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PubMed1999

Antibacterial and antifungal effects of soft contact lens disinfection solutions.

AIMS: To study the antibacterial and antifungal effects of soft contact lens disinfection solutions. METHODS: Eight contact lens disinfection solutions containing hydrogen peroxide or biguanides or polyquad compounds were evaluated with respect to their ability to disinfect a saline solution experimentally contaminated with different bacteria and with a fungus. We used cultures in blood Agar, MuellerHinton agar and Saboureaud's agar to identify the bacterial and fungal growth following 14 h of exposure to the disinfection solutions. RESULTS: Hydrogen peroxide, DYMED and polyhexamide solutions prevented the growth of the four bacteria studied. The solution containing biguanide prevented the growth of Escherichia coli and Staphylococcus epidermidis. The solution with polyquad solution only prevented the growth of Staphylococcus epidermidis and none of the disinfection solutions prevented the growth of Candida albicans. The control solution, which was saline, did not prevent the growth of either bacteria or fungi. CONCLUSIONS: Disinfection solutions containing hydrogen peroxide, or DYMED or polyhexamide can disinfect these four bacteria but none of them prevented the growth of Candida albicans.

Journal Article↗
PubMed2000

Enterobacter cloacae outbreak in the NICU related to disinfected thermometers.

In the first week ot December 1997, an increasing incidence of neonates colonized with multi-drug resistant Enterobacter cloacae (MR-E. cloacae) was observed in the neonatal Intensive care unit of our 950-bed university hospital. Initially, re-enforcement of infection control practices including hand disinfection and cohort isolation seemed to be sufficient to control the outbreak. Nevertheless, an increasing number of newly admitted patients was paralleled by another rise in the incidence of colonized neonates. Since E. cloacae was initially found in urine specimens of the patients, surveillance and environmental cultures were aimed at procedures and instruments that might colonize the gastro-intestinal and/or urinary tract. E, cloacae was isolated from a single cap of an electronic digital thermometer. Despite banning of this possible source, newly admitted neonates still became colonized. The unit was closed for further admissions and a second round of extensive screening was started; this time including all available thermometers and continuous rectal temperature probes. Ready-to-use 'disinfected thermometers and probes were found to be colonized with MR-E. cloacae. Observation of disinfection procedures and a laboratory investigation revealed that 'rushed disinfection with alcohol 80% led to a 1 in 10 chance of thermometers still being contaminated. Furthermore, alcoholic hand rub used for convenience disinfection failed to disinfect thermometers in 40% and 20% of the cases when done in a 'rushed' or 'careful' fashion, respectively. Adequate disinfection of the thermometers led to the control of the outbreak, with no new occurrence of MR-E. cloacae in the following months.

Cross Infection↗
PubMed1998

Does Acanthamoeba protect Pseudomonas aeruginosa from the bactericidal effects of contact lens disinfecting systems?

PURPOSE: The aim of this study was to test the hypothesis that Pseudomonas aeruginosa that have been internalized in Acanthamoeba are protected against the action of contact lens disinfecting solutions. METHODS: The experiments were divided into two parts. First, five commercially available disinfecting solutions, hydrogen peroxide and non-peroxide based, were tested for their efficacy against four strains of P. aeruginosa and one strain of A. castellanii. Cells were inoculated into working concentrations of disinfecting solutions, incubated for 18 h and the numbers of viable bacteria or amoeba were analysed after appropriate growth on agar plates. Second, two strains of P. aeruginosa were allowed to interact with A. castellanii for 4 h prior to addition to disinfecting solutions. The numbers of P. aeruginosa after incubation with the disinfecting solutions were measured after growth on agar plates. RESULTS: In general, disinfecting solutions containing hydrogen peroxide were most effective against the micro-organisms. Solutions containing only traces of polyaminopropyl biguanide were least effective. CONCLUSIONS: For strains of P. aeruginosa, the presence of the amoebae did not protect the bacteria against the disinfecting agents. The amoeba appeared to kill the bacteria, perhaps using them as a food source.

Acanthamoeba↗
PubMed1999

One stage full- versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset periodontitis. II. Long-term impact on microbial load.

BACKGROUND: Recent studies showed the clinical benefits of a one stage full-mouth disinfection, when compared to the worldwide standard treatment strategy of consecutive root planings per quadrant without proper disinfection of the remaining intraoral niches. The purpose of this study was to investigate the microbiological benefits of such a one stage full-mouth disinfection with special attention to all intraoral niches for periodontopathogens and to evaluate the perception by the patients of the new treatment strategy. METHODS: Sixteen patients with early-onset periodontitis and 24 patients with severe adult periodontitis were randomly assigned to test and control groups. The control group was scaled and root planed, per quadrant, at 2-week intervals and given oral hygiene instructions. The test group received the one stage full-mouth disinfection treatment. At baseline and after 1, 2, 4, and 8 months, microbiological samples were taken from all niches (tongue, mucosa, saliva, and pooled samples from single- and multi-rooted teeth). The samples were cultured on selective and non-selective media. Patient perception of the treatment was evaluated using a questionnaire. RESULTS: In comparison to the standard therapy, the one stage full-mouth disinfection resulted in significant additional microbial improvements. The test group showed larger reductions in the proportions of spirochetes and motile organisms in the subgingival flora, and more significant reductions in the density of key pathogens, with even the eradication of P. gingivalis. The beneficial effects in the other niches were primarily restricted to the number of colony-forming units/ml of black-pigmented bacteria, especially on the mucosa and in the saliva and to a lesser extent on the tongue. Both treatments were well tolerated by the patients and the overall severity rating for both therapies was comparable, although 4 quadrants were treated within 24 hours in the test group versus only 1 in the control group. The full-mouth disinfection approach resulted more frequently in a slight increase of body temperature, especially after the second day. CONCLUSIONS: These findings support the benefit of a one stage full-mouth disinfection in the treatment of patients with either chronic adult or early-onset periodontitis.

Adult↗
PubMed2004

Efficacy of full-mouth disinfection vs quadrant root planing.

This article addresses the capability of full-mouth disinfection, full-mouth root planing, and partial-mouth disinfection to improve periodontal health. A basic premise of full-mouth therapy (full-mouth disinfection or full-mouth root planing) is to eradicate or diminish bacterial reservoirs in the mouth that could impede optimal healing or initiate periodontal disease or disease progression. Several investigations conducted at one university indicated that full-mouth disinfection and full-mouth root planing achieved greater therapeutic improvements compared with partial-mouth disinfection regarding decreased probing depths, gained clinical attachment, diminished bleeding from probing, and reduced subgingival microflora. In contrast, other studies from 2 treatment centers demonstrated that there were no statistically significant differences when the effectiveness of quadrant-by-quadrant root planing was compared with full-mouth root planing and full-mouth disinfection regarding probing depth reduction, gains of clinical attachment, and impact on the magnitude and quality of the immune response. Theoretically, full-mouth therapy could decrease the number of patent visits and allow more efficient use of treatment time. Furthermore, no major adverse reactions to full-mouth root planing with or without adjunctive chemotherapy are evident. Nevertheless, small study populations and noncorroborating data from different treatment centers indicate that more clinical trials are required to determine whether full-mouth therapy provides clinically relevant improvements compared with partial-mouth disinfection.

Anti-Infective Agents, Local↗
PubMedDate not supplied

[Current requirements of sterilization and disinfection of endoscopic materials].

Bacterial and viral infectious risks related to gynecologic endoscopy and laparoscopy are a significant problem. Contamination between patients or by environmental bacteria can occur when sterilisation or disinfection procedures are inadequate. Endoscope steam sterilisation is the safest method and have to be employed whenever possible. For heat labile materials, disinfection procedure will comply with the recommendations stated in a recent ministerial decision, including a cleaning step with a non aldehydic detergent-disinfectant and a disinfection step with 2% glutaraldehyde. Rooms and equipment dedicated to disinfection have to be well adapted to this use and specific staff training must be achieved. Endoscope automatic washer disinfections are an alternative method to manual disinfection but they have to meet precise criteria to insure safety and efficacy.

Cross Infection↗
PubMed1985

Disinfection of gastrointestinal fibrescopes: an evaluation of the Pauldrach Endocleaner, and various chemical agents.

The Pauldrach Endocleaner was evaluated for the disinfection of gastrointestinal fibrescopes, and found to be a convenient, relatively inexpensive machine for use in endoscopy clinics. An experimental procedure was designed, for use with the endocleaner, which allowed application of an inoculum of Pseudomonas aeruginosa to a Fujinon OX52 endoscope and its subsequent quantitation before and after disinfection procedures. Using aldehyde based disinfectants ('Cidex', 'Kohrsolin' and 'Gigasept') it was possible to achieve a 99.999% reduction in the recovery of viable Ps. aeruginosa with a minimum exposure time of 20 min 'Dettox ABC' and buffered hypochlorite (100 ppm) were less effective achieving an approximately 99% reduction with a minimum exposure time of 30 min. Following apparently adequate disinfection and irrespective of the disinfectant used, the endoscope was found to be heavily contaminated with Ps. aeruginosa when examined after overnight storage at room temperature thus emphasising the need for meticulous disinfection of instruments prior to use in a day's list.

Disinfectants↗
PubMed2006

Screening and estimating of toxicity formation with photobacterium bioassay during chlorine disinfection of wastewater.

Reclamation and reuse of wastewater is one of the most effective ways to alleviate water shortage. Disinfection plays a key role in killing the harmful pathogens in reclaimed water, while an unwanted side effect is the formation of disinfection by-products (DBPs). Recently, a number of researches have been conducted on the formation regularities of certain DBPs. However, with current physiochemical techniques, it is impossible to detect all the DBPs. In this study, photobacterium bioassay was used to measure the formation of DBPs and their toxic effect as a whole. The effects of water quality characteristics and operational conditions on the toxicity formation during wastewater chlorination disinfection process were evaluated. A statistical model, depending on chlorine disinfectant dosage, concentration of ammonia nitrogen, and concentration of dissolved organic carbon, was developed to quantitatively estimate the toxicity formation during the disinfection process. It was found that the toxicity of the wastewater samples was positively correlated with chlorine disinfectant dosage, concentration of dissolved organic carbon and UV absorbance at 254nm, while negatively correlated with concentration of ammonia nitrogen.

Biological Assay↗
PubMed2004

Household cleaning and surface disinfection: new insights and strategies.

Recently, new insights into the persistence of pathogens, their transfer from inanimate surfaces to humans and the risk of contamination and dissemination of pathogens by detergents have been gained. Furthermore, new experimental data on the interruption of chains of infection by disinfectants as well as results of outbreak-control studies are now available. Hence it has become necessary to reassess the potential benefits using disinfectants to prevent and control nosocomial infections. Based on the new findings and in view of the increasing incidence of nosocomial infections and antibiotic resistances, the German Robert-Koch-Institut has issued completely revised recommendations on Household Cleaning and Surface Disinfection. With respect to these recommendations we developed a new test method, which allows comparison of the efficacy of disinfection in reducing the microbial loads and their dissemination with that of cleaning procedures under practical conditions. In a multi-factor approach, mechanical properties (wet mop technique), utensils (different mop materials) and active agents (disinfectant, detergent) were taken into consideration. We found that under the given conditions, dissemination of the test organism Staphylococcus aureus did not take place when using aldehydes and peroxides, it did take place, however, when water, surfactants, and the disinfectants glycol derivatives, quaternary ammonium compounds and alkylamines were used.

Colony Count, Microbial↗
PubMed2005

Considering risks to healthcare workers from glutaraldehyde alternatives in high-level disinfection.

Due to concerns over glutaraldehyde's toxicity, two substitutes have recently been introduced; ortho-phthalaldehyde (OPA), and a mixture of hydrogen peroxide and peracetic acid. There is limited information about the health effects for employees from these products. This study assesses the current practices regarding the use of high-level disinfectants in British Columbian hospitals and predicts the relative toxicities of each product. Industry practices were compiled using a comprehensive survey of current practices and decision processes in all hospitals in British Columbia. Of 95 hospitals, 64 returned surveys; 80% of these used high-level disinfection. Among user hospitals, 49% used glutaraldehyde alone and 51% had introduced alternatives. Concern about staff health was the most common reason for substituting, but this was frequently not considered when choosing specific alternatives. Hospitals that involved occupational health, infection control or regional staff in high-level disinfectant decisions used glutaraldehyde alternatives less often. In most hospitals, it was difficult to find individuals who were knowledgeable about the use of disinfectants. Potential health effects associated with each type of high-level disinfectant were assessed by review of the published literature and available manufacturers' data along with qualitative structure-activity relationship analysis. Results indicated that although all products irritate the skin and respiratory tract, OPA is a potential dermal and respiratory sensitizer but hydrogen peroxide and peracetic acid do not cause allergic reactions. Despite little being known about the risks to employees from glutaraldehyde alternatives, their use is widespread. The potential risks of all high-level disinfectants are serious; thus regulators and users are faced with important risk management decisions before and after they have been introduced into the workplace.

British Columbia↗
PubMed2004

Evaluation of disinfective potential of reactivated free chlorine in pooled tap water by electrolysis.

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.

Bacillus subtilis↗
PubMed2001

Does hand care ruin hand disinfection?

Hand washing and hand disinfection put considerable stress on the skin thus requiring specific hand care. It is important however that the care products do not impair the effect of hand disinfectants. We therefore investigated the interaction of two hand care products (oil-in-water and water-in-oil emulsions) on the microbicidal efficacy of different alcoholic hand-rubs, using the contamination model described in EN 1500. The mean log10-reduction factors for three hand-rubs varied between 4.03 and 4.22 compared with 3.76 and 4.43 for six possible combinations of hand-rubs and hand care products applied immediately prior to disinfection. Differences between reduction factors achieved with hand-rubs alone and in combination with hand care were not significant. Repeated application of care products with subsequent hand disinfection also did not result in significantly lower reduction factors than achieved with hand disinfection alone. Our data suggest that administration of selected products for hand care does not necessarily impair hand disinfection and is therefore recommended for occupational health as well as for infection control reasons.

1-Propanol↗
PubMed1989

Chemical disinfection of non-porous inanimate surfaces experimentally contaminated with four human pathogenic viruses.

The chemical disinfection of virus-contaminated non-porous inanimate surfaces was investigated using coxsackievirus B3, adenovirus type 5, parainfluenza virus type 3 and coronavirus 229E as representatives of important nosocomial viral pathogens. A 10 microliter amount of the test virus, suspended in either faeces or mucin, was placed onto each stainless steel disk (about 1 cm in diameter) and the inoculum allowed to dry for 1 h under ambient conditions. Sixteen disinfectant formulations were selected for this study based on the findings of an earlier investigation with a human rotavirus. After 1 min exposure to 20 microliters of the disinfectant, the virus from the disks was immediately eluted into tryptose phosphate broth and plaque assayed. Using an efficacy criterion of a 3 log10 or greater reduction in virus infectivity titre and irrespective of the virus suspending medium, only the following five disinfectants proved to be effective against all the four viruses tested: (1) 2% glutaraldehyde normally used as an instrument soak, (2) a strongly alkaline mixture of 0.5% sodium o-benzyl-p-chlorophenate and 0.6% sodium lauryl sulphate, generally used as a domestic disinfectant cleaner for hard surfaces, (3) a 0.04% solution of a quaternary ammonium compound containing 7% hydrochloric acid, which is the basis of many toilet bowl cleaners, (4) chloramine T at a minimum free chlorine level of 3000 p.p.m. and (5) sodium hypochlorite at a minimum free chlorine concentration of 5000 p.p.m. Of those chemicals suitable for use as topical antiseptics, 70% ethanol alone or products containing at least 70% ethanol were ineffective only against coxsackievirus B3. These results emphasize the care needed in selecting chemical disinfectants for routine use in infection control.

Alloys↗
PubMed2006

Secondary effluent disinfection: PAA long term efficiency.

The paper summarizes the results of a bench-scale study to evaluate the long-term disinfection efficiency of peracetic acid (PAA). Bacterial counts were repeated 5, 24, and 29 h after the end of the disinfection test, to simulate real re-growth conditions (no residual quenching) and, for the 5 h interval, the potential re-growth (quenching of residual PAA). Fecal coliforms, Escherichia coli, and total heterotrophic bacteria (THB) were enumerated by traditional plate count technique; THB were also enumerated by cytometry. After disinfection, the residual PAA concentration became negligible in about 5 to 11 h, depending on the tested doses. Microbial counts showed that no appreciable re-growth took place after 29 h for coliform group bacteria. For THB, the previously cited enumeration techniques gave different results in re-growth tests, especially for the lowest PAA doses. Indeed plate count technique evaluates the ability to form colonies, while cytometry enumerates intact membrane cells. No regrowth took place, even when no residual disinfectant was present, suggesting that bacteria are unable, even at the lowest doses, to repair damage caused by the PAA disinfecting action. PAA was found to be an efficient disinfecting agent, not only as a bacteriostatic, but also as a bactericide.

Bacteria↗
PubMed2001

Disinfection of wooden structures contaminated with Paenibacillus larvae subsp. larvae spores.

AIMS: The aim of the study is to examine the disinfection of wood contaminated with Paenibacillus larvae subsp. larvae spores, in order to find a practical decontamination method for hive materials. METHODS AND RESULTS: The number of viable spores recovered after the treatment, on the surface by swabbing, and in the deeper parts of the wood by scraping, was used to test the efficiency of the disinfection. Our results indicate that chemical disinfection is only complete when high concentrations (> 50%) of the disinfectant are used. Heat treatment in general was found to be very effective. The scorching of wood was not satisfactory as it only killed spores at the surface. CONCLUSION: Complete disinfection is only possible with some heat treatments or by using high concentrations of chemical disinfectants. SIGNIFICANCE AND IMPACT OF THE STUDY: This study puts forward some methods that can provide complete decontamination, which is necessary for an effective control of American foulbrood disease.

Animals↗
PubMed1999

The cleaning and disinfecting of hemodialysis equipment using electrolyzed strong acid aqueous solution.

In general, sodium hypochlorite, formalin, and Dialox (Teijin Gambro Medical, Ltd., Tokyo, Japan [main ingredients: H2O2, CH3CHOOOH, CH3COOH, H2O]) are used to clean and disinfect hemodialysis pipelines. In this study, the suitability of electrolyzed strong acid aqueous solution (ESAAS), which has attracted considerable interest in Japan because of its strong disinfecting properties, was examined. The crossover method was used to investigate the effectiveness of ESAAS in disinfecting the dialysis pipelines in comparison to that of sodium hypochlorite (200 ppm) used alternately with 1% acetic acid. The number of bacteria and the concentration of endotoxin (Et) were measured over an approximately 3 year period, starting in September 1994. Until then, 200 ppm sodium hypochlorite had been used alternately with 1% acetic acid, and the contamination of the pipeline had been marked. However, after switching to the ESAAS disinfection method, the dialysis pipelines very rapidly became cleaner. Therefore, the decision to develop an automated ESAAS cleaning system for long-term use was made. During the development period, the original disinfectants (200 ppm sodium hypochlorite used alternately with 1% acetic acid) were used as a stopgap. After confirmation of its performance and safety, the automated ESAAS cleaning system was introduced. To find out whether the decrease in bacteria secondarily caused a decrease in the Et concentration or whether the ESAAS directly inactivated the Et, an in vitro experiment was carried out. Highly concentrated Et, which had been left in the reverse osmosis (RO) drainage pipeline, was used as a sample to investigate the effects of ESAAS on Et at various concentrations and temperatures and on the recovery test. The results showed that ESAAS directly inactivated Et. This paper reports the results of the crossover test. The results of parallel tests carried out over an approximately 4 year period have already been reported. No significant problems occurred in the dialysis. The automated ESAAS cleaning system that was developed proved to be more economical than the conventional disinfecting method.

Acetic Acid↗
PubMed1978

Experiences and problems in the disinfection of fibre endoscopes.

The problem of the disinfection of fibre endoscopes is to achieve a good efficiency together with easy handling. There is not yet a disinfectant which shows a sufficient germicidal effect after a short time of contact with the fibre endoscope and which is harmless to the patient and medical staff. This paper deals with a two-stage disinfecting procedure in which the instrument undergoes a short intermediate disinfection using polyvidoneiodine (Betaisodona) between two investigations and a main disinfection at the end of a series of investigations using glutardialdehyde (Cidex). The measures lead to a sufficient reduction of the number of germs. The importance of the disinfection of all parts of the endoscopes, especially the channels and the accessories (water bottles etc.) is pointed out.

Aldehydes↗
PubMed2001

Efficacy of high-level disinfectants for reprocessing GI endoscopes in simulated-use testing.

BACKGROUND: There has been recent public concern regarding the adequacy of current practices for flexible endoscope reprocessing. High-level disinfection is defined by the Food and Drug Administration (FDA) as a minimum of 6-log reduction of mycobacteria under a worst-case scenario. Several agents are currently approved by the FDA, but published data on their relative efficacies against mycobacteria are lacking. The objective of this study was to determine the efficacy of these agents for high-level disinfection. METHODS: In simulated-use testing, video endoscopes (5 colonoscopes and 5 duodenoscopes) were each inoculated with 9.0 x 10(7) colony-forming units of Mycobacterium chelonae. Cleaning was performed by using a standardized protocol. Each endoscope was then subjected to chemical disinfection with Cidex (2.0% glutaraldehyde) at 20 degrees C for 20 minutes, Sporox (7.5% hydrogen peroxide) at 20 degrees for 30 minutes, and Steris 20 (0.2% peracetic acid) at 50 degrees C to 56 degrees C for 12 minutes using the Steris System 1 processor. Although not FDA-approved, tests were also conducted by using 70% isopropyl alcohol at 20 degrees C for 20 minutes. These results were compared with disinfection with ethylene oxide gas. All channels were sampled for M chelonae before and after manual cleaning and after disinfection. RESULTS: Cleaning alone resulted in an average log reduction of 3. Cidex, Sporox, Steris 20, ethylene oxide gas, and isopropyl alcohol, in combination with manual cleaning, each achieved a 6-log or greater reduction of the mycobacterial inoculum. No organisms were recovered from any channel after reprocessing with ethylene oxide and Steris 20. CONCLUSIONS: Commercially available high-level disinfectants are equally efficacious for reprocessing flexible GI endoscopes when used in conjunction with cleaning and in accordance with recommended guidelines.

2-Propanol↗