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PubMed2002

Fungicidal activities of commonly used disinfectants and antifungal pharmaceutical spray preparations against clinical strains of Aspergillus and Candida species.

The antifungal efficacy of commercial chemical disinfectants and pharmaceutical antifungal agents against medically important moulds and yeast species was investigated. Chlorine, phenol, sodium dodecyl sulfate and quaternary ammonium salts were the chemical disinfectants, and bifonazole and terbinafine were the antifungal pharmaceutical products tested against clinical isolates of Aspergillus and Candida species. Fungal inocula were obtained from conidial preparations of two A. ochraceus strains and yeast cells of C. albicans, C. krusei and C. parapsilosis. The antifungal activities were evaluated either by determining the kill rate in a cell suspension media at different contact periods, or by examining the viability and growth on plates sprayed with the active ingredient. Chlorine (1%) was the only disinfectant with the ability to cause a rapid inactivation of all five strains. Phenol (5%) was equally effective against Candida species; however, a number of A. ochraceus conidia were able to survive this treatment for up to 1 h. Benzalkonium chloride (0.5%) and cetrimide (0.5%) were also able to disinfect the three Candida species rapidly; however, these two quaternary ammonium compounds were relatively ineffective against A. ochraceus. In spray experiments, quaternary ammonium compounds had a fungicidal activity against Candida species and were fungistatic against A. ochraceus conidia. All five fungal strains were able to resist 0.5% sodium dodecyl sulfate, present either in the suspension solution or on the sprayed plate. Of the two pharmaceutical antifungal products tested, bifonazole (1%) were essentially ineffective against all five strains. Terbinafine (1%) had a fungicidal activity against A. ochraceus and C. parapsilosis. In suspension experiments, an exposure to 0.01% terbinafine required a contact period of 1 h for a complete inactivation of A. ochraceus conidia and an onset of fungicidal effect on C. parapsilosis yeast cells. Terbinafine was only moderately effective against C. albicans and was completely ineffective against C. krusei.

Antifungal Agents↗
PubMed1999

Comparative in vitro activity of antiseptics and disinfectants versus clinical isolates of Candida species.

OBJECTIVE: To evaluate the in vitro activity of antiseptics and detergents against Candida. DESIGN: One strain each of Candida albicans, Candida tropicalis, Candida lusitaniae, Candida parapsilosis, Candida kefyr, Candida glabrata, and an American Type Culture Collection strain of Escherichia coli (control) were studied. Clinical isolates were obtained from patients in a bone marrow unit of a large tertiary hospital. Antiseptic and disinfectant agents studied were used in the hospital where isolates were identified for cleaning of inanimate surfaces or hand washing. In vitro susceptibility was determined using a broth macrodilution method with exposure times to antiseptic or disinfectant agent of 15 seconds to 4 minutes and concentrations of agents that ranged from undiluted to 1:10,000 dilution. SETTING: A 900-bed teaching hospital. RESULTS: Of disinfectants tested, Vestal and Sparquat inhibited growth of all species at dilutions of < or = 1:100 at all contact times for all species. Clorox showed inhibition of growth at 1:100 dilution after 30 seconds of contact time for all isolates. Of antiseptics studied, Hibiclens inhibited growth of all species except C tropicalis at dilutions of < or = 1:100 at all contact times and for C tropicalis after 60 seconds. Clinidine inhibited growth of all species at dilutions of < or = 1:100 at all contact times for all species with the exception of Cglabrata and C tropicalis, which grew at the undiluted concentration. Ultradex failed to demonstrate killing of any species for any dilutions tested. CONCLUSIONS: The results of this study show varying degrees of in vitro inhibition of growth by a variety of antiseptics and disinfectants against clinical isolates of Candida species from hospitalized patients.

Anti-Infective Agents, Local↗
PubMed2003

Risk of hospital-acquired legionnaires' disease in cities using monochloramine versus other water disinfectants.

OBJECTIVE: To measure the association between the disinfection of municipal drinking water with monochloramine and the occurrence of hospital-acquired legionnaires' disease (LD). SETTING: One hundred sixty-six U.S. hospitals. DESIGN: Survey of 459 members of the Society for Healthcare Epidemiology of America (SHEA) for hospital features; endemic- and outbreak-related, hospital-acquired LD; the source of the hospital water supply; and the methods of disinfection used by the hospitals and municipal water treatment plants. RESULTS: SHEA members representing 166 (36%) of 459 hospitals responded; 33 (20%) reported one or more episodes of hospital-acquired LD during the period from 1994 to 1998 and 23 (14%) reported an outbreak of hospital-acquired LD during the period from 1989 to 1998. Hospitals with an occurrence of hospital-acquired LD had a higher census (median, 319 vs 221; P = .03), more acute care beds (median, 500 vs 376; P = .04), and more intensive care unit beds (median, 42 vs 24; P = .009) than did other hospitals. They were also more likely to have a transplant service (74% vs 42%; P = .001) and to perform surveillance for hospital-acquired disease (92% vs 61%; P = .001). After adjustment for the presence of a transplant program and surveillance for legionnaires' disease, hospitals supplied with drinking water disinfected with monochloramine by municipal plants were less likely to have sporadic cases or outbreaks of hospital-acquired LD (odds ratio, 0.20; 95% confidence interval, 0.07 to 0.56) than were other hospitals. CONCLUSION: Water disinfection with monochloramine by municipal water treatment plants significantly reduces the risk of hospital-acquired LD.

American Hospital Association↗
PubMed1995

FDA labeling requirements for disinfection of endoscopes: a counterpoint.

Endoscopes are used widely for the diagnosis and therapy of medical disorders. To prevent spread of nosocomial infection, all endoscopes should undergo thorough cleaning and high-level disinfection following each use. The Food and Drug Administration (FDA) has approved a user-friendly package label for one liquid chemical germicide that requires a 45-minute immersion at 25 degrees C to support a high-level disinfection label claim. Scientific data reviewed here suggest that one can achieve at least an 8-log reduction in M tuberculosis contamination with cleaning (4 logs) followed by chemical disinfection for 20 minutes (4 to 6 logs). The FDA should modify the label to state that if cleaning is accomplished using a standardized cleaning protocol, then a 20-minute immersion at 20 degrees C will be sufficient to achieve high-level disinfection.

Cross Infection↗
PubMed1993

The effect of skin disinfection materials on reducing blood culture contamination.

Contaminated blood cultures may cause results to be misinterpreted, create unnecessary work for the laboratory, and increase costs. Disinfection of the venipuncture site is considered to be necessary for preventing contamination, although there is little information about the effectiveness of using different disinfection materials. The use of 70% isopropyl pads and povidone iodine saturated swabs (conventional method) was compared with the use of a 70% isopropyl/10% acetone scrub and povidone iodine dispenser (PREP method) for skin disinfection. Blood culture "kits" were prepared--bags containing collection tubes, instructions, and either conventional or PREP materials and were distributed randomly. The contents were concealed by a cover to prevent the user from selecting a specific type of decontamination kit. The kits were identified in the laboratory by color-coded labels on the collection tubes. Among 1,546 specimens evaluated, the contamination rate observed with conventional disinfection was significantly higher (4.6%; N = 763) than with PREP materials (2.2%; N = 783, P = 0.011) and was equivalent to the preceding 6-month contamination rate (4.7%). The lower contamination rate may be associated with greater effectiveness of a scrub or isopropyl/acetone solution, or both. Decontamination materials may have a significant impact on reducing blood culture contaminants from skin flora.

1-Propanol↗
PubMed1996

Disinfecting agents for removing adherent bacteria from orthopaedic hardware.

This investigation seeks to determine whether surfactants or detergents can be used to clean and disinfect orthopaedic wounds with implanted hardware. Thus, a stepwise investigation of biocompatible surfactants and detergents was performed to identify an irrigation agent for disinfecting orthopaedic wounds. Bacterial adhesions assays, irrigation studies, and bactericidal assays determined that benzalkonium chloride showed the greatest efficacy. Testing involved stainless steel screws colonized with a preformed biofilm of Staphylococcus epidermidis, Staphylococcus aureus, or Pseudomonas aeruginosa, which were immersed in benzalkonium chloride solutions for various time intervals under static conditions. After 10 minutes, benzalkonium chloride achieved a minimum 4 log kill (10,000-fold) for all 3 strains of bacteria. Additional studies demonstrated that the high mechanical energy of jet irrigation improved the disinfecting properties of this agent. With jet lavage, both 1:1000 and 1:5000 concentrations of benzalkonium chloride achieved a minimum 2 log kill (100-fold) for all 3 bacteria. The results or this study suggest that at tissue compatible concentrations, benzalkonium chloride has significant disinfection properties for in vitro colonized orthopaedic devices, and these properties may be enhanced via jet lavage.

Anti-Infective Agents, Local↗
PubMed1988

pH and H2O2 concentration of hydrogen peroxide disinfection systems.

Hydrogen peroxide disinfection has caused discomfort for some soft contact lens wearers even though the solution was neutralized properly. The discomfort could be due to the endpoint pH of the system used or the residual H2O2 concentration. Using a digital pH meter and H2O2 concentration detection strips, we measured the pH and H2O2 concentration of seven different hydrogen peroxide disinfection systems over their recommended disinfection and neutralization cycles to determine their time courses and endpoint values. The final pH of the seven systems varied from 6.15 to 7.74 pH units. All systems resulted in residual H2O2 concentrations below threshold values. These findings indicated that the final pH may be the cause of patient discomfort after hydrogen peroxide disinfection and neutralization.

Contact Lenses, Hydrophilic↗
PubMed1989

The pH of over-the-counter hydrogen peroxide in soft lens disinfection systems.

We evaluated the pH of six hydrogen peroxide (H2O2) soft lens disinfection systems which had over-the-counter (OTC) H2O2 substituted for the manufacturer's recommended H2O2. Substitution of four brands of OTC H2O2 into the five two-step disinfection systems resulted in a pH after neutralization which ranged from 6.70 to 7.55 pH units. There was a small but statistically significant difference in the pH after neutralization when OTC H2O2 was substituted for the manufacturer's recommended H2O2. There was a significantly lower pH after neutralization when the same brands of OTC H2O2 were substituted for the manufacturer's recommended H2O2 in a one-step H2O2 disinfection system. The pH after neutralization for the manufacturer's recommended H2O2 was 6.50 pH units. The pH after neutralization for the OTC H2O2 ranged from 3.35 to 4.77 pH units. This range is below the ocular comfort range of 6.6 to 7.8 pH units. These findings, along with other possible differences between OTC H2O2 and the manufacturer's recommended H2O2, indicate that OTC H2O2 should never be substituted for the manufacturer's recommended H2O2 in any H2O2 soft lens disinfection system.

Contact Lenses, Hydrophilic↗
PubMed1990

In-office microwave disinfection of soft contact lenses.

We evaluated the effectiveness of an in-office microwave disinfection procedure which allowed for the disinfection of up to 40 soft contact lenses at one time. Ciba AOSept cases filled with sterile unpreserved saline were contaminated with one of six FDA test challenge microorganisms at a concentration of approximately 10(3) colony forming units per milliliter (CFU/ml). Twenty cases were placed on the rotating plate of a standard 2450 MHz 650 W microwave oven in a 10-cm diameter circle. The cases were exposed to high intensity microwave irradiation for periods of 0 to 15 min. None of the 6 microorganisms evaluated survived 2 min or longer of microwave exposure. Our findings indicated that microwave irradiation can be a convenient, rapid, and effective method of disinfecting a number of soft contact lenses at one time and thus adaptable as an in-office soft contact lens disinfection procedure.

Bacteria↗
PubMed1993

Ultraviolet disinfection of contact lenses.

To evaluate the efficacy of ultraviolet (UV) radiation as a method of disinfecting contact lenses and their storage solutions, we contaminated soft lenses (Bausch & Lomb Optima 38), rigid gas permeable (RGP) lenses (Oxyflow F-30), and their storage solutions with three common bacteria. Escherichia coli (E.c.), Staphylococcus epidermis (S.e.), and Serratia marcescens (S.m.). The storage solutions used were saline solution and RGP conditioning solution. We determined the exposure times to 253.7-nm wavelength UV radiation necessary to disinfect the contact lenses and solutions. The decimal reduction values (D values) found for UV radiation were 10 to 200 hundred times shorter than reported for currently available disinfection systems. For E.c., sterilization was attained after 100 s of exposure. For S.e. and S.m., sterilization occurred after 300 s of exposure. Different contact lens solutions transmit UV radiation to various degrees, with saline solution passing more than 90% of the UV radiation. Thus, our results indicate that UV radiation is an effective and rapid method of disinfecting contact lenses and their storage solutions.

Colony Count, Microbial↗
PubMed1989

Effect of disinfection on number and stainability of gram-positive bacteria.

Evidence provided by the Brown and Brenn stain for the presence of bacteria in fixed tissue sections depends on the ability to demonstrate them by staining. Previously, in a model experiment, it has been shown that demineralizing agents reduce the number of blue-staining Gram-positive bacteria (Wijnbergen & Van Mullem 1987). In the present study the influence of a structure-destroying disinfectant, a structure-preserving disinfectant or heat disinfection on number and stainability was investigated using S. faecalis suspensions. Numbers were determined using a haemocytometer, and percentages of blue-staining organisms were ascertained from smears. Immediately after disinfection the relative number of Gram-positive staining bacteria was reduced by a factor of three for chlorhexidine, almost two for alcoformol, and was slightly reduced by heat. After 4 days of storage the reduction factors were 90, 4, and 2, respectively. After 14 days of storage the reduction factors were infinite, 30 and 5, respectively. These results were explained on the basis of the rate of cell wall destruction evoked by the respective agents.

Chlorhexidine↗
PubMed1991

Neutralization efficacy of Dey-Engley medium in testing of contact lens disinfecting solutions.

A quantitative assay for the demonstration of neutralizer efficacy was developed to monitor contact lens disinfecting solutions. Adequate neutralization of disinfecting agents is essential to the accurate determination of disinfecting activity with time. This method employed the recovery of small numbers of micro-organisms from neutralizing medium containing a disinfectant. A statistical estimation of significance between treatments demonstrated that Dey-Engley medium (DE; Difco) was generally effective when tested as an agar growth medium with several bacterial test organisms. DE medium from another vendor was less effective, underscoring the need for laboratory quality control and monitoring. DE agar (Difco) adequately neutralized all solutions tested at a 1:20 dilution. The solutions included those containing Dymed (polyaminopropyl biguanide, 0.00005%), chlorhexidine (0.005%), Polyquad (0.001%), chlorhexidine (0.005%) and thimerosal (BP, 0.001%), thimerosal (BP, 0.002%) and Tris(2-hydroxyethyl) tallow ammonium chloride (0.013%), and a solution preserved with 115 ppm benzalkonium chloride (BAK). A modification of this medium was developed which retained virtually all of the neutralizing efficacy for the solutions tested while allowing the use of automated testing procedures.

Bacteria↗
PubMed1992

Evaluation of the repeatability and reproducibility of European suspension test methods for antimicrobial activity of disinfectants and antiseptics.

A collaborative study to determine the precision of the 1987 Method of test for the antimicrobial activity of disinfectants in food hygiene is described. The repeatability and reproducibility of the test was found to vary according to the nature of the test organism, the type of disinfectant product and the skill of the operator. Results indicate that significant differences in microbicidal effect (ME values) occur within test laboratories between test periods as well as between laboratories, and that much of this variability derives from apparently random variations in the resistance of test strains from day to day and test period to test period. Indications are that although the test is sufficiently reliable to be used as a standard method, adequate test replication must be specified to distinguish borderline pass from borderline fail disinfectant concentrations. The implications of the results in relation to current work on the development of unified European test methods for disinfectants is discussed.

Analysis of Variance↗
PubMed2006

Evaluation of otoscope cone cleaning and disinfection procedures commonly used in veterinary medical practices: a pilot study.

The objective of this study was to evaluate the relative efficacy of otoscope cone cleaning and disinfection methods commonly used in veterinary practices. Using sterile technique, 60 new gas-sterilized 4-mm otoscope cones were inoculated with a broth culture of 1.5 billion Pseudomonas aeruginosa bacteria per mL then allowed to dry for 10 min. Six study groups of 10 cones each were created. Group 1 served as positive control and received no cleaning or disinfection. Group 2 cones were wiped with sterile cotton-tipped applicators and gauze then rinsed with water. Group 3 cones were wiped with 70% isopropyl alcohol. Group 4 cones were scrubbed in a speculum cleaner with Cetylcide II solution (Cetylite Industries, Inc., Pennsauken, NJ). Groups 5 and 6 cones were soaked for 20 min in Cetylcide II and chlorhexidine gluconate 2% solutions, respectively. Using sterile technique and after 10-15 min drying time, the cones were swabbed in a consistent pattern, and samples were submitted for quantitative culture. Culture results showed no growth from cones soaked in Cetylcide II or chlorhexidine solutions. Two of the 10 cones wiped with alcohol, 3/10 cones wiped then rinsed with water, and 3/10 cones scrubbed with the speculum cleaner showed growth of P. aeruginosa. All (10/10) cones in the control group showed heavy growth of P. aeruginosa. These results show that P. aeruginosa can survive on otoscope cones cleaned and disinfected by several commonly used methods. Further study is needed to determine practical and optimal cleaning and disinfection methods for otoscope cones.

Animals↗
PubMedDate not supplied

Effect of microwave disinfection procedures on torsional bond strengths of two hard chairside denture reline materials.

PURPOSE: This study evaluated the potential effects of denture base resin water storage time and an effective denture disinfection method (microwave irradiation at 650 W for 6 minutes) on the torsional bond strength between two hard chairside reline resins (GC Reline and New Truliner) and one heat-polymerizing denture base acrylic resin (Lucitone 199). MATERIALS AND METHODS: Cylindrical (30 x 3.9 mm) denture base specimens (n= 160) were stored in water at 37 degrees C (2 or 30 days) before bonding. A section (3.0 mm) was removed from the center of the specimens, surfaces prepared, and the reline materials packed into the space. After polymerization, specimens were divided into four groups (n= 10): Group 1 (G1)--tests performed after bonding; Group 2 (G2)--specimens immersed in water (200 ml) and irradiated twice (650 W for 6 minutes); Group 3 (G3)--specimens irradiated daily until seven cycles of disinfection; Group 4 (G4)-specimens immersed in water (37 degrees C) for 7 days. Specimens were submitted to a torsional test (0.1 Nm/min), and the torsional strengths (MPa) and the mode of failure were recorded. Data from each reline material were analyzed by a two-way analysis of variance, followed by Neuman-Keuls test (p= 0.05). RESULTS: For both Lucitone 199 water storage periods, before bonding to GC Reline resin, the mean torsional strengths of G2 (2 days--138 MPa; 30 days--132 MPa), G3 (2 days--126 MPa; 30 days--130 MPa), and G4 (2 days--130 MPa; 30 days--137 MPa) were significantly higher (p < 0.05) than G1 (2 days--108 MPa; 30 days--115 MPa). Similar results were found for Lucitone 199 specimens bonded to New Truliner resin, with G1 specimens (2 days-73 MPa; 30 days--71 MPa) exhibiting significantly lower mean torsional bond strength (p < 0.05) than G2 (2 day--86 MPa; 30 days--90 MPa), G3 (2 days--82 MPa; 30 days--82 MPa), and G4 specimens (2 days--78 MPa; 30 days--79 MPa). The adhesion of both materials was not affected by water storage time of Lucitone 199 (p > 0.05). GC reline showed a mixed mode of failure (adhesive/cohesive) and New Truliner failed adhesively. CONCLUSIONS: Up to seven microwave disinfection cycles did not decrease the torsional bond strengths between the hard reline resins, GC Reline and New Truliner to the denture base resin Lucitone 199. The effect of additional disinfection cycles on reline material may be clinically significant and requires further study.

Acrylic Resins↗
PubMed2006

Effects of skin disinfection method, deviation bag, and bacterial screening on clinical safety of platelet transfusions in the Netherlands.

BACKGROUND: Bacterial contamination of blood products is a great hazard for development of fatal transfusion reactions. Bacterial screening of platelet concentrates (PC) by aerobic and anaerobic culturing (BacT/ALERT, bioMérieux) was introduced in the Netherlands in October 2001. STUDY DESIGN AND METHODS: In November 2002, a nationwide, uniform skin cleansing method was introduced with a double-swab disinfection with 70 percent isopropyl alcohol. One location routinely used an integrated diversion bag to collect the first 20 to 30 mL. RESULTS: Over the calendar years 2002 and 2003, in total 113,093 PCs derived from pooled buffy coats were screened. After introduction of the new disinfection method, 0.85 percent were initially positive. This was a small reduction compared to the previous disinfection methods under which 0.95 percent were initially positive. The location with use of the diversion bag showed a significantly lower frequency of bacterial contamination, with 0.50 percent before and 0.37 percent after introduction of 70 percent isopropyl alcohol. In addition 8000 apheresis PCs were also screened, showing 24 initially positive samples (0.30%). CONCLUSION: The use of the diversion bag and, to a lesser extent, the use of double swabs with 70 percent isopropyl alcohol, led to a reduction of contamination. As expected, predominant contamination with resident skin bacteria was reduced. The combination of diversion bag and new disinfection led to a frequency of initial positive results for pooled five-donor PCs, which is similar to that of single-donor apheresis PCs. Furthermore, the bacterial detection system and associated product recall procedures have been shown to be effective in preventing transfusion of contaminated PCs and/or related red cells, especially for rapidly growing bacteria.

2-Propanol↗
PubMed1992

Permeation and destructive effects of disinfectants on protective gloves.

In working situations where there is a possibility of acquiring blood-borne infections, the use of disinfectants is important. It is also important to use protective gloves, both to protect the skin against disinfectants and to protect against infections. Changes in the structure of the glove material may, however, interfere with the protective capability of the gloves. The influence of 4 disinfectants on the material structure and protective effect of 6 different brands of protective gloves was studied. The proposed International Organization for Standardization (ISO) standard method for determining the liquid chemical resistance of air-impermeable materials was used for permeation testing. Pieces of latex and vinyl glove were also exposed to isopropanol and ethanol for 10, 30 and 60 min and then viewed in a scanning electron microscope. Isopropanol permeated through latex and vinyl gloves in less than 10 min. The polyethylene (PE) gloves were of quite variable quality, and the breakthrough time ranged from 4 to greater than 240 min. The latex and vinyl gloves were also permeated by ethanol, but at a much lower rate. The disinfectants Blifacid, based on p-chloro-m-cresol, and Cidex, based on glutaraldehyde, did not permeate any of the gloves tested within 60 min. Isopropanol had a destructive effect on the material, which became opaque, stiff and brittle. This change in structure was verified with the scanning electron microscope. The tested gloves of latex, vinyl and PE, gave acceptable protection from contact with Blifacid and Cidex for at least 60 min. The same gloves do not give any total protection from contact with isopropanol and ethanol.

Disinfectants↗
PubMed1995

A micro-suspension-test for evaluation of disinfectants against human immunodeficiency virus.

We devised a micro-suspension-test to evaluate disinfectants against human immunodeficiency virus type-1 (HIV-1) and confirmed its reliability. Suspensions of persistently HIV-1-infected Molt-4 cells were used as targets of disinfectants and residual infectivity was measured by an infectivity assay: after cocultivation with uninfected Molt-4 cells reverse transcriptase activity (RTA) in the supernatant and giant cell formation (GCF) were monitored. Our new infectivity assay consists of a short-term assay, that is RTA and GCF monitoring on the second day of co-culture, and a long-term assay, that is RTA monitoring up to the 28th day of co-culture. The sensitivity of the short-term assay was 1 x 10(3) infected cells and that of the long-term assay 1 x 10(1) infected cells. All the chemical disinfectants examined in this study showed dose- and time-dependent inactivation of HIV-1. By 5-minute contact with ethanol, glutaraldehyde, formalin, sodium hypochlorite and povidone-iodine, HIV-1 was effectively inactivated at concentrations of 20, 0.01, 5, 0.05 and 0.1%, respectively. Since the micro-suspension-test is easy and sensitive, we recommend it as a method for evaluating disinfectants against HIV-1.

Cells, Cultured↗