Patients were evaluated on day 3, at the end of treatment on day 10 (visit 3), and 14 days after completion of therapy for test of cure (visit 4).
RESULTS:
In the intention-to-treat sample at visit 3, the clinical success rate was higher in the Microcyn
Rx alone group (75.0%) than in the saline plus levofloxacin group (57.1%) or in the Microcyn
Rx plus levofloxacin group (64.0%). Results at visit 4 were similar. In the clinically evaluable population, the clinical success rate at visit 3 (end of treatment) for patients treated with
Microcyn Rx alone was 77.8% versus 61.1% for the levofloxacin group. The clinical success rate at visit 4 (test of cure) for patients treated with Microcyn Rx alone was 93.3% versus
56.3% for levofloxacin plus saline-treated patients. This study was not statistically powered, but the high clinical success rate (93.3%) and the P value (P = .033) suggest that the difference is meaningfully positive for Microcyn Rx-treated patients.
CONCLUSIONS:
PMID: 22106196 [PubMed - indexed for MEDLINE]
Similar articles
Microcyn Rx is safe and at least as effective as oral levofloxacin for mild diabetic foot infections.
8. Dis Colon Rectum. 2011 Jul;54(7):826-32. doi: 10.1007/DCR.0b013e318211b83a.

Takesue Y 1 , Takahashi Y , Ichiki K , Nakajima K , Tsuchida T , Uchino M , Ikeuchi H .
Author information:

1 Department of Infection Control and Prevention, Hyogo College of Medicine, Hyogo,
Japan. takesuey@hyo-med.ac.jp
Abstract
BACKGROUND:
Electrolyzed strongly acidic aqueous solution which is produced by electrolysis of a sodium chloride solution has been used in Japan for the irrigation of wounds or body cavities even in the absence of particular evidence.
OBJECTIVE:
The purpose of this study is to investigate the efficacy or harmful effects of the disinfectant when applied before wound closure in colorectal surgery.
DESIGN:
We performed a prospective, randomized study.
SETTING:
The study was conducted at Surgical Department of Hyogo College of Medicine
PATIENTS:
Patients who underwent elective colorectal surgery were randomly assigned to 2 groups. The surgical wound was irrigated with >500 mL of the disinfectant or saline solution after the completion of fascia closure. Patients with dirty/infected wounds were excluded from the study.
MAIN OUTCOME MEASURES:
The primary end point of this study was comparison of the frequency of incisional surgical site infection. The secondary end point was the occurrence of wound dehiscence or wound hernia.

RESULTS:
One hundred eighty patients in the disinfectant group and 183 patients in the saline solution group were analyzed. In multivariate analysis, IBD and contaminated wounds were independent risk factors for incisional surgical site infection. Application of the disinfectant tended to lower the risk of the infection (OR 0.457, 95% CI 0.206-1.013). In the analysis of poor wound healing, preoperative hospital stay of >2 weeks, stoma creation, and use of the disinfectant (OR 2.28, 95% CI 1.03-5.04) were independent risk factors.
LIMITATION:
This study was not a double-blind trial.
CONCLUSIONS:
Application of electrolyzed strongly acidic aqueous solution to the wound impaired wound healing. Routine use of electrolyzed strongly acidic aqueous solution is not recommended in patients undergoing elective colorectal surgery. As for the contribution of the disinfectant to preventing wound infections, further study is needed to make a definitive conclusion.
PMID: 21654249 [PubMed - indexed for MEDLINE]
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9. J Food Prot. 2010 Dec;73(12):2211-6.
Nan S 1 , Yongyu LI , Baoming LI , Wang C , Cui X , Cao W .
Author information:

1 The Key Laboratory of Bio-environmental Engineering, China Agricultural University, P.O.
Box 67, Beijing 100083, People's Republic of China.
Abstract
The use of different available chlorine concentrations (ACCs) of slightly acidic electrolyzed water (SAEW; 0.5 to 30 mg/liter), different treatment times, and different temperatures for inactivating Escherichia coli O157:H7 and Staphylococcus aureus was evaluated. The morphology of both pathogens also was analyzed with transmission electron microscopy. A 3min treatment with SAEW (pH 6.0 to 6.5) at ACCs of 2 mg/liter for E. coli O157:H7 and 8

mg/liter for S. aureus resulted in 100% inactivation of two cultures (7.92- to 8.75-log reduction) at 25°C. The bactericidal activity of SAEW was independent of the treatment time and temperature at a higher ACC (P > 0.05). E. coli O157:H7 was much more sensitive than S. aureus to SAEW. The morphological damage to E. coli O157:H7 cells by SAEW was significantly greater than that to S. aureus cells. At an ACC as high as 30 mg/liter, E. coli
O157:H7 cells were damaged, but S. aureus cells retained their structure and no cell wall damage or shrinkage was observed. SAEW with a near neutral pH may be a promising disinfectant for inactivation of foodborne pathogens.
PMID: 21219738 [PubMed - indexed for MEDLINE]
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10. Anal Chem. 2011 Jan 1;83(1):231-9. doi: 10.1021/ac1022887. Epub 2010 Dec 3.
Prasad B 1 , Lewis AR , Plettner E .
Author information:

1 Department of Chemistry, Simon Fraser University, 8888 University Drive, Burnaby, BC,
Canada - V5A 1S6.
Abstract
A low-abundance form of water, H(2)(17)O, was enriched from 0.04% to ∼ 90% by slow evaporation and fractional distillation of tap water. The density and refractive index for
H(2)(17)O are reported. Gas chromatography-mass spectrometry (GC-MS) of (16)O- and
(17)O-1-hexanols and their trimethyl silyl ethers and of (16)O- and (17)O-hexamethyl disiloxanes was used to determine the percentage of (17)O enrichment in the H(2)(17)O.
Furthermore, the chemical shifts of labeled and nonlabeled water dissolved in CDCl(3) differed sufficiently that we could verify the enrichment of H(2)(17)O. (17)O hexanol was synthesized by the reaction of iodohexane with Na(17)OH. (17)O-Labeled trimethylsilanol and
(17)O-labeled hexamethyldisiloxane were prepared by the reaction of H(2)(17)O with bis(trimethylsilyl)trifluoroacetamide (BSTFA). To generate standards for (17)O NMR,
H(2)(17)O(2), and (17)O camphor were prepared. H(2)(17)O was electrolyzed to form (17)Olabeled hydrogen peroxide which was quantified using two colorimetric assays. (17)O-Labeled camphor was prepared by exchanging the ketone oxygen of camphor using H(2)(17)O. The
(17)O-labeled compounds were characterized using (17)O, (1)H, and (13)C NMR and GC-
MS. While we were characterizing the labeled camphor, we also detected an unexpected oxygen exchange reaction of primary alcohols, catalyzed by electrophilic ketones such as camphor. The reaction is a displacement of the alcohol OH group by water. This is an example of the usefulness of (17)O NMR in the study of a reaction mechanism that has not been noticed previously.

PMID: 21128590 [PubMed - indexed for MEDLINE]
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11. Arch Oral Biol. 2011 Apr;56(4):359-66. doi: 10.1016/j.archoralbio.2010.10.016. Epub 2010
Nov 24.
Morita C 1 , Nishida T , Ito K .
Author information:

1 Nihon University Graduate School of Dentistry, Tokyo, Japan.
Abstract
OBJECTIVE:
Acid electrolyzed functional water has been used in a variety of ways because of its antiseptic action. In the present study, we investigated both the systemic and gastrointestinal effects of ingesting acid electrolyzed functional water, from the perspective of its use in mouthwash.
MATERIALS AND METHODS:
Seventeen mice (three weeks old) were used in the experiment. Three of the mice (threeweek-old group) were euthanized before having been given solid food, whilst the remaining 14 were divided into two groups, one given free access to acid electrolyzed functional water as drinking water (test group) and the other given free access to tap water as drinking water
(control group). Changes in body weight, visual inspections of the oral cavity, histopathological tests, and measurements of surface enamel roughness and observations of enamel morphology were recorded after eight weeks.
RESULTS:
The results showed no significant difference in changes in body weight between the test and control groups. No abnormal findings or measurements were observed for the test group in terms of visual inspections of the oral cavity, histopathological tests, or measurements of surface enamel roughness. In terms of enamel morphology, attrition was seen in the test group.

CONCLUSIONS:
These findings suggest that the use of acid electrolyzed functional water has no systemic effect and is safe for use in mouthwash.
Copyright © 2010 Elsevier Ltd. All rights reserved.
PMID: 21109231 [PubMed - indexed for MEDLINE]
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12. Quintessence Int. 2010 Oct;41(9):e166-72.
Gomi K 1 , Makino T , Suzuki S , Hasegawa M , Maeda N , Arai T .
Author information:

1 Department of Endodontics and Periodontics, Tsurumi University, School of Dental
Medicine, Yokohama, Japan. gomi-k@tsurumi-u.ac.jp
Abstract
OBJECTIVE:
Several kinds of functional water are used in the fields of food hygiene and medicine. The purpose of this study was to evaluate both the disinfection and cytotoxic effects of functional water in comparison with commonly used root canal irrigants such as sodium hypochlorite solution and hydrogen peroxide solution.
METHOD AND MATERIALS:
Three kinds of functional water were examined: alkaline electrolysis water (AEW), strong acid electrolyzed water (SAEW), and hypochlorous acid water (HAW). The disinfection effect was studied using Enterococcus faecalis and Candida albicans with or without organic substance.
Each kind of functional water was applied to samples, and the colony formation was evaluated. The cytotoxic effect was evaluated by mitogenic assay (MTT) and alkaline phosphatase (ALPase) activity in pulp cells.
RESULTS:
SAEW and HAW showed microbicidal effects in the presence of organic substance, with an effect almost similar to sodium hypochlorite solution. AEW did not show any microbicidal effect. SAEW, AEW, and HAW at 10- and 1,000-times dilution did not inhibit the MTT assay and ALPase activity. The cytotoxicity of SAEW and HAW against pulp cells was mild compared to that of sodium hypochlorite solution.

CONCLUSION:
Functional water like SAEW and HAW have a good microbicidal effect under existing organic substance and are also mild to pulp cells.
PMID: 20806093 [PubMed - indexed for MEDLINE]
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13. J Biosci Bioeng. 2010 Sep;110(3):308-13. doi: 10.1016/j.jbiosc.2010.03.012. Epub 2010 Apr
18.
Issa-Zacharia A 1 , Kamitani Y , Tiisekwa A , Morita K , Iwasaki K .
Author information:

1 Department of Environmental Science & Technology, Faculty of Agriculture, Kagoshima
University, 1-21-24 Korimoto, Kagoshima 890-0065, Japan.
godson.issa@yahoo.co.uk
Abstract
In the current study, the effectiveness of slightly acidic electrolyzed water (SAEW) on an in vitro inactivation of Escherichia coli (E. coli), Staphylococcus aureus (S. aureus) and
Salmonella spp. was evaluated and compared with other sanitizers. SAEW (pH 5.6, 23mg/l available chlorine concentration; ACC; and 940mV oxidation reduction potential; ORP) was generated by electrolysis of dilute solution of HCl (2%) in a chamber of a non-membrane electrolytic cell. One milliliter of bacteria suspension (ca. 10-11 log(10)CFU/ml) was mixed with 9ml of SAEW, strong acidic electrolyzed water (StAEW; ca. 50mg/l ACC), sodium hypochlorite solution (NaOCl; ca.120mg/l ACC) and distilled water (DW) as control and treated for 60s. SAEW effectively reduced the population of E. coli, S. aureus and Salmonella spp. by 5.1, 4.8, and 5.2 log(10)CFU/ml. Although, ACC of SAEW was more than 5 times lower than that of NaOCl solution, they showed no significant bactericidal difference (p>0.05).
However, the bactericidal effect of StAEW was significantly higher (p<0.05) than SAEW and
NaOCl solution in all cases. When tested with each individual test solution, E. coli, S. aureus and Salmonella spp. reductions were not significantly different (p>0.05). These findings indicate that SAEW with low available chlorine concentration can equally inactivate E. coli, S. aureus and Salmonella spp. as NaOCl solution and therefore SAEW shows a high potential of application in agriculture and food industry as an environmentally friendly disinfection agent.
Copyright 2010 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.
PMID: 20547336 [PubMed - indexed for MEDLINE]
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14. Int J Food Microbiol. 2010 Jan 31;137(1):67-75. doi: 10.1016/j.ijfoodmicro.2009.10.032. Epub
2009 Nov 6.
Xiong K 1 , Liu HJ , Liu R , Li LT .
Author information:

1 College of Food Science and Nutritional Engineering, China Agricultural University, P. O.
Box 40, No.17 Qing hua dong lu, Hai dian, Beijing 100083, PR China.
Abstract
Neutralized electrolyzed oxidizing water (NEW) and acidic electrolyzed oxidizing water
(AcEW) are electrolyzed oxidizing waters (EOW) that have significantly different fungicidal efficiencies against Aspergillus flavus (A. flavus) (The actuation durations of no survival population to NEW and AcEW were 90s and 120s, respectively.), even when used at the same available chlorine concentration (30ppm). It has been verified by our previous research.
This study hypothesized that this difference did not originate from the structure of water but based on the OH radical (OH). It was proved by the UV spectroscopy, (17)O-NMR spectroscopy and electron spin resonance analysis. NEW contains more OH compared with
AcEW in the same available chlorine concentration level. The OH that exists in NEW and
AcEW was found to have an important fungicidal factor that destroys the cellular structures of the A. flavus conidia. It also damages the cellular normal function of A. flavus conidia that brought about K+ and Mg2+ leakages. The levels of OH that exist in NEW and AcEW could be the important reason that leads to significant fungicidal efficiencies against A. flavus.
Crown Copyright 2009. Published by Elsevier B.V. All rights reserved.
PMID: 19926156 [PubMed - indexed for MEDLINE]
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15. J Food Prot. 2009 Jun;72(6):1315-20.

Handojo A 1 , Lee J , Hipp J , Pascall MA .
Author information:

1 Department of Food Science and Technology, The Ohio State University, 2015 Fyffe
Road, Columbus, Ohio 43210, USA.
Abstract
This study investigated residual bacteria and different food types left on tableware items after various washing and sanitization protocols. Escherichia coli K-12 and Staphylococcus epidermidis were inoculated into whole milk and soft cream cheese. The milk was used to contaminate regular drinking glasses and the cheese was used to contaminate plates and silverware. These tableware items were washed in manual (43 degrees C) and mechanical
(49 degrees C) washers and sanitized with different sanitizers (24 degrees C) for 5 s.
Quaternary ammonium compound, sodium hypochlorite, peroxyacetic acid, neutral electrolyzed water (NEW), and a combination of citric acid with sodium dodecylbenzene sulfonate (acidic formulation) were used as the chemical sanitizers. Tap water was used as a control. Results showed that at least 5-log reductions in both bacterial numbers were achieved for all sanitizers in both types of washers, except for the control. With mechanical dishwashing, the NEW and acidic formulation treatments reduced bacterial populations by
>6.9 and >6.0 log CFU per tableware item, respectively. With the manual operation, bacterial numbers were reduced by >5.4 and >6.0 log CFU per tableware item, respectively. This study revealed that NEW and the acidic formulation are as effective as the other chemical sanitizers for food contact surface sanitization in manual and mechanical ware washing.
PMID: 19610348 [PubMed - indexed for MEDLINE]
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16. Food Microbiol. 2009 Sep;26(6):629-37. doi: 10.1016/j.fm.2009.04.010. Epub 2009 May 7.

Smigic N 1 , Rajkovic A , Antal E , Medic H , Lipnicka B , Uyttendaele M , Devlieghere F .
Author information:

1 Laboratory of Food Microbiology and Food Preservation, Department of Food Safety and
Food Quality, Ghent University, Ghent, Belgium.
Abstract
The utilization of sub-lethal decontamination treatments gains more and more interest due to the increased consumers' demand for fresh, minimally processed and convenient food products. These products rely on cold chain and hurdle (combination) technology to provide microbiological safety and quality during their shelf life. To investigate the ability of surviving cells to resuscitate and grow in a food simulating environment, sub-lethal decontamination treatments were coupled with subsequent storage under sub-optimal growth conditions. For this purpose chlorine dioxide (ClO2) and neutralized electrolyzed oxidizing water (NEW)treated cultures of Escherichia coli O157:H7 were inoculated in TSB-YE of pH 5.8 and aw
0.99, and stored at 10 degrees C, 12.5 degrees C and 15 degrees C, under four different atmospheres (0%, 30% and 60% CO2 balanced with N2, and air). Due to the severity of injury, lactic acid-treated cells were inoculated in TSB-YE pH 7.0. Data obtained reveal that the fraction of sub-lethally injured E. coli O157:H7 undergoes an additional inhibitory effect during the storage period under of sub-optimal conditions. Observed extension in the lag growth phase was a direct consequence prior sub-lethal injury. The effects of liquid ClO2 and
NEW were less pronounced in comparison to lactic acid. The current study signifies the potential utilization of appropriate combination of different extrinsic and intrinsic factors in the elimination or growth inhibition of food-borne pathogens.
PMID: 19527839 [PubMed - indexed for MEDLINE]
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17. Hemodial Int. 2007 Jul;11(3):322-7.
Nakayama M 1 , Kabayama S , Terawaki H , Nakayama K , Kato K , Sato T , Ito S .
Author information:

1 Research Division of Dialysis and Chronic Kidney Disease, Tohoku University Graduate
School of Medicine, Sendai, Japan. mnakayama@mail.tains.tohoku.ac.jp

Abstract
Electrolyzed water (EW) generated on the cathode side reportedly displays anti-oxidative properties, and application of EW to hemodialysis (HD) systems supposedly suppresses oxidative markers in patients on HD. However, most of the chemical properties and biological effects of such solutions remain unclear. This study aimed to examine those issues to clarify the scientific background for the clinical use of EW solution. Reverse osmosis water comprising EW from the cathode side (e-RO) was prepared and used to process a test HD solution (e-HD). Chemical and biological properties of these solutions were compared with controls. Redox properties were examined by chemiluminescence (CL) of the luminol-
H(2)O(2) system. Biological effects of e-RO on human polymorphonuclear leukocytes (PMNs) were tested with respect to the cellular protection against methylglyoxal, and with respect to the preservation of cellular function as to radical generation. Control HD solution presented the highest CL, followed by e-HD, control RO, suggesting a lower oxidative capacity for EWbased solutions. Increased levels of dissolved hydrogen were characteristic of e-RO and e-
HD. Application of e-RO tended to be associated with less injury of PMNs by methylglyoxal, and with significantly higher levels of radical generation compared with the control. Compared with control HD, e-RO-based HD solution displays less-oxidative capacity in chemical terms, and may at least partly facilitate preservation of PMN viability. These results appear to offer a scientific basis for supporting the clinical challenge of applying this technology to HD treatment.
PMID: 17576297 [PubMed - indexed for MEDLINE]
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18. Kansenshogaku Zasshi. 2007 May;81(3):249-55.
[Article in Japanese]
Mori K 1 , Hayashi Y , Akiba T , Noguchi Y , Yoshida Y , Kai A , Yamada S , Sakai S , Hara M .
Author information:

1 Department of Microbiology, Tokyo Metropolitan Institute of Public Health.
Abstract
As a preventive action plan against gastroenteritis caused by the Norovirus (NV), we studied hand hygiene effects using with three hand rubbing products, four wet wipe products, and two

functional water types using Feline Calicivirus as a Norovirus surrogate. After treatment using antiseptic hand rubbing products containing chlorhexidine, quaternary ammonium, and povidone-iodine, high inactivation detected by TCID50 was observed compared to products containing povidone-iodine, although no difference was seen in viral removal measured by the amount of viral genome copies in real-time-PCR. Among wet wipes soaked in chlorhexidine, quaternary ammonium, benzoic acid and PHMB, two groups showed viral inactivation and removal. Two products were more effective for functional water, viral decrease was seen in rinsing in running electrolyzed acid water and handwashing by soap. Results underscore the importance of selection in hand washing metheds (alternative soap and also) in preventing viral gastroenteritis.
PMID: 17564112 [PubMed - indexed for MEDLINE]
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19. Curr Opin Infect Dis. 2005 Aug;18(4):326-30.
Nelson DB 1 .
Author information:

1 Minneapolis VA Medical Center, University of Minnesota, Minneapolis, Minnesota,
USA. douglas.nelson@med.va.gov
Abstract
PURPOSE OF REVIEW:
This article reviews recent publications relevant to endoscope reprocessing and the potential for transmission of infection during gastrointestinal endoscopy.
RECENT FINDINGS:
There have been a number of established reprocessing failures of gastrointestinal endoscopes at various healthcare facilities across the US resulting in patient notifications.
These episodes have been associated with user errors and reprocessing equipment failures, highlighting the need for increased compliance with established guidelines. Surveillance cultures may be useful to monitor the outcome of reprocessing, although their use is controversial. New technology to allow point-of-use monitoring is promising. Biofilm accumulation may be an issue when reprocessing gastrointestinal endoscopes. Although peracetic acid has been promoted as superior to aldehyde-type liquid chemical germicides with regard to soil fixation, it may only be a modest improvement. Electrolyzed acid water is an emerging liquid chemical germicide that may be equivalent to currently accepted disinfectants. There appears to be no benefit to an additional reprocessing cycle before use for endoscopes that have been appropriately cleaned, disinfected, and stored.

SUMMARY:
With the recent media attention on gastrointestinal endoscope reprocessing failures, despite the absence of documented transmission of infection, increased compliance with existing guidelines and new initiatives to enhance endoscope reprocessing are increasingly important to maintain public confidence.
PMID: 15985829 [PubMed - indexed for MEDLINE]
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20. Arq Gastroenterol. 2005 Jan-Mar;42(1):60-2. Epub 2005 Jun 22.
[Article in Portuguese]
Machado AP 1 , Fischman O , Geocze S .
Author information:

1 Departamento de Microbiologia, Immunologia e Parasitologia, Escola Paulista de
Medicina, Universidade Federal de São Paulo, São Paulo, SP.
Abstract
BACKGROUND:
The manual disinfection of endoscopes with glutharaldeyde is widely employed. The great routine in gastroenteroscopy services, low number of equipment and the lack of technical knowledge about the decontamination processes are factors that stimulate the inadequate endoscope disinfection, intensifying the risk of transmission of microorganisms. The electrolysed acid water has been effective in the inactivation and destruction of microorganisms.
AIM:
The purpose of this investigation was to verify the microbicidal efficiency of electrolyzed acid water (Cleantop WM-1) to decontaminate gastroscopes after their using in patients.
MATERIAL AND METHODS:
Samples from biopsy channel of flexible endoscopes collected after patient use (n = 20) and after disinfection (n = 20) were cultivated in tryptic soy agar, MacConkey agar and Sabouraud

dextrose agar.
RESULTS:
Seventeen of the 20 samples collected after patients examination yielded gram-negative bacilli, gram-positive coccus and yeast cells in contamination of 3 to 5 log10 ufc/mL. Microbial growth was not verified in samples collected after the decontamination process. Conclusion -
In this preliminary study, the mechanical disinfection carried through the Cleantop device with electrolyzed acid water showed satisfactory results for the elimination of microorganisms and time optimization in the reprocessing of gastroscopes.
Free Article
PMID: 15976913 [PubMed - indexed for MEDLINE]
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21. J Agric Food Chem. 2005 Jun 15;53(12):4906-10.
Stan SD 1 , Daeschel MA .
Author information:

1 Department of Food Science and Technology, Oregon State University, 100 Wiegand Hall,
Corvallis, Oregon 97331, USA.
Abstract
Electrolyzed oxidizing (EO) water has recently generated much interest as a disinfectant in the food industry. 5,5-Dimethyl-1-pyrroline-N-oxide (DMPO) is a spin trapping agent widely used in the electron spin resonance (ESR) characterization of oxygen-centered free radicals.
The reaction between electrolyzed water, collected from the anode side of a two-chamber electrolyzer, and DMPO was investigated by ESR spectroscopy. Addition of DMPO to EO water generated an ESR spectrum identical to that of 5,5-dimethyl-2-pyrrolidone-N-oxyl
(DMPOX), suggesting that a compound from EO water oxidized DMPO with the formation of
DMPOX. To further investigate the electrolytically generated compound that oxidized DMPO, aqueous solutions of different sodium salts (sodium chloride, sodium citrate, and sodium iodide) with similar conductivities were electrolyzed. The DMPOX signal was not detected in

the electrolyzed sodium citrate sample, suggesting that DMPOX formation in the electrolyzed
NaCl sample might be due to an electrolytically generated chlorine species. A low DMPOX signal was also observed from the electrolyzed NaI sample, suggesting that a similar species obtained through the electrolysis of I- can also oxidize DMPO. Hypochlorous acid is proposed to oxidize the spin trap DMPO with the formation of DMPOX. In a neutral pH environment, electrolyzed water also oxidized DMPO to DMPOX. This is consistent with the DMPOX formation in the reaction of chlorine water (containing HOCl and Cl2) or sodium hypochlorite with DMPO.
PMID: 15941334 [PubMed - indexed for MEDLINE]
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22. Kyobu Geka. 2004 Nov;57(12):1110-2.
[Article in Japanese]
Ichihara T 1 , Fujii G , Eda T , Sasaki M , Ueda Y .
Author information:

1 Department of Cardiovascular Surgery, Tosei General Hospital, Seto, Japan.
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infection after cardiac surgery has recently increased. We compared the anti-inflammatory effect of an electrolyzed strong acid solution and a warm saline solution in patients with open heart surgery. These solutions were used for mediastinal irrigation before closing the sternum. Group A patients were irrigated by a warm saline solution, and group B patients were irrigated by an electrolyzed strong acid solution, administration of this water is safe, feasible, and easy for the prevention of MRSA infection. Postoperative infection was significantly decreased in the group B as compared in the group A. An electrolyzed strong acid solution may be effective on postoperative infection, particularly MRSA infection following open heart surgery.
PMID: 15553026 [PubMed - indexed for MEDLINE]
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23. J Gastroenterol Hepatol. 2004 Aug;19(8):897-903.

Lee JH 1 , Rhee PL , Kim JH , Kim JJ , Paik SW , Rhee JC , Song JH , Yeom JS , Lee NY .
Author information:

1 Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of
Medicine, 50 Ilwon-Dong. Kangnam-Ku, Seoul 135-710, Korea.
Abstract
BACKGROUND AND AIM:
Two percent glutaraldehyde, the most widely used liquid chemical germicide (LCG), may be hazardous to patients and medical personnel. Alternatives to glutaraldehyde, such as electrolyzed acid water (EAW), are being developed, but data from well-controlled studies with patient-used endoscopes are rare. The purpose of the present paper was to evaluate the high-level disinfection capability of EAW and compare it with glutaraldehyde.
METHODS:
A random sample of 125 endoscopes was collected immediately after upper endoscopic examination. After careful manual cleaning, endoscopes were divided into a glutaraldehyde and EAW group. After the disinfection procedure, samples from working channel (S-1), insertion tube (S-2), umbilical cord (S-3), and angulation knob (S-4) were taken and cultured.
Another twenty endoscopes were experimentally contaminated with hepatitis B virus (HBV) and samples were collected after contamination (T-1), after manual cleaning (T-2), and after final disinfection (T-3). Polymerase chain reaction (PCR) for HBV-DNA was performed.
RESULTS:
In the EAW group, culture-positive rates were 3.2% in S-1, 9.5% in S-2, 3.2% in S-3, and
27.0% in the S-4 samples. There was no significant difference between the EAW and glutaraldehyde groups for all sampling sites. However, in both groups, disinfection of the angulation knobs (S-4) was less efficient than the others. For the T-1 site, HBV-DNA was detected from all of them, and in 95% (19/20) of T-2. However, HBV-DNA was not detected from T-3 samples.
CONCLUSIONS:

Electrolyzed acid water is as efficient as glutaraldehyde in eliminating bacteria from patientused endoscopes. After disinfection procedures using both methods, HBV-DNA was not detected from any endoscopes experimentally contaminated with HBV-positive mixed sera.
However, some bacteria may remain on the surface of the endoscopes. Therefore, more careful precleaning of the endoscopes may help achieve high-level disinfection in the clinical setting.
PMID: 15242493 [PubMed - indexed for MEDLINE]
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24. Artif Organs. 2004 Jun;28(6):590-2.
Vorobjeva NV 1 , Vorobjeva LI , Khodjaev EY .
Author information:

1 Department of Physiology of Microorganisms, Biology Faculty, Moscow State University,
Lenin Hills 1/12, Moscow 119992, Russia. nvvorobjeva@mail.ru
Abstract
The study is designed to investigate bactericidal actions of electrolyzed oxidizing water on hospital infections. Ten of the most common opportunistic pathogens are used for this study.
Cultures are inoculated in 4.5 mL of electrolyzed oxidizing (EO) water or 4.5 mL of sterile deionized water (control), and incubated for 0, 0.5, and 5 min at room temperature. At the exposure time of 30 s the EO water completely inactivates all of the bacterial strains, with the exception of vegetative cells and spores of bacilli which need 5 min to be killed. The results indicate that electrolyzed oxidizing water may be a useful disinfectant for hospital infections, but its clinical application has still to be evaluated.
PMID: 15153153 [PubMed - indexed for MEDLINE]
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25. J Microbiol Methods. 2004 May;57(2):163-73.

Nakajima N 1 , Nakano T , Harada F , Taniguchi H , Yokoyama I , Hirose J , Daikoku E , Sano K .
Author information:

1 Department of Microbiology, Osaka Medical College, 2-7 Daigaku-machi Takatsuki, Osaka
569-8686, Japan.
Abstract
Tap water is one of the causative factors of hospital infections. We examined the disinfective potential of electrolysis and mechanism of disinfection, and clarified the disinfective effect of electrolysis on tap water contaminated with bacteria, and discussed its clinical applications.
Tap waters artificially contaminated with Pseudomonas aeruginosa, Escherichia coli,
Legionella pneumophila, and Staphylococcus aureus could be sterilized by electrolysis at 20-
30 mA for 5 min. A high-density suspension (10(6) CFU/ml) of a spore forming bacterium,
Bacillus subtilis was not completely sterilized by electrolysis at 50 mA up to 30 min, but a lowdensity suspension (10(5) CFU/ml) was totally sterilized by electrolysis at 50 mA for 5 min.
Electrolyzed P. aeruginosa changed morphologically, that is, there was bleb formation on the cell wall and irregular aggregation of cytoplasmic small granules. Moreover, cytoplasmic enzyme, nitrate reductase, was inactivated by the electrolysis. On the other hand, genomic
DNA of the electrolyzed bacteria was not degenerated, therefore, their DNA polymerase activity was not completely inactivated. Consequently, the major agent in electrolysis for bactericidal action was considered to be free chlorine, and the possible bactericidal mechanism was by destruction of bacterial membranes, followed by the aggregation of peripheral cytoplasmic proteins. Electrolysis of tap water for both disinfecting contaminating bacteria and increasing the disinfectant capacity was considered effective with some limitations, particularly against high-density contamination by spore-forming bacteria. In clinical settings, electrolysis of tap water is considered effective to disinfect water for hand washing in operation theatres, and bathing water for immunocompromised hosts.
PMID: 15063056 [PubMed - indexed for MEDLINE]
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26. Dent Mater J. 2003 Dec;22(4):494-506.
Hiraguchi H 1 , Nakagawa H , Uchida H , Tanabe N .

Author information:

1 Laboratory of Dental Materials Research, Division of Biomaterials Science, Dental
Research Center, Nihon University School of Dentistry 1-8-13 kanda-Surugadai, Chiyoda-ku,
Tokyo 101-8310.
Abstract
This study investigated the effect of rinsing alginate impressions using acidic electrolyzed water on the dimensional change and deformation of stone models. Two brands of alginate impression materials were used. The impressions were rinsed using tap water or acidic electrolyzed water with a pH of 2.3, an oxidation-reduction potential of 1,230 mV, and a residual chlorine concentration of 45.0 ppm for 30 sec or 3 min. The sectional profiles of the stone models obtained from them were measured using a three-dimensional coordinate measuring system. For the same rinsing time, there was no significant difference in dimensional change between the two types of rinsing water. The change in shape from the master die was approximately the same for the stone models obtained from rinsed impressions using either water. The results suggest that the use of acidic electrolyzed water rather than tap water for rinsing is an acceptable treatment for alginate impressions.
Free Article
PMID: 15005227 [PubMed - indexed for MEDLINE]
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27. Kyobu Geka. 2003 Jul;56(7):597-601.
[Article in Japanese]
Hara H 1 , Ihara S , Ando H , Miyahara S , Ichiki K , Doki Y , Tsuda M , Usuda K , Misaki T .
Author information:

1 First Department of Surgery, School of Medicine, Toyama Medical and Pharmaceutical
University, Toyama, Japan.

Abstract
It has been known that treatments of post-pneumonectomy empyema are difficult. We report a successful case of irrigation for the post-pneumonectomy. The patient was 68-year-old man with advanced lung cancer. He underwent induction chemoradiotherapy following by pneumonectomy of the right side. A few days later after the chest drain was withdrawn, spike fever appeared. Empyema was suspected, so a 28 Fr diameter double lumen chest drain was intubated again. Turbid effusion was discharged through the drain, in which methicillinresistant staphylococcus aureus (MRSA) was cultured. Irrigation using a lot of saline and acid electrolyzed water started. A month later, irrigator through the drain was looking clear, however, MRSA was cultured so far. After putting minomycine into the irrigator, MRSA died away. This physical and chemical irrigations were effective.
PMID: 12854472 [PubMed - indexed for MEDLINE]
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28. Kansenshogaku Zasshi. 2003 May;77(5):316-22.
[Article in Japanese]
Iwasawa A 1 , Nakamura Y .
Author information:

1 Showa University Fujigaoka Hospital, Department of Clinical Pathology.
Abstract
Cytotoxic effect and guinea pig wound cure stage, pus fabrication presence in infected wound were compared with strong acidic electrolyzed water (AcEW) and povidone-iodine solution
(PVP-I), chlorhexidine (CHG) and benzalkonium chloride (BAC). It gave the following results:
In a cytotoxic test, the toxicity was recognized in 0.1%-0.01% PVP-I, in 0.0002-0.0004% CHG, in 10-0.1 micrograms/ml BAC, but there was no toxicity in AcEW. By a guinea pig wound cure process, no significance was recognized between each pharmaceutical agent in epidermal cell migration, but by an inflammation locus area, the significance was considerable in comparison with no-treatment. The pyopoiesis of P. aeruginosa infected wound was recognized in a ratio of 38.2% physiological saline, 27.3% CHG, 20.6% PVP-I and 12.1%
AcEW. When pollution locus includes an infection image of bacteria, while draining AcEW

PMID: 12806927 [PubMed - indexed for MEDLINE]
Similar articles instead of physiological saline, disinfection, indication was expected, and, as for the disorder in cure stage. I do not agree with that mentioned above. As for AcEW, availability by organism use was recognized for the cytotoxic effect of antiseptic instead of action of acceleration for wound cure.
29. Dent Mater J. 2002 Jun;21(2):93-104.
Nagamatsu Y 1 , Chen KK , Tajima K , Kakigawa H , Kozono Y .
Author information:

1 Department of Materials Science, Kyushu Dental College, Kokurakita, Kitakyushu, Japan.
Abstract
Electrolyzed strong and weak acid waters have been widely used for sterilization in clinical dentistry because of their excellent bactericidal activities. Electrolyzed neutral water was recently developed with a new concept of long-term good durability in addition to the excellent bactericidal activity similar to acid waters. The present study, evaluated the storage life of this water compared with the acid waters in terms of the changes in pH, oxidation-reduction potential (ORP), residual chlorine and bactericidal activity under several conditions using
Staphylococcus aureus 209P. The strong acid water showed a rapid deterioration of its bactericidal activity. The weak acid and neutral waters exhibited excellent durability. Although all the bacteria were annihilated by the contact with the waters even stored for 40 days in the uncapped bottle, the neutral water was superior in further long-term duration.
Free Article
PMID: 12238791 [PubMed - indexed for MEDLINE]
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30. J Microbiol Methods. 2002 May;49(3):285-93.

Kiura H 1 , Sano K , Morimatsu S , Nakano T , Morita C , Yamaguchi M , Maeda T , Katsuoka Y .
Author information:

1 Department of Microbiology, Osaka Medical College, Takatsuki, Osaka 569-8686, Japan.
Abstract
Electrolyzed strong acid water (ESW) containing free chlorine at various concentrations is becoming to be available in clinical settings as a disinfectant. ESW is prepared by electrolysis of a NaCl solution, and has a corrosive activity against medical instruments. Although lower concentrations of NaCl and free chlorine are desired to eliminate corrosion, the germicidal effect of ESW with low NaCl and free-chlorine concentrations (ESW-L) has not been fully clarified. In this study, we demonstrated that ESW-L possesses bactericidal activity against
Mycobacteria and spores of Bacillus subtilis. The effect was slightly weaker than that of ESW containing higher NaCl and free-chlorine concentrations (ESW-H), but acceptable as a disinfectant. To clarify the mechanism of the bactericidal activity, we investigated ESW-Ltreated Pseudomonas aeruginosa by transmission electron microscopy, a bacterial enzyme assay and restriction fragment length polymorphism pattern (RFLP) assay. Since the bacterium, whose growth was completely inhibited by ESW-L, revealed the inactivation of cytoplasmic enzyme, blebs and breaks in its outer membrane and remained complete RFLP of DNA, damage of the outer membrane and inactivation of cytoplasmic enzyme are the important determinants of the bactericidal activity.
PMID: 11869793 [PubMed - indexed for MEDLINE]
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31. Dent Mater J. 2001 Jun;20(2):148-55.
Nagamatsu Y 1 , Tajima K , Kakigawa H , Kozono Y .
Author information:

1 Department of Materials Science, Kyushu Dental College, Kokurakita, Kitakyushu, Japan.

Abstract
Bactericidal activities of electrolyzed strong and weak acid waters for acrylic denture base resin were evaluated in order to discuss the applicability of these waters for sterilization of denture base. Only 1-minute immersion in the electrolyzed strong or weak acid water could completely eliminate the attached bacteria, Staphylococcus aureus 209P, on the resin plate.
When the resin was relined with tissue conditioner, 5-minute immersion or 1- to 2-minute ultrasonic cleaning reduced the number of the bacteria from 10(5)/cm2 level to 10(1)/cm2 and no surviving bacteria could be detected after 10-minute treatment. These findings suggest that both the electrolyzed strong and weak acid waters are well applicable to the disinfectant for acrylic denture base showing excellent bactericidal activities in a significantly shorter treatment as compared with the conventional denture cleaning.
Free Article
PMID: 11523978 [PubMed - indexed for MEDLINE]
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32. Artif Organs. 2000 Dec;24(12):921-8.
Tanaka N 1 , Tanaka N , Fujisawa T , Daimon T , Fujiwara K , Yamamoto M , Abe T .
Author information:

1 Kiyokai Tanaka-Kitanoda Hospital, Sakai-shi, Osaka, Japan.
Abstract
Recently, the use of electrolyzed solutions has attracted considerable interest in Japan. This study investigates the efficiency of electrolyzed solutions as disinfecting agents (DA) in the reuse of dialyzers and compares their efficiency to that of other disinfectants currently in use.
The following 3 methods were employed. First, the rinsing time and rebound release of reused dialyzers were measured and compared after electrolyzed solutions, electrolyzed strong acid aqueous solution (ESAAS) and electrolyzed strong basic aqueous solution (ESBAS), made from reverse osmosis (RO) water (ESAAS, ESBAS; Generating apparatuses: Super Oxseed alpha 1000, Amano Corporation, Yokohama, Japan), 2% Dialox-cj (Teijin Gambro Medical,
Tokyo, Japan), and 3.8% formalin were used as DAs. This involved performing dialysis with 2 types of dialyzers: a cellulose acetate membrane (CAM) dialyzer and a polysulfone membrane (PSM) dialyzer. The dialyzers were cleaned and disinfected using the different DA and left for 48 h. Next, after performing dialysis the dialyzer membranes were cleaned with a saline solution (0.9% NaCl) and RO water and then cleaned with the various DA. These membranes were observed using a scanning electron microscope (SEM) to check for the presence of physical and biological contaminants. Finally, in vitro tests were performed to

determine the level of dialyzer clearance when PSM dialyzers were reused after having been cleaned and disinfected with the electrolyzed solutions. The rinsing time results for both the
CAM and PSM dialyzers showed the electrolyzed solutions (ESBAS and ESAAS) as being undetectable within 10 min. With regard to the rebound release, for both the CAM and PSM dialyzers, the electrolyzed solutions were undetectable at all checking times between 30 and
240 min. Observation by SEM showed that cleaning with both ESAAS and ESBAS left the fewest contaminants, and cleaning with 2% Dialox-cj left the highest level of contaminants in the CAM dialyzers. With regard to experiments concerning use in vitro, no major changes in the dialyzer clearance were noticed after 6 uses. In every experiment, the previous investigations showed the electrolyzed solutions to be superior to 3. 8% formalin and 2%
Dialox-cj DA for the reuse of dialyzers.
PMID: 11121970 [PubMed - indexed for MEDLINE]
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33. J Trauma. 2000 Sep;49(3):511-4.
Nakae H 1 , Inaba H .
Author information:

1 Department of Emergency and Critical Care Medicine, Akita University School of Medicine,
Japan.
Abstract
OBJECTIVE:
The purpose of the study was to determine whether electrolyzed oxidized water (EOW) functions as a bactericide in burn injury with Pseudomonas aeruginosa infection in a rat burnwound model.
METHODS:
Anesthetized Sprague-Dawley rats (n = 31) were subjected to third-degree burns to 30% of total body surface area. Two days after injury, all rats were infected with P. aeruginosa using
1 mL of a suspension containing 1 x 10(8) colony-forming units. Rats were assigned to one of three groups: no irrigation (group I), irrigation with physiologic saline (group II), or irrigation with EOW (group III). Blood culture, endotoxin levels, and survival rates were determined.
RESULTS:
Survival rate was significantly higher in group III than in groups I or II (p < 0.0001). Serum

endotoxin levels on day 3 after infection in group III were significantly lower than the levels in group I (p < 0.01) and group II (p < 0.01). There were significant differences between the three groups in the culture of P. aeruginosa (p < 0.05).
CONCLUSION:
Irrigation and disinfection with EOW may become useful in preventing burn-wound sepsis.
PMID: 11003331 [PubMed - indexed for MEDLINE]
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34. Kansenshogaku Zasshi. 1999 Oct;73(10):1025-31.
Okubo K 1 , Urakami H , Tamura A .
Author information:

1 Department of Pharmacy, Koseiren Murakami General Hospital, Murakami City, Japan.
Abstract
The cytotoxic effects of electrolyzed strong acid water and acidic hypochlorite solution, as well as these solutions after isotonization, against cultivated L cells were compared along with their microbicidal activities. Isotonization was accompanied by a reduction in the cytotoxic effects of these solutions against L cells. Microbicidal activity was also reduced somewhat but was still retained after isotonization. No difference was observed in these properties between these antiseptic solutions. The results obtained indicate that acidic hypochlorite solution may be useful as well as acidic electrolyzed water.
PMID: 10565117 [PubMed - indexed for MEDLINE]
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35. Kansenshogaku Zasshi. 1996 Sep;70(9):915-22.

[Article in Japanese]
Iwasawa A 1 , Nakamura Y .
Author information:

1 Department of Clinical Pathology, Showa University Fujigaoka Hospital, Kanagawa.
Abstract
Acidic electrolyzed water is made recently by various kinds of machines and is widely utilized.
In this study, we intended to clarify the relationship between the concentration of chloride and pH in the bactericidal effects with acidic electrolyzed water. The effects of weak or strong acidic electrolyzed water were compared with a pseudo-acidic water of pH adjusted by diluted hydrochloric acid and sodium hydroxide, on Staphylococcus aureus, Staphylococcus epidermidis and Pseudomononas aeruginosa. At pH 5.0 approximately 6.0, 3 bacterial strains were killed soon after being exposed to the acidic water containing chloride 50 mg/liter, and the amount of chloride did not change after allowing to stand open for 6 hours. At pH 2.67 approximately 2.80, the bactericidal effects was observed at the concentration of chloride 5 mg/liter, and 80% of chloride remained after allowing to stand for 6 hours. These results indicated that newly made strong acidic water is more effective under a smaller amount of chloride at pH 2.7, and that weak acidic electrolyzed water should be used, if stable bactericidal effect is expected in cleaning the surroundings.
PMID: 8921674 [PubMed - indexed for MEDLINE]