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Effects of different disinfectants on physical properties of four temporary soft denture-liner materials.

OBJECTIVE: The purpose of this study was to evaluate the effects of some commonly used disinfectants on physical properties of four temporary soft denture-liner materials. METHOD AND MATERIALS: Soft-liner materials, including three plasticized acrylic resin-liners (Tempo, Immediate, Flexacryl Soft) and one silicone-based material (Ufi Gel P) were studied. Specimens prepared with the soft-liner materials were tested after the application of disinfectants (5% Deconex and 3.5% Savlex for 10 minutes; 2% sodium hypochlorite and 5.25% sodium hypochlorite for 5 minutes) and were compared with the control group (not disinfected; immersed in distilled water). Five specimens of each material were tested and data collected on days 4, 7, 11, and 15. The hardness values were determined using the Shore A hardness test. RESULTS: Water sorption test results showed that the disinfectants had statistically significant effects on water sorption values (except days 7 and 15 for Flexacryl Soft and days 4, 7, and 11 for Ufi Gel P). Water solubility and hardness test results also showed statistically significant effects on the materials by the disinfectants. CONCLUSION: Disinfectants significantly affected the physical properties of water sorption, water solubility, and hardness of the soft-liner materials.

Absorption↗

[Current status of disinfection and sterilization for dental handpieces in the hospitals].

OBJECTIVE: To understand current status of the uses of dental handpieces, methods of disinfection and sterilization and their effectiveness in dental-care hospitals and out-patient departments of stomatology in general hospitals. METHODS: Ten dental-care hospitals and departments of stomatology in general hospitals at varied levels were randomly sampled during 2000 to 2001 to investigate the uses of dental handpieces and means of their disinfection and sterilization. One used dental handpiece from each hospital or department of stomatology in general hospital selected was detected for possible contamination of bacteria by aerobic bacterial count and Coliform bacterial examinations and hepatitis B surface antigen (HBsAg) on it, based on "The Technical Standards for Disinfection" set by the Ministry of Health of China, and the effectiveness of its disinfection and sterilization was evaluated as well. RESULTS: Anti-suction handpieces were used only in 5.9% of the hospitals or departments, 94.1% of them without anti-suction devices. Cleansing disinfection was applied for used dental handpieces in 62.9% of the dental-care hospitals and the departments of stomatology, with an effective rate of 26.17%, immersing disinfection in 10.0%, with an effective rate of 55.88%, and autoclave in 27.1%, with an effective rate of 80.43%. Used dental handpieces in the hospitals and departments of stomatology in general hospitals were all contaminated by bacteria and HBsAg could be detected in 1.67% of them. CONCLUSIONS: Dental handpieces without anti-suction should be replaced soon by those with it or comprehensive dental unit with anti-suction device should be used. Used dental handpieces must be sterilized effectively before next use. Awareness on prevention from cross-infection should be improved for dental-care professional staff and operation of sterilization should be standardized.

Cross Infection↗

[Bacterial flora of conjunctival sac in patients with cataract. Methods of disinfection and evaluation of their efficiency].

PURPOSE: 1) To evaluate the microbacterial flora of the conjunctival sac and the sensitivity of the isolated microorganisms to 0.3% gentamicin solution and 5.0% PVP-Jodi solution, which is used to disinfect conjunctival sac. 2) To evaluate the role of the adhesive foil in prevention of the infection of the operative field. MATERIAL AND METHODS: 170 patients with senile cataract were examined. Before admission to Ophthalmology Department each patient received 0.3% gentamicin solution three times a day. All patients had their conjunctival sac disinfected with the use of 5% PVP-Jodi before surgery. Patients were divided into two groups. In the first group (120 patients), first samples were taken on admission to the Ophthalmology Department. Next in the day of the procedure, in the operation room--first before and second after disinfection of conjunctival sac. Adhesive foil was not used in this group. In the second group (50 patients), we used adhesive foil before surgery and samples were taken before and after disinfection of conjunctival sac. RESULTS: On admission, positive cultures were obtained in 40.0% cases. Most of the bacterial flora were Gram-positive bacteria. The number of the positive cultures before disinfection with 5.0% PVP-Jodi solution diminished to 5.8%, compared with positive results obtained on admission to the Ophthalmology Department. Secondary infection of the conjunctival sac has been revealed in 10% after disinfection with the use of the 5.0% PVP Jodi. It was due to bacterial flora coming from the skin and limbs of the lids (in the group without adhesive foil), whereas positive samples were obtained in 2.0% in the group where adhesive foil was used. CONCLUSIONS: 1) Gentamicin significantly reduces the amount of bacterial flora in conjunctival sac in patients before cataract surgery. 2) Adhesive foil is efficient to protect operative field from infection.

Administration, Topical↗

Periodontal disease and diabetes metabolic control: a full-mouth disinfection approach.

Some studies demonstrated that local mechanical periodontal treatment and systemic antibiotics might improve the level of metabolic control in patients with diabetes. The aim of this clinical pilot trial was to evaluate if type 1 diabetes patients with periodontitis will experience improvement in periodontal status and glycemic control after a full-mouth disinfection treatment. Ten adult patients with poor metabolic control (mean glycated hemoglobin (HbA1c) = 10.7 %) and periodontitis were included in the study. All patients received a full-mouth disinfection in 24 hours as described by Quirynen et al. (1995) at baseline and 6 months later. The periodontal parameters included plaque index (PI), bleeding on probing, probing depth and clinical attachment loss. Metabolic control was measured by the serum level of HbA1c. All measurements were done at baseline and at 3, 6, 9 and 12 months. The results demonstrated a significantly lower PI, less bleeding on probing, reduction in probing depth and gain of clinical attachment at 3 months and 9 months of the study. Similarly, a significant reduction in the serum level of HbA1c was measured three months after full-mouth disinfection but disappeared 6 months later at the 6- and 12-month check points. We conclude that a full-mouth disinfection approach significantly improves periodontal status and metabolic control in type 1 diabetes patients with periodontitis. However, the results of our study imply that a full-mouth disinfection method has to be applied at least every 3 months to control periodontal status and glycemic control in type 1 diabetes patients. Further studies with greater numbers of diabetes patients are needed to confirm the long-term beneficial effects of a full-mouth disinfection approach on diabetic metabolic control.

Adult↗

The effectiveness of soft contact lens disinfection systems against Acanthamoeba on the lens surface.

BACKGROUND: This investigation compared the efficacy of three widely used contact lens disinfection systems against an ocular isolate of Acanthamoeba polyphaga. METHODS: Twenty-seven worn Ciba NewVues lenses were quartered, heat sterilized and inoculated with Acanthamoeba. Lens quarters were then randomly assigned to three experimental groups, with Group A lenses exposed to cleaner and saline rinse only, Group B to disinfection only, and Group C to both cleaner and disinfection. One quarter of each lens served as a control and the other three quarters were experimental. Quantification of viable Acanthamoeba remaining on the lens was performed after each step of the disinfection process. RESULTS: Group A lenses showed no significant difference between the treatments, or the treatments and the control. Group B lenses demonstrated a significant difference (p = 0.0001) between the treatments and the control. In Group C (cleaning and disinfection), the control lens quarters were significantly different (p = 0.037) from the experimental group, but there was no significant difference between the treatments. CONCLUSIONS: All three disinfection regimens were very effective in reducing the number of viable Acanthamoeba on the contact lens surface. In the absence of proper cleaning (Group B), AOSept was the most effective of the three. These results also show the importance of thoroughly rubbing the contact lens surface to decrease the number of Acanthamoeba.

Acanthamoeba↗

[Pilot study of disinfection of optical instruments in otorhinolaryngology].

There is undoubtedly a need for a safe disinfection method of optical instruments used by ENT specialists. So far, a standard method that sufficiently covers the risk of infection for patients and medical staff alike while serving the need of practicability in daily routine has not been established. Therefore, in the ENT departments of the hospitals of Mannheim, Kaiserslautern, and Tübingen, studies on the disinfection of rigid optical instruments without working channel were performed between February 1999 and May 1999. Instruments were wiped either with an aldehyde or alcohol (ethanol 80%) and germs were detected by quantitative swab cultures. As discussed in the article, disinfection with ethanol proved to be at least equally efficient if not better than disinfection with aldehyde. Therefore, it fully serves the requirements of a safe method for disinfecting optical instruments without working channels.

Aldehydes↗

Preliminary results from disinfection of irreversible hydrocolloid impressions.

The virucidal efficacy of germicides acting on an irreversible hydrocolloid surface is not known. Tests that are currently performed on germicides do not simulate the conditions under which the germicides are often used. One major concern for the dental profession is the disinfection of dental impressions, particularly irreversible hydrocolloid impressions. This study was designed to test the biocidal action of germicides against an enveloped virus on an irreversible hydrocolloid surface. The disinfection model, which was developed to simulate clinical conditions, specified the use of vesicular stomatitus virus, an animal virus amenable to safe handling. A 0.5% sodium hypochlorite spray inactivated the virus when the spray was allowed to remain on the impression 3 to 10 minutes. The iodophor disinfectant required a 3- to 10-minute immersion for total inactivation. Although 2% glutaraldehyde achieved total viral inactivation in less than 1 minute, the authors conclude that short disinfectant sprays, in general, are not an appropriate disinfection method.

Analysis of Variance↗

Chairside disinfection of radiographs.

Routine disinfection of materials that have contacted human blood products and body fluids during patient care is recommended by the American Dental Association and the Centers for Disease Control. The purpose of this study was to determine whether surface disinfection with sodium hypochlorite would be an effective means for disinfection of radiographic film packets used in chairside developers. Disinfection of exposed radiographic film packets for 30 seconds in 5.25% sodium hypochlorite has been found to be a simple procedure suitable for routine use. A suggested disinfection protocol for the use of chairside developing boxes is described. This procedure should be considered for adoption as an infection control guideline.

Communicable Disease Control↗

Rinsing time and disinfectant release of reused dialyzers: comparison of formaldehyde, hypochlorite, warexin, and renalin.

The influence of disinfecting agent (DA) type on the rinsing time of reused dialyzers and DA rebound release after rinsing is unknown. We compared 10 groups of five dialyzers each: cellulose acetate capillaries and AN69 plates disinfected with formaldehyde (F), polysulfone and cuprophane capillaries disinfected with 3.5% Renalin (R; Renal Systems, Minneapolis, MN), polysulfone capillaries and AN69 plates disinfected with 0.5% R, and AN69 capillaries and plates disinfected with Hypochlorite (H; Solvay, Brussels, Belgium) or Warexin (W; Guardian Chemical, Division of United Guardian Inc, Hauppage, NY), respectively. Formaldehyde, R, H, and W were detected by standard tests. The rinsing time required to reach undetectable levels of DA is shortest for H and W, intermediate for R 0.5% and 3.5%, and longest for F (F v R, H, and W; R v H and W; and H v W: P < 0.001). The rebound release 30 minutes after completion of rinsing is the highest for F (average 6 ppm), intermediate for R 0.5% and 3.5% (mean 1.4 ppm, P < 0.002 compared with F and mean 2.95 ppm, P < 0.05 compared with F, respectively), and low (< or = 1 ppm) for W and H (P < 0.001 compared with F and P < 0.01 compared with R 3.5% and 0.5%). We conclude that the dialyzer rinsing time needed to obtain undetectable levels of DA depends on the DA type. In addition, we demonstrate that like F, R is released from reused dialyzers after "adequate rinsing." The potential clinical consequences of this phenomenon require further investigation.

Acetic Acid↗

Efficacy of various disinfectants against SARS coronavirus.

The recent severe acute respiratory syndrome (SARS) epidemic in Asia and Northern America led to broad use of various types of disinfectant in order to control the public spread of the highly contagious virus. However, only limited data were available to demonstrate their efficacy against SARS coronavirus (SARS-CoV). We therefore investigated eight disinfectants for their activity against SARS-CoV according to prEN 14476. Four hand rubs were tested at 30s (Sterillium, based on 45% iso-propanol, 30% n-propanol and 0.2% mecetronium etilsulphate; Sterillium Rub, based on 80% ethanol; Sterillium Gel, based on 85% ethanol; Sterillium Virugard, based on 95% ethanol). Three surface disinfectants were investigated at 0.5% for 30 min and 60 min (Mikrobac forte, based on benzalkonium chloride and laurylamine; Kohrsolin FF, based on benzalkonium chloride, glutaraldehyde and didecyldimonium chloride; Dismozon pur, based on magnesium monoperphthalate), and one instrument disinfectant was investigated at 4% for 15 min, 3% for 30 min and 2% for 60 min [Korsolex basic, based on glutaraldehyde and (ethylenedioxy)dimethanol]. Three types of organic load were used: 0.3% albumin, 10% fetal calf serum, and 0.3% albumin with 0.3% sheep erythrocytes. Virus titres were determined by a quantitative test (endpoint titration) in 96-well microtitre plates. With all tested preparations, SARS-CoV was inactivated to below the limit of detection (reduction factor mostly > or =4), regardless of the type of organic load. In summary, SARS-CoV can be inactivated quite easily with many commonly used disinfectants.

Animals↗

Evaluation of disinfected casts poured in gypsum with gum arabic and calcium hydroxide additives.

STATEMENT OF PROBLEM: Disinfection of stone casts is an important measure for the control of cross-contamination. Many approaches have been used to disinfect stone casts, but information regarding the accuracy of the resultant casts is limited. PURPOSE: The purpose of this in vitro study was to evaluate the dimensional accuracy, incidence of abutment fracture, and the abutment reproduction of disinfected stone casts made from elastomeric impressions and to determine the effect of gum arabic and calcium hydroxide additives on these properties. MATERIAL AND METHODS: Two aqueous solutions of chemical disinfectants (0.525% sodium hypochlorite and 0.1% povidone iodine) were used as mixing water substitutes for 3 types of dental stone: Types III (Lab Stone), IV (Mile Stone), and V (Die Keen). These stone powders were subjected to further modification by adding 1% gum arabic and 0.132% calcium hydroxide before mixing at the manufacturer-recommended liquid/powder ratios (0.30 for Type III, 0.21 for Types IV and V, respectively). As these additives increased the fluidity of the mix, reduced liquid/powder ratios (0.26 for Type III, 0.19 for Types IV and V, respectively) were also evaluated. Unmodified stone powder mixed with water served as the control. These modifications resulted in 7 test groups for each type of stone. Mixed stones of these groups were poured into 10 putty/wash vinyl polysiloxane impressions made of a customized definitive cast. The percentage of abutments fractured at the time of releasing the resultant casts, as well as the percentages of incompletely reproduced abutments, abutments with air bubbles, and abutments with defective finish lines were compared statistically among the tested groups using the chi-square test (alpha=.05). The average dimensional deviations of the resultant cast from the definitive cast measured in mm were statistically analyzed using 1-way ANOVA (alpha=.05) followed by the Dunnett test to detect any differences among the tested groups. RESULTS: No significant difference was found in abutment fracture or abutment defects for the different formulations of each type of stone used. The resultant casts showed no significant dimensional changes except for Type III and IV stones modified by gum arabic and calcium hydroxide additives and mixed at the recommended liquid/powder ratios. CONCLUSION: Both 0.525% sodium hypochlorite and 0.1% povidone iodine can be used to disinfect dental gypsum with no significant effect on the dimensional accuracy and reproducibility of the resultant casts. Addition of gum arabic and calcium hydroxide to the hemihydrate powders before mixing does not aid in reducing the incidence of defective abutment reproduction.

Analysis of Variance↗

Disinfection of gutta-percha cones with chlorhexidine and sodium hypochlorite.

OBJECTIVES: To evaluate the effectiveness of chlorhexidine (CHX) or sodium hypochlorite (NaOCl) in disinfecting gutta-percha cones, to verify contamination of gutta-percha cones in their boxes, and to identify microorganisms after intentional contamination by handling cones. STUDY DESIGN: Gutta-percha cones contaminated in vitro with several microorganisms were left in contact with tested disinfecting solutions for different times, sterility of storage boxes was evaluated by immersing cones in broth medium, and the microorganisms most frequently found in handling cones were identified using biochemical tests. RESULTS: CHX was not effective in eliminating Bacillus subtilis spores on gutta-percha cones after 72 h of contact with the disinfecting substance. 5.25% NaOCl eliminated spores from gutta-percha after 1 min of disinfection. The cones evaluated from their boxes did not show contamination in 94.5% of the cases. The microbial genus most frequently found after intentional contamination with gloves was Staphylococcus. CONCLUSION: 5.25% NaOCl is an effective agent for a rapid disinfection of gutta-percha cones.

Anti-Infective Agents, Local↗

Efficacy of routine fiberoptic endoscope cleaning and disinfection for killing Clostridium difficile.

We have evaluated a standard procedure for cleaning and disinfection of endoscopes for efficacy in eradicating a spore-forming bacterial organism, Clostridium difficile. Initially, 23 endoscopes were cultured for the presence of C. difficile after hanging in storage for at least 24 hours after cleaning and disinfection. All cultures were negative. Subsequently, endoscopes used in 15 patients who had stool cultures positive for C. difficile were cultured immediately after use and again after cleaning and disinfection with 2% alkaline glutaraldehyde for 5 min. Ten of 15 (67%) endoscopes were culture positive for C. difficile immediately after use. After cleaning and disinfection, all of the endoscopes were culture negative except one, which yielded two negative cultures and two cultures showing late growth of rare C. difficile colonies, but contamination could not be ruled out. In vitro exposure to 2% alkaline glutaraldehyde for 5 min resulted in 99% or greater killing of C. difficile spores. We conclude that cleaning and a minimum of 5 min of disinfection with 2% alkaline glutaraldehyde are likely to be effective in killing C. difficile vegetative organisms and spores on endoscopes.

Aldehydes↗

Use of microwave energy to disinfect a long-term soft lining material contaminated with Candida albicans or Staphylococcus aureus.

STATEMENT OF PROBLEM: Soft lining materials have been found to be more susceptible to microbial adhesion than acrylic resin base materials. Denture hygiene is essential to maintain the serviceability of the denture, and microwave energy has been suggested for denture disinfection. PURPOSE: The purpose of this study was to determine the effectiveness of microwave energy in the disinfection of a long-term soft lining material. MATERIAL AND METHODS: A long-term soft lining material was contaminated with known microorganisms and the reduction of organism counts after test disinfection regimes calculated. The disinfection regimes were microwaving for 5 minutes, leaving dry overnight, and soaking overnight in a dilute sodium hypochlorite solution. The test microorganisms were Candida albicans or Staphylococcus aureus. RESULTS: For both organisms, soaking in sodium hypochlorite reduced the number of viable adherent microorganisms recovered significantly more than exposure to microwave energy, which led to greater reduction than leaving the lining material dry overnight (p < 0.001, Wilcoxon nonparametric signed rank test). CONCLUSION: With reference to the tested microorganisms, disinfection of Molloplast-b soft lining material in dilute sodium hypochlorite solution proved to be more effective than exposure to microwave energy, which in turn was more effective than leaving the lining dry overnight.

Acrylic Resins↗

Surface disinfection: should we do it?

The effective use of disinfectants constitutes an important factor in preventing hospital-acquired infections. Surfaces are considered non-critical items as they come in contact with intact skin. Use of non-critical items or contact with non-critical surfaces carries little risk of transmitting a pathogen to patients. Thus, the routine use of disinfectants to disinfect hospital floors and other non-critical items is controversial. However, surfaces may potentially contribute to cross-transmission by acquisition of transient hand carriage by health care personnel due to contact with a contaminated surface or by patient contact with contaminated surfaces or medical equipment. This paper reviews the epidemiological and microbiological data regarding the use of disinfectants on non-critical surfaces. It concludes that while non-critical surfaces are uncommonly associated with transmission of infections to patients, one should clean and disinfect surfaces on a regularly scheduled basis.

Anti-Infective Agents, Local↗

Dermatological aspects of a successful introduction and continuation of alcohol-based hand rubs for hygienic hand disinfection.

With the new Centers for Disease Control and Prevention (CDC) guideline on hand hygiene, hospitals often introduce alcohol-based hand rubs for hand disinfection. Healthcare workers, however, may reject the new products because of skin irritation or other skin-related problems, which they experience after years of handwashing. In order to facilitate a successful introduction and continued use of alcohol-based hand rubs in hospitals, we have reviewed and summarized the major studies on the topic. Occupational hand dermatitis may occur in up to 30% of healthcare workers. It is mainly described as an irritant contact dermatitis caused by detergents. The diagnosis is usually clinical. Allergic reactions are very rare. After using an alcohol-based hand rub for the first time, healthcare workers may have a burning skin sensation that can be explained by pre-irritated skin. In this case the skin barrier has usually been impaired by frequent handwashing or occlusive gloves. This may result in a vicious circle whereby the healthcare worker increases the frequency of handwashing and reduces the frequency of hand disinfection. Prevention of irritant contact dermatitis is possible by selection of a low-irritating hand rub, which contains emollients, the correct use of the hand rub and a clear guideline when to disinfect and wash hands in the clinical setting. Common mistakes in the use of alcohol-based hand rubs are application to pre-irritated skin and washing hands before hand disinfection, which is, in general, not necessary, or after hand disinfection, which results in washing off the emollients. Clear preparation and guidance of healthcare workers before the introduction of alcohol-based hand rubs can help to enhance compliance in hand hygiene. The switch from handwash to alcohol-based hand rub will improve healthcare workers skin if mistakes are avoided and hand rinses are used correctly.

Alcohols↗

The potential for disinfection of separated faecal matter by urea and by peracetic acid for hygienic nutrient recycling.

No efficient, reliable, and scale independent disinfection methods for toilet waste are available today for safe recycling of plant nutrients. Therefore, two chemical treatment methods, addition of urea or of PAA (a quaternary mixture of 15% peracetic acid, 15% hydrogen peroxide and 30% acetic acid), were evaluated for disinfection of faecal matter.Degradation of the added urea resulted in 30 g of ammonia nitrogen per kilogram of treated matter and a pH increase to approximately 9.3. This produced an efficient disinfection of E. coli, Enterococcus spp., and Salmonella spp. within 3 weeks (>6log(10) reduction) and a reduction of the chemical resistant Salmonella typhimurium 28b phage, corresponding to a decimal reduction within 7.5 days. No viable Ascaris suum eggs were found after 50 days of treatment. No reduction of spore forming Clostridia spp. was observed. Urea treatment proved to be efficient for disinfection of source separated faecal matter in a scale independent method used for safe recycling of nutrients found in the faecal matter.PAA reduced all of the above indicator organisms within 12 h after application. For this faecal material, with a dry matter content of approximately 10%, an addition of 0.5-1% of PAA (active substance, corresponding to 3.3-6.7% of the Proxitane 15 used) was required before no viable organisms were found in the material. However, this was not tested for the A. suum. No viable spore-forming bacteria or phages were detected. A high rate of bacteria regrowth occurred at 0.15% dosage and 5 days of treatment. PAA is an efficient alternative for disinfection of separated faeces if a rapid treatment is needed.

Animals↗

Hygienic hand disinfection.

The purpose of hygienic hand disinfection is to render hands safe after contact with pathogens. Comparing effects of disinfection procedures on infection ratios is too difficult for routine purposes but the degerming efficacy may be determined in laboratory tests with volunteers. In the Vienna test model the efficacy of a specific procedure being tested is compared to that of a standard disinfection (rubbing into hands 3 ml of isopropanol 60% v/v, 30 seconds, twice) tested in parallel with the same volunteers. This ensures standardization, thus comparability of results between laboratories, and provides the investigator with a yardstick for efficacy. The model includes artificial contamination, assessment of the release of test bacteria (E. Coli ATCC 11229) before and after disinfection by the finger tip method, and addition of neutralizers to sampling fluids. Alcohols in appropriate concentrations are highly effective (log reductions: greater than 4.0) whereas procedures employing disinfectant detergents act like soap (log reductions: less than or equal to 3.2) and may cause dissemination of pathogens.

Bacteriological Techniques↗