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PubMed1986

Evaluation of procedures for hygienic hand-disinfection: controlled parallel experiments on the Vienna test model.

Controlled parallel experiments were performed on the Vienna test model for the evaluation of procedures for hygienic hand-disinfection in three laboratories (Vienna, Mainz, Birmingham). The degerming activity of four procedures, each taking 1 min, was assessed repeatedly and compared with that of a standard disinfection procedure (ST) using isopropanol 60% (v/v). The mean log reductions (mean log RF) for each procedure were as follows: n-propanol 50% (v/v) 4.85 and 5.14 in Vienna (V) and Mainz (M) respectively, ethanol 70% (v/v) + chlorhexidine-gluconate 0.5% (w/v), 4.01 (V), 3.76 (M) and 4.00 in Birmingham (B). Washing procedures were less effective, mean log RF's of 3.19 (V), 3.49 (M) and 3.04 (B) were obtained with povidone-iodine soap, and 2.91 (V), 3.37 (M) and 3.27 (B) with a liquid phenolic soap. Analysis of variance on the data from Vienna and Mainz revealed significant differences of means not only between procedures ('preparations') but also on repeat testing. To compensate for the influence of variables such as test subjects, laboratory and day, the Vienna test model provides a method of standardization by testing a ST in parallel with the test procedure (P). Standardization of the results was obtained by pair-wise substraction, log RFPi-log RFSTi. Analysis of variance on the resulting values demonstrated that comparability of the results between laboratories and on repeat testing was achieved. The relative variation of the measurements within the laboratories ranged from 0.9 to 4.2%. As assessed by power-analysis, a disinfection procedure will be detected as significantly (P = 0.1) inferior to the standard processes in 95 of 100 experiments if it produces a mean log RF that is at least 0.55-0.65 log units smaller than that of the standard.

Austria↗
PubMed1995

Inactivation of HIV-1 by chemical disinfectants: sodium hypochlorite.

The efficacy of sodium hypochlorite was assessed against human immunodeficiency virus type 1 suspended in low (8% v/v) or high (80% v/v) concentrations of serum or in a high (80%) concentration of blood. In the presence of 8% serum, 100 p.p.m. available chlorine in the disinfectant test mixture inactivated 3.75 log TCID50 HIV/ml within 30 s. When the test mixture contained 80% serum, 500 p.p.m. available chlorine inactivated more than 4 log TCID50 HIV/ml in 1-2 min. Lower concentrations of available chlorine were unable to inactivate the virus completely. In the presence of 80% blood, 1000 p.p.m. available chlorine in the disinfectant test mixture was unable to inactivate 3.75 log TCID50 HIV/ml, although 2500 p.p.m. available chlorine was able to inactivate at least 1.5 log TCID50 HIV/ml. In all test mixtures, the chlorine rapidly became combined and thus less active. Our results emphasise the importance of cleaning prior to disinfection with sodium hypochlorite since it may prove to be ineffective in the presence of high levels of organic matter. In cases where prior cleaning is impossible, care must be taken to use the higher recommended concentration (a minimum of 10,000 p.p.m. available chlorine).

Cell Survival↗
PubMed2005

Reduction of disinfection byproduct formation by molecular reconfiguration of the fulvic constituents of natural background organic matter.

Experiments were performed to assess the effects of treating the fulvic acid fractions of background natural organic matter (NOM) by catalyst-induced oxidative coupling reactions. Changes in the molecular characteristics of the fulvic acids and related disinfection byproduct formation potentials of these important NOM constituents were investigated. The coupling reactions were induced by addition of horseradish peroxidase (HRP) and hydrogen peroxide to aqueous solutions of the fulvic acids (FAs) in semicontinuous flow reactors. Subsequent removal of organic matter by ultrafiltration was found to be markedly enhanced for FA solutions subjected to oxidative coupling treatment. Uniform formation condition tests further indicated that the disinfection byproducts formed upon chlorination of FAs treated via induced oxidative coupling were reduced significantly on a unit carbon basis relative to those formed upon chlorination of their untreated counterparts. Spectroscopic examinations revealed thatthe FA molecules were effectively reconfigured in the oxidative coupling reactions. Substantial conversion of aromatic hydroxyl groups into ether-bonded moieties is evident, and a loss of primary amine groups, probably through conversion into secondary or tertiary amines, was also observed. These conversions apparently result in cross-linking of the natural FA moieties to form stable species of larger sizes, thus rendering them more readily removable by ultrafiltration and less reactive with chlorine. The results of the study may be interpreted as indicating that catalytically induced oxidative coupling reactions of the type conducted in this work can be combined with ultrafiltration to provide an effective scheme for removal of disinfection byproduct precursors.

Adsorption↗
PubMed1996

A survey of the methods of disinfection of dental impressions used in dental hospitals in the United Kingdom.

The potential for cross-infection from microbial contaminated dental impressions has long been recognised. This study set out to investigate impression decontamination procedures currently used in UK dental hospitals (1995) and to see how these may have changed since a previous survey, carried out in 1988. A variety of disinfection solutions and regimes were highlighted both within and between dental hospitals. Several of the disinfecting solutions currently being used have not been specifically tested for efficacy with impression materials. The laboratories were asked to highlight any adverse reactions. Five laboratories reported that some alginates resulted in casts with poor surface properties when immersed in hypochlorite (0.1 and 1%), sodium dichloroisocyanurate, and 2% glutaraldehyde solutions. This paper highlights that there is no universally recognised impression disinfection/sterilisation protocol. It is recommended that all impressions should at least undergo a disinfecting procedure by immersion in 1% sodium hypochlorite for a minimum of 10 minutes.

Dental Impression Materials↗
PubMed1999

An investigation into the differences between the Bioscreen and the traditional plate count disinfectant test methods.

Investigations of biocide efficacy by automated methods involving optical density measurements, e.g. using the recently published 'Bioscreen' method, are complicated by the fact that a poor correlation often exists between the log reductions obtained using the automated method vs those obtained by the traditional plate count methods. It was hypothesized that the differences observed between the two methods were due to the level of cell injury, which was masked by the optical density methods but which was recognized by the plate counts. Comparisons of log reductions following a disinfection test always showed the Bioscreen method to be overestimating the log reductions with respect to the plate counts. A correlation between colony size on the plates and the 'Bioscreen' results for a fixed disinfectant concentration and contact time was found using Global Imaging software. The results obtained also suggested that the observed colony area was dependent on the amount of injury incurred by a microbe during the disinfection process. A mathematical model of injury was developed which predicted the observed differences between the Bioscreen and the traditional plate method. The model further suggested a possible reason for biocidal lags.

Colony Count, Microbial↗
PubMed2000

Disinfection kinetics: a new hypothesis and model for the tailing of log-survivor/time curves.

A new hypothesis for the understanding of chemical disinfection, which we have termed the Intrinsic Quenching hypothesis, is presented. This mechanistic treatment of disinfection kinetics is based on the hypothesis that the biocide concentration may not be in vast excess over the microbes, as is normally assumed. A mathematical model was developed and found to be useful in describing the observed kinetics of several disinfectants. The model suggested that the reason for the observation of non-linear, log-survivor curves was due to the ability of the microbes, in clean, soil-free conditions, to intrinsically quench the bulk concentration of biocide.

Disinfectants↗
PubMed2003

Effects of chemical disinfectants on the transverse strength of denture base acrylic resins.

The disinfection of dental prostheses by immersion in a chemical solution should be capable of rapid inactivation of pathogenic microorganisms, without causing any adverse effect on the denture base resins. This study evaluated the effect of disinfection immersion on the transverse strength of two heat-cured resins. The denture base resins (Lucitone 550 and QC 20) were polymerized according to the manufacturers' instructions. After polymerization, the specimens were polished, and then stored in water at 37 degrees C for 50 +/- 2 h prior immersion in one of the following solutions for 10 min: 4% chlorhexidine, 1% sodium hypochlorite and 3.78% sodium perborate. The specimens were submitted to disinfection twice, simulating when dentures come from the patient and before being returned to the patient. Ten specimens were made for each group. The transverse strength was evaluated by a 3-point bend test. The flexural strength of the two denture base acrylic resins evaluated remained unaffected after immersion in the three solutions evaluated. In general, the QC 20 resin specimens exhibited lower transverse strength than the Lucitone 550 resin specimens, regardless of immersion solutions.

Acrylic Resins↗
PubMed1998

Disinfectant testing: use of the Bioscreen Microbiological Growth Analyser for laboratory biocide screening.

A new method is described for screening potential biocides based on the traditional suspension test using the Bioscreen optical plate reader. This new method is rapid, reproducible, quantitative and cost effective. Data obtained by this new method are not directly equivalent to the log reduction normally quoted, but give a measurement of the total effect of the biocide on the microbe population, measuring the effect of injury as well as death (non-viability). The method allows for the routine examination of disinfection kinetics, the study of which leads to greater scientific insight into disinfection than that achieved by the standard 5 min, one-point, disinfection tests currently employed.

Colony Count, Microbial↗
PubMed2001

Better compliance and better tolerance in relation to a well-conducted introduction to rub-in hand disinfection.

The aim of the study was to demonstrate that the introduction of rub-in hand disinfection (RHD) in hospital units, with the implementation of suitable equipment, drafting of specific protocols, and training users, improved compliance of hand disinfection and tolerance of user's hands. In four hospital units not previously using RHD an external investigator conducted two identical studies in order to measure the rate of compliance with, and the quality of, disinfection practices, [rate of adapted (i.e., appropriate) procedures, rate of correct (i.e., properly performed) procedures, rate of adapted and correct procedures carried out] and to assess the state of hands (clinical scores of dryness and irritation, measuring hydration with a corneometer). Between the two studies, the units were equipped with dispensers for RHD products and staff were trained. Compliance improved from 62.2 to 66.5%, quality was improved (rate of adapted procedures from 66.8% to 84.3%, P > or = 10(-6), rate of correct procedures from 11.1% to 28.9%, P > or = 10(-8), rate of adapted and correct procedures from 6.0 to 17.8%, P > or = 10(-8)). The tolerance was improved significantly (P > or = 10(-2)) for clinical dryness and irritation scores, although not significantly for measurements using a corneometer. This study shows the benefit of introducing RHD with a technical and educational accompaniment.

Attitude of Health Personnel↗
PubMed2002

Intra-laboratory reproducibility of the hand hygiene reference procedures of EN 1499 (hygienic handwash) and EN 1500 (hygienic hand disinfection).

The bactericidal efficacy of hand antiseptic products is determined in Europe using two norms--EN1499 (hygienic handwash), and EN 1500 (hygienic hand disinfection) based on reducing the counts of bacteria on artificially contaminated hands. Each requires 12-15 data sets per test and comparison with a reference procedure. Recent research using EN 1500 suggested that most alcohol-based hand gels are significantly less effective than the reference alcohol (2-propanol 60%), whereas liquid alcohol-based rubs are not. However concerns about the accuracy and reproducibility of the norm reference procedures have been raised. We therefore analysed 23 experiments carried out using EN 1500 representing 342 hand disinfection procedures, and 12 experiments using EN 1499 representing 178 handwashes, all performed in the same laboratory for reproducibility of the reference procedures. The reference alcohol gave a mean log(10) reduction factor (RF) of 4.64 +/- 0.93; only one data set gave a significantly higher result (5.14, P = 0.034), and one significantly lower (4.05; P = 0.034). Analysis of all 23 means revealed no significant difference (P = 0.188; ANOVA model). The reference soap gave a mean reduction of 2.82 +/- 0.49. Two data sets were significantly higher than this (3.35,P < 0.001; 3.12, P < 0.001) and two significantly lower (2.55, P = 0.031; 2.47,P = 0.004). Analysis of all the means did reveal a significant difference (P < 0.001, ANOVA model), which is probably explained by the smaller standard deviations of these results. Pre-values (bacteria recovered from fingers before a reference procedure) correlated significantly with RFs for both hand disinfection (correlation coefficient: 0.291;P = 0.01) and handwash (correlation coefficient: 0.372, P = 0.01). Overall both procedures gave accurate and reproducible results.

Analysis of Variance↗
PubMed1976

Disinfection procedures of fiberscopes in endoscopy departments.

Disinfection of fibre endoscopes was examined in 5 endoscopy departments during endoscopy sessions. On the endoscopes, especially in the instrument channels, Pseudomonas aeruginosa and Proteus species could be regularly found, in some cases also Enterobacter cloacae and Candida albicans. With the results of disinfection experiments, proposals are made to reduce the infection risk due to insufficiently disinfected instruments in endoscopy departments.

Bacteriological Techniques↗
PubMedDate not supplied

Acanthamoeba and disinfection of soft contact lenses.

The association between acanthamoeba keratitis and the use of soft contact lenses is firmly established. Despite alerts and warnings, education of eye-care professionals and patients, and identification of risk factors that are associated with the use of soft contact lenses, acanthamoeba keratitis remains a threat. It is presumed that in some cases, the soft contact lens is the vector by which Acanthamoeba is introduced to the cornea. This presumption has spurred concern regarding the efficacy of systems used for the disinfection of soft contact lenses in killing the organism. Many questions have been raised regarding the proficiency of disinfection. These have stemmed from a poor understanding of the interactions among soft contact lenses, soft contact lens paraphernalia, and Acanthamoeba. Another issue to be addressed is the need for standardized testing of the efficacy of contact lens disinfection systems against Acanthamoeba. Only through a concerted and focused effort by eye-care and other concerned health care professionals can these questions be answered.

Acanthamoeba↗
PubMed1993

Efficacy of a one-step hydrogen peroxide system for disinfection of soft contact lenses.

We investigated the efficacy of a one-step hydrogen peroxide system by culturing soft contact lenses before and after exposure to the AOSEPT disinfection system. Sixteen of 38 soft contact lenses obtained from asymptomatic wearers showed microbial growth. Nine cultures were positive for Pseudomonas sp., four showed growth of Staphylococcus sp., two were positive for beta-hemolytic streptococci, and one culture was positive for Alcaligenes faecalis. A second culture of the contact lenses after hydrogen peroxide disinfection showed no growth in 12 of the 16 previous positive cultures. The rate of disinfection was 55% for Pseudomonas sp. and 100% for other bacteria.

Adolescent↗
PubMed1999

High-level disinfection of gastrointestinal endoscopes: are current guidelines adequate?

OBJECTIVE: For a germicide to obtain a high level disinfection (HLD) claim, FDA requires demonstration of a 6-log reduction of mycobacterial inoculum under worst case conditions. The purpose of this study was to assess the adequacy of current guidelines for high level disinfection of GI endoscopes using alkaline glutaraldehyde in simulated-use testing. METHODS: Various gastrointestinal endoscopes were contaminated with Mycobacterium chelonae in 46 experiments. Quantitative cultures were obtained from each endoscope channel separately after each step: inoculation, standardized manual cleaning, immersion in 2% glutaraldehyde (Cidex) for 10, 20, or 45 min at room temperature, 70% isopropanol rinse, and drying. RESULTS: Manual cleaning alone achieved a 4-log reduction. After 10 min of glutaraldehyde exposure, but before alcohol rinse, two of 10 experiments failed to achieve a 6-log reduction. However, after alcohol rinse, all 10 experiments achieved HLD. After 20 min of glutaraldehyde exposure, but before alcohol rinse, one of 18 experiments failed to achieve a 6-log reduction. After alcohol rinse, all 18 experiments achieved HLD. After 45 min of glutaraldehyde exposure, but before alcohol rinse, one of 18 experiments failed to achieve a 6-log reduction. After alcohol rinse, all 18 experiments achieved HLD. Thus, if the entire reprocessing protocol including manual cleaning, glutaraldehyde exposure, alcohol rinse, and drying was taken into account, the required 6-log reduction of mycobacteria was achieved with a minimum of 10 min of glutaraldehyde exposure at room temperature. CONCLUSIONS: Current guidelines for high level disinfection using glutaraldehyde are appropriate. Alcohol rinse is a valuable adjunctive step for drying and for its bactericidal effects.

Disinfectants↗
PubMed1993

Methodological approaches to disinfection of human hepatitis B virus.

Three commercial disinfectants (two quaternary formulations and one phenolic) were tested against human hepatitis B virus (HHBV). The treated virus was assayed for infectivity by the chimpanzee assay and for morphological alteration by the Morphological Alteration and Disintegration Test. The same agents were tested against duck hepatitis B virus in a duck hepatocyte infectivity assay. It is apparent that human and duck hepatitis viruses were relatively susceptible to disinfection, becoming noninfectious after < or = 10 min of contact with the disinfectant. The Morphological Alteration and Disintegration Test accurately predicted activity in the two infectivity tests. The anti-human hepatitis B virus effect of the low-level quaternary ammonium germicides is a novel finding and suggest that members of the family Hepadnaviridae are relatively susceptible to chemical agents.

Animals↗
PubMed2001

A comparison of cyst age and assay method of the efficacy of contact lens disinfectants against Acanthamoeba.

AIMS: (i) To determine effect of Acanthamoeba cyst age, method of production, and (ii) to assay technique on the efficacy of multipurpose solutions (MPS) and hydrogen peroxide based contact lens disinfectants. (iii) To establish if MPS can remove mature cysts from contact lenses according to the ISO/DIS 14729 regimen test for microbe removal. METHODS: Immature and mature cysts of A polyphaga were tested against the MPS Opti-Free express and the hydrogen peroxide based solutions Oxysept 1Step and Oxysept 1 using two assay methods. Simulated patient regimen testing was performed with the Opti-Free express and Complete using mature cysts inoculated on to group I or group IV lenses. RESULTS: Immature cysts were sensitive to disinfection by all solutions. No killing was observed with mature cysts with Opti-Free express, while immature cysts yielded a 1-2 log reduction in viability. Oxysept 1Step gave a 1.1 (SD 0.3) log reduction in mature cysts after 6 hours. Oxysept 1 gave a 2.4 (0.3) log reduction in mature cysts after 4 hours and a 3.8 (0.5) log reduction after 6 hours. Patient regimen testing using Opti-Free express and Complete resulted in no recovery of viable mature cysts from the contact lenses or from the soaking solutions. CONCLUSION: Cyst age but not method of production used in this study influences the efficacy of contact lens disinfectants against Acanthamoeba. MPS are effective in removing cysts from contact lens surfaces and may have a role in the prevention of acanthamoeba keratitis.

Acanthamoeba↗
PubMed1961

Disinfection of hospital blankets with synthetic phenolic compounds.

A cheap method by which hospital blankets may be effectively disinfected (approximately 3d. per blanket) is described. A recommendation is made that blankets from the patients' beds be divided into: ;socially dirty' blankets to be laundered, possibly at infrequent intervals; and ;socially clean' blankets to be disinfected frequently. The wide range of a synthetic phenolic compound is described. This substance is effective against all the common pathogenic bacteria in the presence of organic matter, anionic, or cationic detergents. Details are given of laboratory trials with this method of disinfection and of pilot trials at the Group hospital laundry. The recommended method is simpler and takes less time than ordinary washing.

Disinfection↗
PubMed1961

Disinfection of woollen blankets in steam at subatmospheric pressure.

Blankets may be disinfected in steam at subatmospheric pressures by temperatures below boiling point inside a suitably adapted autoclave chamber. The chamber and its contents are thoroughly evacuated of air so as to allow rapid heat penetration, and steam is admitted to a pressure of 10 in. Hg below atmospheric pressure, which corresponds to a temperature of 89 degrees C. Woollen blankets treated 50 times by this process were undamaged. Vegetative organisms were destroyed but not spores. The method is suitable for large-scale disinfection of blankets and for disinfecting various other articles which would be damaged at higher temperatures.

Disinfection↗