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PubMed2003

Do conventional cleaning and disinfection techniques avoid the risk of endoscopic Helicobacter pylori transmission?

BACKGROUND AND STUDY AIMS: The aim of the present study was to determine whether endoscopes serve as a reservoir for Helicobacter pylori and whether the disinfection technique currently recommended for manual cleaning and disinfection of the instruments completely removes the risk of H. pylori transmission. PATIENTS AND METHODS: A prospective study was carried out in 400 patients who were undergoing upper gastrointestinal endoscopy for routine clinical indications. The patients' H. pylori status of the patients was identified using a urea detection system (HUT) and culture. H. pylori contamination was assayed by culturing rinsing samples from the endoscopes before and after manual cleaning and disinfection. Gastric biopsies were assayed using rapid urease testing (Helicobacter urease test, HUT) of two antral and gastric body biopsies and cultures. RESULTS: A total of 128 of the 400 patients examined were found to be H. pylori-positive using HUT testing. Endoscopes were contaminated in 54 of the 128 rinsing samples from endoscopes used in H. pylori-positive patients (42 %) before cleaning and disinfection. One of the 128 rinsing samples (0.8 %) was found to be contaminated with H. pylori even after routine manual cleaning and disinfection - indicating that these cleaning and disinfection procedures may be insufficient to eradicate H. pylori from endoscopes completely. No seroconversion was observed during serological follow-up in the patient who had previously been examined with an endoscope contaminated with H. pylori. The patient was still found to be seronegative 5 months after inoculation. CONCLUSIONS: Endoscopes are frequently contaminated with H. pylori immediately after gastroduodenal endoscopy in H. pylori-infected patients. Iatrogenic transmission is possible, as H. pylori can survive manual cleaning and disinfection with 2 % glutaraldehyde, particularly when there is ineffective cleaning before disinfection.

Aged↗
PubMed1984

Comparing thermal and chemical disinfection systems for the etafilcon A 58% water content contact lens.

Several high water content lenses (greater than or equal to 55%) have been approved for either thermal or chemical disinfection. Thermal disinfection has been reported to be contraindicated for higher water content lenses, yet no studies have been performed to show this with a high water content daily or extended wear lens approved for thermal disinfection. A three-phase clinical study was initiated in which eight previously successful soft contact lens wearers were fitted with etafilcon A lenses. The subjects were placed on an approved thermal disinfection regimen for the lens on the right eye, and on an approved chemical disinfection regimen for the lens on the left eye. Results show that thermal disinfection of the etafilcon A lenses results in lens discoloration and reduced lens performance over a short period of time, as compared to the chemically disinfected lenses which showed no compromise in fit or any discoloration. Possible causes of the poor performance and appearance of the thermally disinfected lenses are discussed.

Adult↗
PubMed2005

Characterization of micro-organisms isolated from dairy industry after cleaning and fogging disinfection with alkyl amine and peracetic acid.

AIMS: To characterize micro-organisms isolated from Norwegian dairy production plants after cleaning and fogging disinfection with alkyl amine/peracetic acid and to indicate reasons for survival. METHODS AND RESULTS: Microbial samples were collected from five dairy plants after cleaning and fogging disinfection. Isolates from two of these production plants, which used fogging with alkylamino acetate (plant A), and peracetic acid (plant B), were chosen for further characterization. The sequence of the 16S ribosomal DNA, fatty acid analysis and biochemical characteristics were used to identify isolates. Three isolates identified as Rhodococcus erythropolis, Methylobacterium rhodesianum and Rhodotorula mucilaginosa were isolated from plant A and one Sphingomonas sp. and two M. extorquens from plant B. Different patterns of resistance to seven disinfectants in a bactericidal suspension test and variable degree of attachment to stainless steel were found. The strains with higher disinfectant resistance showed lower degree of attachment than susceptible strains. CONCLUSIONS: The study identifies and characterizes micro-organisms present after cleaning and fogging disinfection. Both surface attachment and resistance were shown as possible reasons for the presence of the isolates after cleaning and disinfection. SIGNIFICANCE AND IMPACT OF THE STUDY: These results contribute to the awareness of disinfectant resistance as well as attachment as mechanisms of survival in dairy industry. It also strengthens the argument of frequent alternation of disinfectants in the food processing industry to avoid the establishment of resistant house strains.

Amines↗
PubMed1988

Cleaning and disinfection of equipment for gastrointestinal flexible endoscopy: interim recommendations of a Working Party of the British Society of Gastroenterology.

1. All patients undergoing gastrointestinal endoscopy must be considered 'at risk' for HIV and appropriate cleaning/disinfection measures taken for endoscopes and accessories. 2. Thorough manual cleaning with detergent, of the instrument and its channels is the most important part of the cleaning/disinfection procedure. Without this, blood, mucus and organic material will prevent adequate penetration of disinfectant for inactivation of bacteria and viruses. 3. Aldehyde preparations (2% activated glutaraldehyde and related products) are the recommended first line antibacterial and antiviral disinfectant. A four minute soak is recommended as sufficient for inactivation of vegetative bacteria and viruses (including HIV and HBV). 4. Quaternary ammonium detergents (8% Dettox for two minutes for bacterial disinfection), followed by exposure of the endoscope shaft and channels to ethyl alcohol (70% for four minutes for viral inactivation), is an acceptable second-line disinfectant routine where staff sensitisation prevents the use of an aldehyde disinfectant. 5. Accessories, including mouthguards and cleaning brushes, require similarly careful cleaning/disinfection, before and after each use. Disposable products (especially injection needles) may be used and appropriate items can be sterilised by autoclaving and kept in sterile packs. 6. Closed circuit endoscope washing machines have advantages in maintaining standards and avoiding staff sensitisation to disinfectants. Improved ventilation including exhaust extraction facilities may be required. 7. Endoscopy staff should receive HBV vaccination, wear gloves and appropriate protective garments, cover wounds or abrasions and avoid needlestick injuries (including spiked forceps, etc). 8. Known HIV-infected or AIDS patients are managed as immunosuppressed, and require protection from atypical mycobacteria/cryptosporidia etc, by one hour aldehyde disinfection of endoscopic equipment before and after the procedure. A dedicated instrument is not required. 9. Increased funding is necessary for capital purchases of GI endoscopic equipment, including extra and immersible endoscopes with additional accessories to allow for safe practice. 10. Greater numbers of trained GI assistants are needed to ensure that cleaning/disinfection recommendations and safety precautions are followed, both during routine lists and emergency endoscopic procedures. 11. These recommendations are based on expert interpretation of current data on infectivity and disinfection; they may require future modification.

Acquired Immunodeficiency Syndrome↗
PubMed1979

Limits to progressive reduction of resident skin bacteria by disinfection.

Antiseptic preparations used repeatedly to disinfect the skin caused a reduction in yield of resident flora to a low equilibrium level beyond which further reduction did not occur. This equilibrium varied with the antiseptic preparation used. In a comparison of three preparations, the lowest equilibrium level was obtained with 95% ethyl alcohol. The further reduction in yield of skin bacteria on using alcohol after repeated disinfection with an antiseptic detergent preparation ('two-phase' disinfection) was not paralleled by a further reduction when the preparations used in the two phases were reversed, the antiseptic detergent being used after repeated disinfection with ethyl alcohol. 'Two-phase' disinfection was therefore seen to be due to further reduction in skin bacteria from the low equilibrium obtained with the antiseptic detergent to the lower level obtainable by alcohol disinfection. When repeated disinfection to equilibrium with alcohol was followed by a 'second-phase' handwash with a non-antiseptic detergent and water, there was a large increase in the yield of skin bacteria. This finding supports the view that a low equilibrium level occurs when the reduction in density of accessible bacteria through disinfection is balanced by the emergence of bacteria drawn from deeper layers of the skin.

Bacteria↗
PubMed1986

Products identified at an alternative disinfection pilot plant.

Many drinking water utilities have recently changed or are seriously considering changing their disinfection practice from chlorine to some alternative treatment process. However, most of these utilities are changing their disinfectants without evaluating chemical impacts. Therefore, a research cooperative agreement was developed with Jefferson Parish, LA, to evaluate four parallel streams treated with four different disinfectants (chlorine, monochloramine, chlorine dioxide, and ozone.) These streams, along with a fifth parallel stream, which was not treated with a disinfectant (control), were passed through both sand and granular activated carbon (GAC). Ozonation reduced the total organic carbon (TOC) and total organic halide (TOX) concentration by 0.3 mg/L and 10 micrograms/L, respectively. The average concentration of TOC for the other disinfectants was comparable to that associated with the nondisinfected stream (3.3 mg/L). The average instantaneous TOX concentration for chlorine dioxide, chloramine, and chlorine disinfection after 30 min contact time increased by 60, 92, and 238 micrograms/L, respectively, from a nondisinfected concentration of 25 micrograms/L. The volatile organics most affected by disinfection (chlorination) were the trihalomethanes. No significant change in concentration was noted after disinfection for the other volatile organics evaluated, such as 1,2-dichlorethane, dichloromethane, trichloroethylene, 1,1,2-trichloroethane, and carbon tetrachloride. Ozonation produced an average concentration reduction of 11 to 84% for most of the nonvolatiles evaluated. Conversely, a concentration increase of 43 to 100% was noted, after chlorination, for some of the nonvolatile organics.

Chloramines↗
PubMed2000

Disinfection and communication practices: a survey of U.S. dental laboratories.

BACKGROUND: The need to disinfect impressions is crucial to prevent the transmission of infectious diseases. The authors report the results of a survey of U.S. dental laboratory directors. The survey was designed to determine how well dental laboratory personnel are communicating with dentists regarding the disinfection of impressions, and, in turn, what laboratory technicians are doing to protect themselves against microbial cross-contamination. METHODS: Four hundred dental laboratory directors were selected in a blinded and random manner. To create a geographically representative sample, an equal number of laboratory directors from the East, Midwest and West were interviewed. A survey consisting of 16 open-ended questions was conducted by trained interviewers via 10- to 15-minute telephone interviews. All dental laboratory directors stated that they were thoroughly familiar with their laboratory's disinfection protocol. RESULTS: The survey documented that the majority of impressions were made of polyvinyl (57 percent) or polyether (27 percent) materials. Only 44 percent of the respondents stated that they knew if the impressions they received had been disinfected. Twenty-three percent of the laboratory directors did not know the method of disinfection used, and 47 percent did not know the length of time involved. Forty-five percent of the respondents reported that they receive inadequate instruction in regard to disinfection techniques. No one class of impression materials was found to be more problematic than others by the laboratory directors. CONCLUSIONS: The results indicate a significant and problematic lack of communication between these team members. The responses also suggested that laboratory-perceived problems with impressions were not linked to any particular type of material, but more to the disinfection technique used. PRACTICE IMPLICATIONS: Lack of communication between dentists, staff members and dental laboratory personnel, along with poor training of laboratory personnel in disinfection techniques, may have a direct effect on the prosthetic results achieved in dental practices.

Administrative Personnel↗
PubMed1995

Use of disinfectants in zoos and game parks.

Disinfection is used in the animal quarters of zoos and game parks as an adjunct to physical cleaning and the removal of potentially contaminated materials. Disinfection is particularly useful in reducing infection risks in young animal nursery facilities, and in routine cleaning operations of animal quarters and feeding utensils. Specific disinfectants may be selected for certain known microbial contaminants following an infectious disease outbreak. For example, premises contaminated by foot and mouth disease virus are usually disinfected with 2% sodium hydroxide (lye). The disinfectants most commonly used in zoo operations usually have a broad spectrum of microbicidal activities, such as o-phenylphenol salts, especially sodium o-phenylphenol. Equally popular for routine cleaning and sanitizing operations in zoos are quaternary ammonium compounds and chlorine bleach (sodium hypochlorite). It is important to remember that many disinfectants are protoplasmic poisons, or may be caustic or corrosive. Animals must usually be excluded from facilities being disinfected and premises should be rinsed thoroughly, after a suitable environmental exposure time to such disinfectants, before animals are allowed to return.

Animal Husbandry↗
PubMedDate not supplied

High-level microwave disinfection of dental gypsum casts.

PURPOSE: To test whether microwave oven irradiation can disinfect gypsum casts in compliance with current disinfection requirements, and to determine whether this procedure would be as effective as a validated method of chemical disinfection of impressions. MATERIALS AND METHODS: In 2 in vitro experiments, samples of 5 irreversible hydrocolloid impressions of a disinfected acrylic resin model were contaminated with suspensions of recommended test organisms Staphylococcus aureus and Pseudomonas aeruginosa, respectively. In 1 in vivo experiment, 10 impressions were made of 10 subjects. All impressions were poured and the resulting casts cut in 2 halves. One half of each cast was exposed to 5 minutes of irradiation in a microwave oven at 2,450 MHz and 900 W. The other halves were left untreated as controls. In a second in vivo experiment, 10 impressions were disinfected by immersion in a 0.07% solution of NaOCl at pH of about 10 for 3 minutes, and then poured. All casts were incubated aerobically in Bacto tryptic soy broth at 37 degrees C for 6 hours and assessed for bacterial growth by counting colony-forming units per milliliter (cfu/mL) of the culture. The results were analyzed using the Wilcoxon signed-rank test. RESULTS: Untreated gypsum casts showed cfu/mL counts with a median log value of 6, while microwave-irradiated ones had median cfu/mL counts of 0. Casts poured from chemically disinfected impressions demonstrated cfu/mL counts with a median log value of 4. CONCLUSION: Under the described conditions, microwave-irradiated gypsum casts satisfy current disinfection requirements, but gypsum casts poured from chemically disinfected impressions do not.

Alginates↗
PubMedDate not supplied

[Evaluation of the effectiveness of disinfectants used in several Neapolitan hospitals].

Among the various and complex aspects concerning the etiology of nosocomial infections, a relevant role is played by the indiscriminate and incorrect use of disinfectants: they may change paradoxically from devices used for nosocomial infection prevention into carriers of infections. Critical situations are: a) inadequate cleaning of the container; b) inaccurate concentrations set up; c) use of unsterilized water as a diluent; d) introduction of gauze or cotton flocks into the container; e) disinfectant contact with inactivating substances such as soaps, detergents, and organic substances; f) solution stability; etc.. Therefore, in the light of the experience we acquired in the field of nosocomial infections, we believed interesting to carry out a study in order to detect contamination of disinfectants used in various hospitals in Naples as well as their usage. In the period from January to May 1988, 243 disinfecting solutions routinely used in surgical departments of the 2nd School of Medicine and of three large neapolitan hospitals were tested for microbiological contamination. The analysis was carried out according to Kelsey and Maurer. 13 disinfectants were contaminated. The bacterial count exceeded the value of 5000 col/ml in 6 cases, while for he other disinfectants there were levels between 2500 and 4500 col/ml. 64% of the microorganisms isolated belonged to Pseudomonas spp. (cepacia, aeruginosa, fluorescens, maltophilia), while Acinetobacter calcoaceticus and Staphylococcus epidermidis were found in 21% and 15% of specimens respectively. A major consideration arising out from our study is the little attention played to health problems related to disinfection by hospital staff, together with a lack of knowledge about the proper way of using disinfectants.(ABSTRACT TRUNCATED AT 250 WORDS)

Disinfectants↗
PubMed1986

[Hand, skin and mucous membrane disinfection in medical and dental practice].

Disinfection of hands, skin or mucous membranes or the mere cleansing of hands have different functions, which should be differentiated clearly. With different cleansing methods dirt will be removed, whereas disinfection methods will eliminate microbial contamination or reduce the resident skin flora. Cleansing of hands removes only a very limited amount of microorganisms and cannot replace disinfection. Skin has to be disinfected when the integrity of the body is harmed. Depending on the tasks which are to be performed, sometimes an immediate onset of action and not a long duration of effect can be desirable. In other cases it is just the prolonged action, even with slow onset, that is required. Furthermore a long-lasting effect can be useful, when recontamination takes place later on. Skin disinfectants can be applied by spraying or swabbing. There are only limited data known over disinfection of mucous membranes and till now there exist no suitable test-methods. Experimental studies have shown no really convincing results, even though sometimes a sufficient disinfection could be seen in clinical practice. This is partly due to the bacteriostatic effect. The problematical nature of recontamination of mucous membranes is naturally very serious, but the adhesion of disinfectants due to the special conditions on mucous membranes usually rather bad. Which procedures have to be applied in particular cases has to be decided after weighting the risks against each other.

Disinfection↗
PubMed1987

[Thirty years of disinfection 1955-1985].

The article deals with disinfectants and disinfection during 1955-1985 and analyses the disinfectant lists no. 1-6 made up by the German Society for Hygiene and Microbiology. It is shown that changes in test methods may influence the composition of disinfectants. During the time taken in consideration a change from phenols/phenol derivatives as main active material in disinfectants to aldehydes took place. Main active materials in hand disinfectants are the alcohols ethanol, iso-propanol and n-propanol. Since 1974 (list no. 4) the number of products based on PVP-iodine for hand disinfectants increases. Strikingly quaternary ammonium compounds in detergent disinfectants increase as well as sole active material or in combination with aldehydes. This depends on the fact, that their acceptance is well because they are less smelling. On the other hand in combination with aldehydes they make it possible to reduce the amount of bad smelling aldehydes.

Disinfectants↗
PubMed1979

Effect of disinfectants with and without usage of detergent for the flexible fiberoptic bronchoscope.

The purpose of this study was to find a safer, more rapid and easier disinfection process for the flexible fiberoptic bronchoscope (F.F.B.) by using ordinary disinfectants and a detergent. Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aures, E. coli, Serratia marcescens and Candida albicans were used as sources of contamination. The mixed bacterial growth preparations for contamination of the F.F.B. were the same as those previously mentioned in our study. Comparative bacteriological studies, between glutaraldehyde (GA) ethylalcohol (AL) and chlorhexidine (CHX) with and without usage of benzalkonium chloride (B.C.) solution and sterile water (W) as the detergent were performed and the following conclusions were obtained: 1. Contaminating microorganisms were reduced from 10(-3)/ml to 10(-4)/ml colony count after flushing with W and B.C. This procedure is very helpful for consecutive rapid disinfections or sterilizations of the F.F.B. 2. The effect of disinfectants with usage of a detergent was much better than without a detergent. Required immersion time in the disinfectants with detergent was reduced to periods as short as 60 seconds. 3. Of the three disinfectants, the most effective was CHX, GA next, and AL third. 4. Unsatisfactory disinfection occurred in some instances when there were functional disorders with the F.F.B. despite adequate amounts of disinfectant and detergent.

Bronchoscopes↗
PubMedDate not supplied

Disinfection of impressions. Methods and effects on accuracy.

An understanding of the methods and mechanics of sterilization and disinfection is necessary to prevent bacterial cross-contamination. Since sterilization of impressions is not possible, because of the high temperature and time needed, disinfection is the method of choice. The most effective means of disinfecting impressions is to immerse them in disinfectant solution for 30 minutes. Most hydrophobic impression materials exhibit minimal distortion when disinfected in this manner. Irreversible hydrocolloid (alginate) and hydrophilic silicones distort when immersed and can be disinfected by spraying and placing in a sealed plastic bag for manufacturer's recommended time. Internal disinfection (replacing water with disinfectant before impression taking) is the method of choice for alginate, since it allows immediate pouring of the impression after removal from the oral cavity.

Aerosols↗
PubMed1998

Cleaning and disinfection of equipment for gastrointestinal endoscopy. Report of a Working Party of the British Society of Gastroenterology Endoscopy Committee.

Two per cent glutaraldehyde is the most commonly used disinfectant in endoscopy units within the UK. Unfortunately adverse reactions to glutaraldehyde are common among endoscopy personnel and the Health and Safety Commission has recommended substantial reductions in atmospheric levels of glutaraldehyde in order to comply with the Control of Substances Hazardous to Health Regulations, 1994. The Working Party addressed ways of eliminating or minimising exposure to glutaraldehyde in endoscopy units by reviewing alternative disinfectants and the use of automated washer/disinfectors. Alternatives to glutaraldehyde must be at least as microbicidal as glutaraldehyde, non-irritating and compatible with endoscope components and decontamination equipment. Peracetic acid is a highly effective disinfectant and may be a suitable alternative to glutaraldehyde. Peracetic acid has a vinegary-like odour and is claimed to be less irritating than glutaraldehyde. Experience with this agent remains relatively limited and the Working Party recommends that peracetic acid should be used in sealed or exhaust ventilated facilities until further experience is obtained. It is considerably more expensive than glutaraldehyde, is less stable and large volumes have to be stored. It causes cosmetic (but not functional) damage to endoscopes and is not compatible with some washer/ disinfectors. Chlorine dioxide is a powerful oxidising agent and highly effective as a disinfectant. Once activated it must be stored in sealed containers with little head space. Fumes cause irritation and sealed or exhaust ventilated facilities are necessary. The agent may damage some metallic and polymer components of endoscopes and automated washer/disinfectors and compatibility should be established with equipment manufacturers before the agent is used. Other disinfectants such as peroxygen compounds and quaternary ammonium derivatives are less suitable because of unsatisfactory mycobactericidal and/or virucidal activity, or incompatibility with endoscopes and automated washer/disinfectors. Alcohol is effective but, on prolonged contact, is damaging to lens cements. It is also flammable and therefore unsuitable for use in large quantities in automated systems. Superoxidised water (Sterilox) is an electrochemical solution (anolyte) containing a mixture of radicals with strong oxidising properties. It is highly microbicidal when freshly generated, provided items are thoroughly clean and strict generation criteria are met--that is, current, pH, redox potential. It seems to be safe for users and provided field trials substantiate laboratory efficacy tests, and the agent is non-damaging, it too may become an alternative to glutaraldehyde. When 2% glutaraldehyde is used for manual and automated disinfection, 10 minutes' immersion is recommended for endoscopes before the session and between patients. This will destroy vegetative bacteria and viruses (including hepatitis B virus (HBV) and HIV). A five minute contact period is recommended for 0.35% peracetic acid and for chlorine dioxide (1100 ppm av ClO2), but if immersed for 10 minutes sporicidal activity will also be achieved. At the end of each session 20 minutes' immersion in glutaraldehyde or five minutes in peracetic acid or chlorine dioxide is recommended. Microbiological studies show that 20 minutes of exposure to 2% glutaraldehyde destroys most organisms, including Mycobacterium tuberculosis. The Working Party concludes therefore that immersion of the endoscope in 2% glutaraldehyde for 20 minutes is sufficient for endoscopy involving patients with AIDS and other immunodeficiency states or pulmonary tuberculosis. Similarly, 20 minutes' immersion is recommended at the start of the list and between cases for endoscopic retrograde cholangiopancreatography (ERCP) when high level disinfection is required. Cleaning and disinfection of endoscopes should be undertaken by trained staff in a dedicated room. Thorough cleaning with detergent

Disinfectants↗
PubMed2005

Vaginal disinfection for preventing mother-to-child transmission of HIV infection.

BACKGROUND: Mother-to-child transmission (MTCT) of HIV infection is one of the most tragic consequences of the HIV epidemic, especially in resource-limited countries, resulting in about 650 000 new paediatric HIV infections each year worldwide. The paediatric HIV epidemic threatens to seriously undermine decade-old child survival programmes. OBJECTIVES: To estimate the effect of vaginal disinfection on the risk of MTCT of HIV and infant and maternal mortality and morbidity, as well as tolerability of vaginal disinfection in HIV-infected women. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, Cochrane Pregnancy and Childbirth Register, PubMed, EMBASE, AIDSLINE, LILACS, AIDSTRIALS, and AIDSDRUGS, using standardised methodological filters for identifying trials. We also searched reference lists of identified articles, relevant editorials, expert opinions and letters to journal editors, and abstracts and proceedings of relevant conferences, and contacted subject experts and pharmaceutical companies. There were no language restrictions. SELECTION CRITERIA: Randomised trials or clinical trials comparing vaginal disinfection during labour with placebo or no treatment, in known HIV-infected pregnant women. Trials had to include an estimate of the effect of vaginal disinfection on MTCT of HIV and or infant and maternal mortality and morbidity. DATA COLLECTION AND ANALYSIS: Three authors independently assessed trial eligibility and quality, and extracted data. Meta-analysis was performed using the Yusuf-Peto modification of Mantel-Haenszel's fixed effect method. MAIN RESULTS: Only two trials that included 708 patients met the inclusion criteria. The effect of vaginal disinfection on the risk of MTCT of HIV (OR 0.93, 95% CI 0.65 to 1.33), neonatal death (OR 1.38, 95% CI 0.30 to 6.33), and death after the neonatal period (OR 1.45, 95% CI 0.47 to 4.45) is uncertain. There was no evidence that vaginal disinfection increased adverse effects in mothers (OR 1.15, 95% CI 0.41 to 3.22), and evidence from one trial showed that adverse effects decreased in neonates (OR 0.14, 95% CI 0.07 to 0.31). AUTHORS' CONCLUSIONS: Currently, there is no evidence of an effect of vaginal disinfection on the risk of MTCT of HIV. Given its simplicity and low cost, there is need for a large well-designed and well-conducted randomised controlled trial to assess the additive effect of vaginal disinfection on the risk of MTCT of HIV in antiretroviral treated women.

Disinfection↗
PubMed2006

Virucidal activity of a quaternary ammonium compound disinfectant against feline calicivirus: a surrogate for norovirus.

BACKGROUND: Norovirus, formerly known as Norwalk virus, is an important cause of gastroenteritis outbreaks in hospitals, food services, schools, and cruise ships. Infection control practices by using disinfectants to eliminate noroviruses from surfaces and environmental samples reduce the morbidity and spread of virus outbreaks. There are not many commercial disinfectants effective against norovirus. Noroviruses cannot be cultivated in vitro. However, feline calicivirus can be used as a surrogate to determine disinfectant efficacy against noroviruses. Feline calicivirus was used in a virucidal effectiveness test protocol as a surrogate for norovirus to determine the virucidal efficacy of R-82, a quaternary ammonium compound disinfectant cleaner. METHODS: Feline calicivirus suspensions containing at least 5% fetal bovine serum were dried on carriers and treated with 1:256 dilutions of R-82 disinfectant in water, with a hardness of 400 ppm as calcium carbonate, for 10 minutes. Hypochlorite concentrations of 100 +/- 10 and 1,000 +/- 10 ppm, respectively, were also analyzed as internal control standards. After contact period, the test agents were neutralized with 2 mL of appropriate neutralizer, and mixtures were scraped from carrier surfaces with a cell scraper. Selected dilutions of the neutralized inoculum/test agent mixtures were added to cultured cell monolayers of appropriate host cells. Postincubation, the infectious feline calicivirus was scored microscopically by observing virus-specific cytopathic effects produced by replicating infectious virus. The performance criterion was a minimum of 4-log(10) reduction in cytopathic effects of feline calicivirus. RESULTS: After a 10-minute contact time, formulation R-82 diluted 1:256 showed a 6.6- and 6.4-log(10) reductions in cytopathic effects of feline calicivirus during initial and confirmatory testing, respectively, demonstrating complete inactivation of the virus. A hypochlorite solution of 1,000 ppm exhibited similar log(10) reductions to the quaternary ammonium disinfectant, demonstrating the reproducibility of the protocol. CONCLUSION: Formulation R-82, a quaternary ammonium compound, is a 1-step disinfectant cleaner, which exhibited virucidal activity against feline calicivirus suspensions dried on hard surface carriers. Surfaces are vectors for virus transmission during outbreaks by transferring the virus to people or other environmental surfaces. Therefore, treatment of contaminated surfaces with formulation R-82 will optimize disinfection of noncritical and critical surfaces in health care institutions, reducing the possibility of virus transmission during outbreaks.

Animals↗
PubMed2005

Effect of microwave disinfection on the flexural strength of hard chairside reline resins.

OBJECTIVES: This study investigated the effect of microwave disinfection (650W/6 min) on the flexural strength of five hard chairside reline resins (Kooliner, Duraliner II, Tokuso Rebase Fast, Ufi Gel Hard, New Truliner) and one denture base resin (Lucitone 550). METHODS: Thirty-two specimens (3.3x10x64 mm) from each acrylic resin were produced and divided into four groups of eight specimens each. The flexural test was performed after polymerization (G1), after two cycles of microwave disinfection (G2), after 7 days storage in water at 37 degrees C (G3) and after seven cycles of microwave disinfection (G4). Specimens from group G4 were microwaved daily being stored in water at 37 degrees C between exposures. The specimens were placed in three-point bend fixture in a MTS machine and loaded until failure. The flexural values (MPa) were submitted to ANOVA and Tukey's test (p=0.05). RESULTS: Two cycles of microwave disinfection promoted a significant increase in flexural strength for materials Kooliner and Lucitone 550. After seven cycles of microwave disinfection, materials Kooliner and New Truliner showed a significant increase (p<0.05) in flexural values. The flexural strength of the material Tokuso Rebase was not significantly affected by microwave irradiation. Seven cycles of microwave disinfection resulted in a significant decrease in the flexural strength of material Duraliner II. Material Ufi Gel Hard was the only resin detrimentally affected by microwave disinfection after two and seven cycles. CONCLUSIONS: Microwave disinfection did not adversely affect the flexural strength of all tested materials with the exception of material Ufi Gel Hard.

Acrylic Resins↗