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PubMed1994

Knowledge and practices among injecting-drug users of bleach use for equipment disinfection--New York City, 1993.

Sharing (i.e., multiperson use) of drug-injection equipment among injecting-drug users (IDUs) is a major risk factor in the transmission of human immunodeficiency virus (HIV) and other bloodborne pathogens. Abstaining from injection of drugs eliminates this risk; disinfection of needles and syringes with household bleach can reduce this risk. Because studies suggest the effectiveness of bleach disinfection may be limited, the March 1993 National Institute on Drug Abuse (NIDA) Community Alert Bulletin included recommendations that IDUs who do not stop injecting and sharing injection equipment use full-strength household bleach and keep the bleach in contact with the equipment for at least 30 seconds (1). To determine whether these new recommendations had been disseminated effectively to IDUs, the knowledge of bleach use for disinfection of drug-injection equipment among IDUs participating in a NIDA-sponsored New York City cohort study was assessed during August-December 1993. This report presents data about knowledge of bleach use for disinfection among persons who reported injecting drugs at least once during the 3-6 months preceding the interview.

Cohort Studies↗
PubMed1993

Comparison of bactericidal activities of various disinfectants against methicillin-sensitive Staphylococcus aureus and methicillin-resistant Staphylococcus aureus.

Various disinfectants were compared in terms of the duration of bactericidal activity against methicillin-sensitive Staphylococcus aureus (MSSA), and methicillin-resistant Staphylococcus aureus (MRSA), among S. aureus isolated in our hospital. Strains of S. aureus which showed minimum inhibitory concentrations of cloxacillin of less than 1.56 micrograms/ml and of 3.13 micrograms/ml or higher were designated MSSA and MRSA respectively. There was no difference in sensitivity to disinfectants between MSSA and MRSA. There was a great variation in the duration of bactericidal activity of chlorhexidine gluconate against these species with the majority requiring contact times of between 2 minutes and over 20 minutes. All strains except for one strain of MRSA were killed within 20 seconds after disinfection with benzalkonium chloride. All strains were killed within 20 seconds after disinfection with alkyldiaminoethylglycine hydrochloride or povidone-iodine.

Benzalkonium Compounds↗
PubMed1995

An evaluation of knowledge and awareness of disinfection and sterilization among health care workers.

Awareness of the disinfection and sterilization policy among hospital staff and their knowledge in basic principles and methods of disinfection and sterilization were studied before and after intervention using a self-administered questionnaire. Survey results showed that awareness (56.2%) before intervention was unsatisfactory. The nurses were more aware of the policy than other groups of medical personnel. Those unaware of the policy perform duties from memory or verbal instructions. A significant increase in awareness to 73.3% was observed after intervention (p < 0.05). Knowledge on methods of decontamination, disinfection and sterilization of equipment varies widely from 28.8% to 90.1%. 23.1% were unaware of the temperature used for sterilization while 72.4% did not know how containers of disinfectant should be refill. Only 14.7% knew the recommended method for washing containers. With education improvement was observed. The average knowledge improved from 44.4% to 57.3%. Our results indicated that continuous in-service education is needed to improve, supplement and update knowledge in this field after basic training. In addition orientation programs for new staff should also be aimed at creating awareness and providing information on guidelines and policies related to their duties.

Disinfection↗
PubMedDate not supplied

Evaluation of disinfectants against Salmonella enteritidis.

Five classes of disinfectants (phenol, quaternary ammonium, chlorine, glutaraldehyde, and a combination of quaternary ammonium and formaldehyde) were diluted in "field" water (well, stream, or pond water) and compared with dilutions of the disinfectants in laboratory-grade water for their efficacy against the AOAC (Association of Official Agricultural Chemists) test organism Salmonella cholerasuis (ATCC 10708), S. enteritidis isolated from the spleen of an infected laying hen, and an egg-invasive S. enteritidis isolate. In all cases when S. cholerasuis was used, there was a significant association between the use of well, pond, and stream water and the growth of the bacterium. If we exclude glutaraldehyde, there was also a significant association between the use of "field" water and the growth of both isolates of S. enteritidis. There was no significant association when glutaraldehyde was used. There was a significant association between the use of lab water and the growth of S. enteritidis. The results suggested that the inability to remove S. enteritidis from layer houses may in part be associated with the source of water. Variables in pH, hardness, conductivity, nitrate content, or bacterial contamination of the water did not appear to affect the ability of the disinfectant to kill S. enteritidis. If "field" water is used for disinfection against S. enteritidis, the use of quaternary ammonium, the combination (quaternary ammonium/formaldehyde), or phenol should be considered.

Chlorine↗
PubMed1996

Quantitative analysis of a presence/absence microbiological assay: the hard surface carrier test of disinfectant efficacy.

The Hard Surface Carrier Test (HSCT) is a presence/absence assay for determining the extent to which chemical disinfectants kill bacteria. The disinfectants are marketed for cleaning surfaces in hospitals, restaurants, the home, etc. In the HSCT, a presence response (or equivalently, a positive carrier) is recorded if one or more bacteria survive among M bacteria attached to a glass carrier and exposed to the chemical disinfectant; otherwise, the response is absence. The presence or absence response is observed for each of many (usually 60) glass carriers and the disinfectant is considered effective if few (e.g., < or = 5%) of the carriers are positive. It would be more satisfactory to microbiologists if effectiveness were based on the fraction of bacteria that survive exposure; denote the expected survival fraction by phi. An equivalent parameter commonly used in antimicrobial research is the log-reduction, denoted by psi, where psi = -log10(phi). Although the number M of bacteria on each exposed carrier is not known, this paper shows it is possible to estimate psi. The suggested estimator is based on the assumption that M follows a gamma distribution. The gamma parameters are estimated using counts of bacteria on the HSCT nonexposed (control) carriers. This paper provides a formula for the standard error of the estimate, a computer simulation technique for calculating the lower confidence limit, and a computer simulation study of these statistical methods.

Bacteria↗
PubMedDate not supplied

Cavity disinfectants and dentin bonding.

The purpose of this study was to examine the effect on microleakage of two disinfectants, one chlorhexidine based and the other I2-KI/CuSO4 based, used as cavity washes prior to the application of the dentin bonding systems Tenure and Syntac in class 5 composite restorations. Class 5 cavity preparations were placed on extracted molars with occlusal margins in enamel and gingival margins in cementum. Preparations were treated with either Syntac or Tenure, combinations of one of the two disinfectant washes with Syntac or Tenure, or with one of the disinfectants only and filled with Tetric composite. Samples were thermocycled, stained, and sectioned to evaluate dye penetration. The chlorhexidine-based wash did not significantly affect microleakage when compared to the Tenure and Syntac controls, while the I2-KI/CuSO4-based wash resulted in significantly higher gingival microleakage when used with Syntac. The use of cavity disinfectants with composite resin restorations appears to be material specific regarding their interactions with various dentin bonding systems' ability to seal dentin.

Analysis of Variance↗
PubMed1996

Effect of disinfectants on the bond strength of composite to dentin.

PURPOSE: To investigate the effect of two cavity disinfectants, a 2% chlorhexidine (Bisco) and a 0.11% iodine/potassium-iodide/copper sulfate solution (ORA-5), on the shear bond strength of composite to dentin mediated by the dentin bonding agents (DBA), Syntac and Tenure. MATERIALS AND METHODS: The occlusal surfaces of 72 noncarious extracted human molar teeth were flattened to dentin using 500 grit sandpaper. They were randomly assigned (n = 12) to three groups within each DBA system: Bisco/Tenure, ORA-5/Tenure, Tenure, Bisco/Syntac, ORA-5/Syntac and Syntac. Dentin disinfectants were applied for 20 seconds and dried. DBA was applied following manufacturer's instructions. A hybrid resin composite (Tetric) was then bonded to all treated samples. The samples were thermocycled and tested in shear until failure. Fracture analysis was performed on dentin surfaces with both light and scanning electron microscopy. Shear bond strength data was analyzed using ANOVA, Student-Neuman-Keuls and Dunnett tests at P < 0.05. RESULTS: Shear bond values (Mean +/- SD, MPa) were: Syntac control 14.3 +/- 2.0, Bisco/Syntac 8.1 +/- 4.9 and ORA-5/Syntac 5.7 +/- 5.1; Tenure control 15.0 +/- 1.9, Bisco/Tenure 14.2 +/- 3.0 and ORA-5/Tenure 13.9 +/- 3.7. The only significant difference found between disinfectant treatment groups and the control groups was with Syntac. Fracture surface analysis revealed that with Tenure most failures were cohesive in resin but with Syntac, the disinfected samples displayed adhesive failures.

Analysis of Variance↗
PubMedDate not supplied

Resistance of Escherichia coli growing as biofilms to disinfectants.

The bactericidal activity of various disinfectants (cationic or amphoteric surfactants, oxidizing agents, phenolic derivatives) was determined against Escherichia coli CIP 54127 obtained by culture on tryptic soy agar (in-suspension or on-germ-carrier test) or in the form of biofilms produced in a continuous culture system. The bacteria tested on germ-carriers or included in biofilms were more resistant than the same strain in suspension. The extent of the reduction in activity depended on the nature of the disinfectant. In the two cases, the greatest reduction was observed with benzalkonium chloride and hexadecyl trimethylammonium bromide, the agents with the lowest hydrophile-lipophile balance. The activity of the oxidizing agents (sodium hypochlorite, peracetic acid/H2O2) and alkyl trimethylammonium derivatives (C12 and C14) was somewhat reduced, while that of the phenolic derivatives (o-cresol, phenol) was either slightly attenuated or unaffected. The reduction in sensitivity was attributed to a reduced accessibility of the bacterial cells to the disinfectants, due to the fact that the former adhered to a support. Furthermore, the interfering action of the substances in contact with the bacteria (milk in the germ-carrier test and exopolymers in the biofilms) could play a role. The reduced sensitivity of the bacteria in the biofilms was not due to any alteration in the metabolic state of the bacteria (mostly in a quiescent state) since this resistance was lost after the mechanical resuspension of the cells before the contact with the disinfectants.

Biofilms↗
PubMedDate not supplied

In vitro susceptibility of Staphylococcus aureus including MRSA to four disinfectants.

The spread of nosocomial infections caused by pathogenic organisms such as methicillin-resistant S. aureus (MRSA) has prompted the dental community to focus more attention on certain control strategies. In the present study, we tested the abilities of the four skin disinfectants (povidone iodine, benzalkonium chloride, chlorhexidine gluconate, and ethanol) to prevent horizontal transmission of MRSA in the dental office. The bactericidal activities of the disinfectants were evaluated by the decrement over time of viable cell numbers of four clinical isolated strains of S. aureus: two MRSA strains and two methicillin-sensitive S. aureus (MSSA) strains. The most effective disinfectant was 70 percent ethanol, which eradicated both MRSA and MSSA in less than three minutes. The 0.1 percent chlorhexidine gluconate proved the least effective of four disinfectants. More than 10(2) bacteria survived despite exposure to it for thirty minutes.

Anti-Infective Agents, Local↗
PubMed1997

Psychosocial antecedents of needle/syringe disinfection by drug users: a theory-based prospective analysis.

Working from the AIDS risk reduction model and other theories of behavior change, we tested psychosocial antecedents of needle/syringe disinfection by 136 injection drug users. High perceived self-efficacy for risk reduction exerted a positive effect on needles/syringe disinfection attempts 1 year later. Self-efficacy was, in turn, related to lower perceived infection risk, peer norms more favorable to risk reduction, and greater knowledge of AIDS. Behavioral intention had no significant effect on subsequent disinfection attempts. These results suggest that disinfecting needles/syringes is partly non-volitional; that high perceived infection risk may be counterproductive to injection risk reduction; and that perceive self-efficacy, but not intention to change behavior, may be a useful leverage point for AIDS preventive intervention.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Wound cleaning versus wound disinfection: a challenging dilemma.

Our experience with this resident has had a significant impact on our approach to wound management. We no longer accept normal saline as the only option for wound cleansing. Instead, we approach wound cleansing systematically using the wound cleansing model outlined in Figure 1. If healing is not apparent, we critically review the situation and consider the bacterial status of the wound, the phase of wound healing, and the effects of wound cleansing versus wound disinfection on both the bacteria and the cells responsible for wound repair. In infected wounds or those colonized with a high bacterial count, careful attention is given to eradicating bacterial contamination. We carefully weigh the benefits of wound disinfection (eradication of bacterial contamination) against wound cleansing and the potential harm to the resident (delayed wound healing and unnecessary discomfort). If the benefits of wound disinfection outweigh the potential harm to the resident, we choose wound disinfection and monitor its effectiveness on a daily basis. When bacterial contamination has been eradicated and the wound is clean, we resume wound cleansing with normal saline.

Acetic Acid↗
PubMed1998

[Endoscopes in urology: disinfection, sterilization, labeling and tracking. Circulars and decrees. Modes of application and commentary. The Committee of Infectious Diseases of the French Association of Urology. Congressional forum UFA--Paris, November 1996. DGS Circular 20 October 1997].

Administrative texts published in 1995, 1996 and 1997, have reinforced materiovigilance and impose disinfection precautions for endoscopes. The steps of disinfection of non-sterilizable endoscopes are: preliminary treatment, rinsing, actual disinfection, final rinsing, storage (see: Progrès en Urologie, 1997, 7, 505-507). Each procedure from collection of the endoscope until storage must be defined by written standard operating procedures validated by CLIN. The risk of transmission of Creutzfeld-Jakob disease requires autoclaving, which is only possible, at the present time, with the most recent rigid endoscopes. Until disinfection has become generalized, the traceability of endoscopes (labelling, utilization files) must be established on the model recommended for haemovigilance (circular of 02/04/96).

Creutzfeldt-Jakob Syndrome↗
PubMed1997

Efficacy of topical disinfectants.

A comparison of bactericidal activity of two surface disinfectants showed that both were highly effective. The glutaraldehyde-based disinfectant showed higher efficacy on roughed surfaces than the alcohol-based disinfectant. The study used a novel, and generally applicable, method to evaluate the surface killing potential of disinfectants.

2-Propanol↗
PubMed1998

Disinfection of water distribution systems for Legionella.

Hospital-acquired legionnaires' disease arises from the presence of Legionella in hospital water systems. Legionella not only persists in hot water tanks but is also found in the biofilm throughout the entire water distribution system. Conditions within water systems that promote Legionella colonization include water temperature, configuration and age of the hot water tank, physicochemical constituents of the water, plumbing materials, and commensal microflora. Hospital-acquired legionnaires' disease has been prevented by instituting control measures directed at the water distribution system. These include superheat-and-flush, copper/silver ionization, ultraviolet light, instantaneous heating systems, and hyperchlorination. Each of the above disinfection methods has been proven to be effective in the short-term, but long-term efficacy has been difficult due to limitations associated with each method. The complexities of Legionella disinfection, including advantages and disadvantages of each method, are reviewed. A successful Legionella prevention program requires cooperation and communication among hospital administrative personnel, engineers, and infection control staff. Routine environmental surveillance cultures for Legionella are the critical component for successful long-term disinfection. Culture results document the efficacy of the disinfection method and alert the hospital staff to consider Legionella in hospitalized patients with pneumonia.

Cross Infection↗
PubMed1976

The antimicrobial activity of embalming chemicals and topical disinfectants on the microbial flora of human remains.

The antimicrobial activity of embalming chemicals an topical disinfectants was evaluated to determine the degree of disinfection achieved during the embalming of human remains. The administration of arterial and cavity embalming chemicals resulted in a 99% reduction of the postmortem microbial population after 2 hours of contact. This level of disinfection was maintained for the 24 hours test period. Topical disinfection of the body orifices was also observed. Therefore, it is probable that present embalming practices reduce the hazard from transmission of potentially infectious microbial agents within the immediate environment of embalmed human remains.

Anal Canal↗
PubMed1998

Severe anaphylaxis to a new disinfectant: polyhexanide, a chlorhexidine polymer.

We describe the cases of an 18-year-old female and a 15-year-old male who developed severe anaphylaxis following contact of surgical wounds with the disinfectant Lavasept, containing polyhexanide, a polymerised form of chlorhexidine, during orthopaedic interventions. According to the manufacturer, this product is the only polyhexanide containing medical disinfectant, has recently been commercialised and is only available in Switzerland. One of the patients denied previous contact with this compound but both patients were previously exposed to chlorhexidine. Immediate-type hypersensitivity to polyhexanide was suggested by positive skin prick tests in the two patients and by negative skin tests in control individuals. Skin tests with chlorhexidine in the patients remained negative. We conclude that contact with the new disinfectant Lavasept can trigger anaphylactic reactions, even in the absence of previous history of exposure to this compound. It remains to be established whether this new disinfectant is a frequent anaphylactogen.

Administration, Topical↗
PubMed1998

Investigation into the efficacy of disinfectants against MRSA and vancomycin-resistant enterococci.

In the study reported here, several disinfectants for surfaces, instruments, hands and mucous membrane were tested for their effectiveness against methicillin-resistant strains of S. aureus and vancomycin-resistant enterococci. The results show that after use of the recommended concentrations with the recommended contact times, which were determined on the basis of the criteria for disinfectants according to the DGHM guideline for the testing and evaluation of chemical disinfection procedures, an adequate effect was able to be proved. Increased resistance of the methicillin-resistant S. aureus and vancomycin-resistant E. faecium strains to the tested disinfectants was not found. Only after use of diluted solutions differences in the bacterial count reductions were observed. In further studies it is to be investigated whether these differences are due to resistance to antibiotics or to intrinsic resistance.

Disinfectants↗
PubMed1993

Chemical disinfection to interrupt transfer of rhinovirus type 14 from environmental surfaces to hands.

Rhinoviruses can survive on environmental surfaces for several hours under ambient conditions. Hands can readily become contaminated after contact with such surfaces, and self-inoculation may lead to infection. Whereas hand washing is crucial in preventing the spread of rhinovirus colds, proper disinfection of environmental surfaces may further reduce rhinovirus transmission. In this study, the capacities of Lysol Disinfectant Spray (0.1% o-phenylphenol and 79% ethanol), a domestic bleach (6% sodium hypochlorite diluted to give 800 ppm of free chlorine), a quaternary ammonium-based product (7.05% quaternary ammonium diluted 1:128 in tap water), and a phenol-based product (14.7% phenol diluted 1:256 in tap water) were compared in interrupting the transfer of rhinovirus type 14 from stainless steel disks to fingerpads of human volunteers upon a 10-s contact at a pressure of 1 kg/cm2. Ten microliters of the virus, suspended in bovine mucin (5 mg/ml), was placed on each disk, and the inoculum was dried under ambient conditions; the input number on each disk ranged from 0.5 x 10(5) to 2.1 x 10(6) PFU. The dried virus was exposed to 20 microliters of the test disinfectant. The Lysol spray was able to reduce virus infectivity by > 99.99% after a contact of either 1 or 10 min, and no detectable virus was transferred to fingerpads from Lysol-treated disks. The bleach (800 ppm of free chlorine) reduced the virus titer by 99.7% after a contact time of 10 min, and again no virus was transferred from the disks treated with it.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗