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Dialyser reuse: an automated system using peracetic acid.

For 3 years starting in April 1989, in a 17-station, in-centre haemodialysis unit at the Toronto Western Hospital, re-use of dialysers was performed using the Renatron-2 Dialyser Reprocessing System with peracetic acid as a sterilant. During this period 40,234 treatments were carried out and dialysers were used an average of 4.2 times. Net savings, after taking into account the total costs of re-use, averaged Can $309,000,000 per year. There were no deaths and no discernible morbidity attributable to the practice of re-use. We conclude that dialyzer re-use is an effective way to reduce the costs of haemodialysis and is entirely safe providing that it is carried out properly.

Canada↗

Use of peracetic acid as a disinfectant in a water-treatment plant: effect on the plasmid contents of Escherichia coli strains.

Total thermotolerant coliforms (TTC) and Escherichia coli strains were isolated from sewage from a treatment plant before and after peracetic acid (PAA) disinfection. The plasmid profiles of 120 E. coli strains were analyzed. Although PAA disinfection effectively reduced the number of TTC and E. coli strains, the percentage of E. coli strains containing plasmids was not statistically different among water samples. The sizes of the plasmids found ranged from < 3 kb to > 56 kb, but plasmids of between 3 and 5 kb were encountered most frequently.

Disinfectants↗

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↗

Disinfection efficiency of peracetic acid, UV and ozone after enhanced primary treatment of municipal wastewater.

The City of Montreal Wastewater Treatment Plant uses enhanced physicochemical processes (ferric and/or alum coagulation) for suspended solids and phosphorus removal. The objective of this study was to assess the ability of peracetic acid (PAA), UV, or ozone to inactivate the indicator organisms fecal coliforms, Enterococci, MS-2 coliphage, or Clostridium perfringens in the effluent from this plant. PAA doses to reach the target fecal coliform level of 9000 CFU/100mL exceeded 6 mg/L; similar results were obtained for enterococci, and no inactivation of Clostridium perfringens was observed. However a 1-log reduction of MS-2 occurred at PAA doses of 1.5 mg/L and higher. It was expected that this effluent would have a high ozone demand, and would require relatively high UV fluences, because of relatively high effluent COD, iron and suspended solids concentrations, and low UV transmittance. This was confirmed herein. For UV, the inactivation curve for fecal coliforms showed the typical two-stage shape, with the target of 1000 CFU/100 mL (to account for photoreactivation) occurring in the asymptote zone at fluences >20 mJ/cm(2). In contrast, inactivation curves for MS-2 and Clostridium perfringens were linear. Clostridium perfringens was the most resistant organism. For ozone, inactivation was already observed before any residuals could be measured. The transferred ozone doses to reach target fecal coliform levels ( approximately 2-log reduction) were 30-50 mg/L. MS-2 was less resistant, but Clostridium perfringens was more resistant than fecal coliforms. The different behaviour of the four indicator organisms studied, depending on the disinfectant, suggests that a single indicator organism might not be appropriate. The required dose of any of the disinfectants is unlikely to be economically viable, and upstream changes to the plant will be needed.

Clostridium perfringens↗

Simultaneous potentiometric determination of peracetic acid and hydrogen peroxide.

A rapid and highly selective potentiometric method for the simultaneous analysis of peracetic acid (PAA) and hydrogen peroxide (H2O2) has been proposed, for the first time, using glassy carbon (GC) as an indicator electrode and I2/I- potential buffer. On the basis of the large difference in the reaction rates of PAA and H2O2 with I-, which was confirmed using stopped-flow spectrophotometry, a transient potential response corresponding to the reactions of the two species with I- was observed. The response times were typically a few seconds and several minutes for PAA and H2O2, respectively. The effects of the concentrations of molybdate catalyst, H+, I2, and I- in the potential buffer on the selectivity as well as the sensitivity were examined. The potential response obtained using the GC indicator electrode was found to be Nernstian over a wide range of their concentrations (typically from micromolar to millimolar) with slopes of 30.5 and 29.5 mV for PAA and H2O2, respectively (in close agreement with the theoretical value, that is, 29.6 mV). O2 was found to have no substantial effect on the potential change at the GC electrode in the present potential buffer.

Journal Article↗

An EPR study on wastewater disinfection by peracetic acid, hydrogen peroxide and UV irradiation.

EPR spectroscopy was applied to obtain qualitative and quantitative information on the radicals produced in disinfection processes of wastewater for agricultural reuse. The DEPMPO spin trap was employed to detect hydroxyl and carbon-centered short living radicals in two different peracetic acid solutions and a hydrogen peroxide solution used for water disinfection either in the absence or in the presence of UV-C irradiation. Moreover, three different kinds of water (wastewater, demineralized water, distilled water) were analysed in order to assess the contribution of Fenton reactions to the radical production. The spectroscopic results were discussed in relation to the efficiency of the different oxidizing agents and UV irradiation in wastewater disinfection evaluated as Escherichia Coli, Faecal and Total Coliforms inactivation.

Disinfection↗

Oxidation state analysis of mercury: evidence of the formation of mercurous ion in the oxidation of mercury by peracetic acid.

Both elemental mercury and the mercurous ion give rise to a signal in Cold-Vapor Atomic Absorption Analysis under non-reducing conditions. Distinction between these species based on the greater solubility of the mercurous ion in water is possible, and the potential of this analytical distinction is illustrated with the finding that oxidation of mercury by peracetic acid involves the mercurous state.

Acetates↗

[Evaluation of genotoxicity of sodium hypochlorite, chlorine dioxide and peracetic acid using plant tests].

The aim of this research was to evaluate the potential genotoxic effects of three drinking water disinfectants by means of in vivo short-term mutagenicity tests using plants. The study was carried out in laboratory using distilled water disinfected with sodium hypochlorite (NaClO), chlorine dioxide (ClO2) and peracetic acid (PAA) at different concentrations both in neutral and acid conditions. Untreated distilled water was used as a negative control. Micronuclei test in Tradescantia pollen cells and chromosomal aberration test in root cells of Allium cepa were the bioassays performed by exposing directly plant bioindicators to treated and untreated distilled water. The Tradescantia/micronuclei test gave positive results in most of the ClO2-treated water samples but only at acid pH. The Allium cepa test showed genotoxicity in NaClO-treated samples at acid pH and in a ClO2-treated sample at pH 7. PAA-treated samples were always nongenotoxic. Since the concentrations tested of free disinfectants are usually present in drinking water for biocidal purposes, genotoxicity of these compounds could be a public health problem.

Chlorine Compounds↗

Peracetic acid stress-induced genetic rearrangements in Escherichia coli H10407 detected by RAPD and RFLP analyses.

The discriminatory powers of random amplified polymorphic DNA (RAPD) analysis and restriction fragment length polymorphism (RFLP) were assessed for the detection and comparison of DNA modifications caused by an oxidative stress. DNA extracted from peracetic acid (PAA)-treated Escherichia coli H10407 was randomly amplified with the 10-mer primer OPZ14, which generated one stress-induced fragment. RFLP and RAPD profiles were hybridized by Southern blotting with the digoxigenin-labelled RAPD product. Untreated and PAA-treated cells had difference band profiles. The results indicate that RAPD analysis could be used as a discriminatory tool for investigating genetic rearrangements in E. coli caused by oxidative stress and that RFLP analysis could be used to confirm the rearrangements.

DNA Fingerprinting↗

Biomechanical comparison of human bone-patellar tendon-bone grafts after sterilization with peracetic acid ethanol.

Recent reports of disease transmission following ACL reconstruction with fresh-frozen non-sterilized allografts have highlighted the need for new sterilization techniques that do not impair the mechanical properties as it was shown for most of the current sterilization techniques. In this in-vitro biomechanical study, it was investigated if peracetic acid ethanol sterilization (PES) has any adverse effects on the mechanical properties of human bone-patellar tendon-bone grafts (BPTB). Paired human BPTB grafts either underwent PES or were used as fresh-frozen non-sterilized grafts. Viscoelastic properties (strain, creep) were analyzed during cyclic submaximal loading and mechanical properties were investigated during load-to-failure (LTF) testing. It was found that there were no differences in viscoelastic and mechanical properties between both groups. The findings of this study provide baseline data for future in vitro and in vivo analyses of this promising new sterilization technique for soft-tissue allografts.

Biomechanical Phenomena↗

Characterization of micro-organisms isolated from dairy industry after cleaning and fogging disinfection with alkyl amine and peracetic acid.

AIMS: To characterize micro-organisms isolated from Norwegian dairy production plants after cleaning and fogging disinfection with alkyl amine/peracetic acid and to indicate reasons for survival. METHODS AND RESULTS: Microbial samples were collected from five dairy plants after cleaning and fogging disinfection. Isolates from two of these production plants, which used fogging with alkylamino acetate (plant A), and peracetic acid (plant B), were chosen for further characterization. The sequence of the 16S ribosomal DNA, fatty acid analysis and biochemical characteristics were used to identify isolates. Three isolates identified as Rhodococcus erythropolis, Methylobacterium rhodesianum and Rhodotorula mucilaginosa were isolated from plant A and one Sphingomonas sp. and two M. extorquens from plant B. Different patterns of resistance to seven disinfectants in a bactericidal suspension test and variable degree of attachment to stainless steel were found. The strains with higher disinfectant resistance showed lower degree of attachment than susceptible strains. CONCLUSIONS: The study identifies and characterizes micro-organisms present after cleaning and fogging disinfection. Both surface attachment and resistance were shown as possible reasons for the presence of the isolates after cleaning and disinfection. SIGNIFICANCE AND IMPACT OF THE STUDY: These results contribute to the awareness of disinfectant resistance as well as attachment as mechanisms of survival in dairy industry. It also strengthens the argument of frequent alternation of disinfectants in the food processing industry to avoid the establishment of resistant house strains.

Amines↗

Halophilic bacteria susceptibility to peracetic acid vapor and ethylene oxide.

Extremely to slightly halophilic bacteria were tested for susceptibility to two sterilizing agents, peracetic acid (PAA) and ethylene oxide (ETO). PAA susceptibility was explored by two methods: an agar plate (constant pH of 7.2) and a filter strip (constant incubation period of 37 days); 100% susceptibility was obtained by both methods. The dosage (0.5 ml/min) was applied to a filter pad in a petri dish cover. Glove box experiments with ETO (input 1.5 lb. [ca. 680.4 g]/24 hr, the only constant) yielded 100% susceptibility for all halophiles tested. These experiments demonstrated the efficacy of two lethal agents for extreme halophiles, PAA and ETO. Variation in pH did not affect susceptibility.

Acetates↗

Assessment of the biological properties of human split skin allografts disinfected with peracetic acid and preserved in glycerol.

Skin allografts derived from cadaveric human donors are widely used in the treatment of serious burn injuries and other conditions, such as ulcers. In order to render these allografts safe for clinical use, and to enable them to be preserved and banked for long periods, effective methods of decontamination and preservation are required. These methods must not adversely affect graft properties essential for clinical performance. We have investigated the application of a peracetic acid (PAA) disinfection protocol, coupled with preservation in either glycerol or propylene glycol to achieve these goals. An effective decontamination procedure, comprising of a 3h exposure to 0.1% (v/v) PAA in phosphate buffered saline (PBS) at pH 7.0, was developed and had no significant detrimental effects on the structure of skin. Cadaveric skin allografts were then treated with this disinfection protocol and subsequently preserved in either 85% (v/v) glycerol or propylene glycol in PBS, and the biological properties of the allografts thought to be essential to successful clinical performance were assessed. The cytotoxicity of the grafts was assessed using both extract and contact assays; damage to the skin collagen was assessed using a collagenase susceptibility assay and the capacity of the grafts to elicit an inflammatory response in vitro was assessed by quantifying the production of the pro-inflammatory cytokine TNF-alpha by human peripheral blood mononuclear phagocytes. Neither the disinfection protocol nor either of the preservation techniques rendered the grafts cytotoxic or pro-inflammatory. The PAA disinfection and glycerol preservation protocol had no effects on collagenase susceptibility, whereas the disinfection protocol in combination with propylene glycol rendered some of the test samples significantly more susceptible to collagenase digestion. Therefore, this study has demonstrated that PAA disinfection combined with glycerol preservation is suitable for skin allografts. The use of propylene glycol as a preservation agent for skin requires further development.

Bacillus subtilis↗

Design and use of a novel peracetic acid sterilizer for absolute barrier sterility testing chambers.

Increasing use is being made of absolute barrier chambers in the pharmaceutical industry for sterility testing of sterile pharmaceuticals. Since these barriers are designed to form a microbial-tight enclosure to eliminate laboratory microbial contamination derived from the operator and the environment,it is important that the method used to sterilize these barriers, product containers, and articles used within, provide a high degree of sterility assurance. A major part of incorporating absolute barriers in the sterility testing laboratory at the Upjohn Company was to design an automated sterilization system to facilitate the spraying of a liquid sterilant, e.g., peracetic acid, inside these barriers. This article focuses on general design considerations, specific details of the apparatus, and the operational steps. The sterilization efficacy of this method is also described, with particular emphasis on validation criteria and results. Finally, operational sterility testing results are discussed.

Equipment Contamination↗

Effects of a peracetic acid disinfection protocol on the biocompatibility and biomechanical properties of human patellar tendon allografts.

Patellar tendon allografts, retrieved from cadaveric human donors, are widely used for replacement of damaged cruciate ligaments. In common with other tissue allografts originating from cadaveric donors, there are concerns regarding the potential for disease transmission from the donor to the recipient. Additionally, retrieval and subsequent processing protocols expose the graft to the risk of environmental contamination. For these reasons, disinfection or sterilisation protocols are necessary for these grafts before they are used clinically. A high-level disinfection protocol, utilising peracetic acid (PAA), has been developed and investigated for its effects on the biocompatibility and biomechanics of the patellar tendon allografts. PAA disinfection did not render the grafts either cytotoxic or liable to provoke an inflammatory response as assessed in vitro . However, the protocol was shown to increase the size of gaps between the tendon fibres in the matrix and render the grafts more susceptible to digestion with collagenase. Biomechanical studies of the tendons showed that PAA treatment had no effect on the ultimate tensile stress or Young's modulus of the tendons, and that ultimate strain was significantly higher in PAA treated tendons.

Adult↗

Sporicidal activity of peracetic acid and beta-propiolactone at subzero temperatures.

A method was developed to evaluate and measure the sporicidal activity of peracetic acid (PAA) and beta-propiolactone (BPL) at subzero temperatures as low as -40 C. Bacillus subtilis var. niger spores were used as the test organism. Both PAA and BPL were sporicidal at low temperatures, with PAA the more active. The temperature coefficients of the two chemicals are generally low over a range of 20 to -20 C, but increase significantly at temperatures below this. Results showed an initial lag in the PAA death rates that was directly dependent on the temperature. BPL did not show this lag time.

Acetates↗

[Mutagenicity testing in the sperm head test/mouse and mutagenic potency of 2 disinfectants on the basis of peracetic acid and phenols, respectively].

For the improvement of the registration of data by assessment of mutagenic risk the analysis of sperm-head abnormalities have been rendered as a suitable at indirect evidence of mutagenic potency. The reproduction of the results is well. The sensitivity of the test is high. The quantitative evaluation of genotoxic effects is possible. By reason of comparatively low methodical expense the screening investigations of species mouse are suitable, before more expensive tests will be accomplished for the elucidation of the mutation type. At 35 day-long intraperitoneal application the double number of sperm head abnormalities was approximately induced through Wofasteril (dose refer to main agent peracetic acid 2.6 mg/kg bw/d) and about 1/3 through cyclophosphamide (dose 25 mg/kg bw/d). With a 50% reduction of Wofasteril dose the mutagenic threshold-concentration was too low. The phenolic disinfectant Wofasept caused only slight no significant increase of the rate of sperm-head abnormalities (doses refer to the content of compounds, for Chlorocresol 1.6 mg/kg bw/d, for Clorofen 0.7 mg/kg bw/d and for detergent 4.8 mg/kg bw/d).

Acetates↗

Application of a high-level peracetic acid disinfection protocol to re-process antibiotic disinfected skin allografts.

Skin allografts, derived from cadaveric donors, are widely used for the treatment of burns and ulcers. Prior to use in clinical situations, these allografts are disinfected using a cocktail of antibiotics and then cryopreserved. Unfortunately, this antibiotic disinfection procedure fails to decontaminate a significant proportion and these contaminated grafts can not be used clinically. We have investigated whether it is possible to apply a second, more potent disinfection procedure to these contaminated grafts and effectively to re-process them for clinical use. Cadaveric skin grafts, treated with antibiotics and cryopreserved, were thawed and a peracetic acid (PAA) disinfection protocol applied. The grafts were then preserved in a high concentration of glycerol or propylene glycol, and properties thought to be essential for successful clinical performance assessed. The cytotoxicity of the grafts was assessed using both extract and contact assays; damage to the skin collagen was assessed using a collagenase susceptibility assay and the capacity of the grafts to elicit an inflammatory response in vitro was assessed by quantifying the production of the pro-inflammatory cytokine TNF-alpha by human peripheral blood mononuclear phagocytes. PAA disinfection, in conjunction with either glycerol or propylene glycol preservation, did not render the grafts cytotoxic, pro-inflammatory, or increase their susceptibility to collagenase digestion. The rates of penetration of glycerol and propylene glycol into the re-processed skin were comparable to those of fresh skin. This study has demonstrated that PAA disinfection combined with immersion in high concentrations of either glycerol or propylene glycol was an effective method for re-processing contaminated skin allografts, and may justify their clinical use.

Anti-Bacterial Agents↗