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[The mechanism of action of aerosol disinfection].

It is drawn up a list of physical laws describing the behavior of an aerosol system. First the influence of sedimentation, diffusion, coagulation and impaction is described. In the second part the evaporation and the condensation from droplets in relation to the vapor tension of disinfectants is regarded. Finally the circumstances under which the vaporized disinfectants will reach the microorganisms by diffusion are described. It is demonstrated, that the terminus technicus "aerosol disinfection" should be restricted to systems, that operate with drop diameters less than or equal to 10 microns.

Aerosols↗

Influence of the growth characteristics of Candida albicans on disinfectant testing.

In order to standardize antifungal disinfectant testing using Candida albicans as a test organism, the morphology of four type strains of C. albicans DSM 1836, ATCC 10231, CNCM 1180-79 and CBS 562, grown on sixteen different media was determined. The incubation was carried out at 28 degrees C and 37 degrees C. The yeast phase was obtained predominantly on TSA medium with all strains. Mixed phases, i. e. true mycelium and yeast cells, were easily obtained in TSB in shaking flasks for three type strains but not for CBS 562. True mycelium was formed on corn meal media (CMA) for all strains, but the growth was very poor. The morphology of the growth was determined more by the type of strain than by the nutritive medium. Therefore C. albicans ATCC 10231 grown on either TSA or CMA was used as a test organism. Its resistance was determined towards four disinfectant standards: benzalkonium chloride, mercuric chloride, phenol and o-phenylphenol. No difference in sensitivity was found for the former disinfectant, but yeast cells grown on TSA were more resistant than C. albicans cultures on CMA in case of mercuric chloride, phenol and o-phenylphenol.

Antifungal Agents↗

Use of glutaraldehyde for disinfection in dialysis.

We compared Cidex HD Disinfecting Solution (CHD), a brand of glutaraldehyde disinfectant, alone and with bleach (B) to formaldehyde (F) with bleach for disinfection and cleaning of hemodialysis equipment. Two Drake-Willock central delivery systems (CDS) with 15 accompanying bedside stations and one Drake-Willock 4216 single patient delivery system (SPS) were used. The CDS designated #1, delivered dialysate to bedside stations 1 through 9, while CDS#2 supplied bedside stations 10 through 16. The study was conducted in three stages. Stage I used F six nights per week and B cleaning Wednesday (CDS#1/SPS) versus F Monday, Wednesday, and Friday with B on Wednesday (CDS#2) for four weeks. Stage II compared CHD six nights/week versus CHD Monday, Wednesday, and Friday for eight weeks. Stage III compared CDH six nights/week with B cleaning on Wednesday versus CHD on Monday, Wednesday, and Friday with B cleaning on Wednesday for four weeks. Samples of pretreated water were collected aseptically on Mondays, Wednesdays, and Fridays each week from the following sites: pre/CDS, inflow Hansen-bedside stations #5, #13, and SPS and pre-blood detector on BS #5, #13, and the SPS. During the study, 763 samples were cultured. Microbiological test results were reported as colony forming units per ml (CFU/ml). The CFU/ml were obtained by filtrating a 10 ml aliquot through a 0.45 mu filter, the filter transferred to a petri dish containing standard plate count agar and counted.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldehydes↗

[Development of a new testmethod for surface disinfection procedures. VII. Proposal for the method (author's transl)].

Based on the findings obtained from the previous experiments (information I-VI), a proposal is made for the examination of surface disinfection procedures under conditions roughly resembling those prevailing in practice. This test allows the action of the disinfectant to be calculated, while making due allowance for the natural rate of kill. The results of three tests with a liminally effective disinfectant concentration extensively agreed with each other. This permits the conclusion that the method has reached optimal standardization.

Candida albicans↗

[Efficacy of 8 disinfectants on 3 types of surfaces contaminated by Pseudomonas aeruginosa].

The disinfecting capacity of eight commercial chemical products was evaluated by the use--dilution method given by the Associated of Official Analytical Chemists (AOAC) on three types of surface material (steel, aluminum, and plastic). For most products tested the limit concentration was 10 times higher for disinfecting aluminum and plastic surfaces than stainless steel. As observed on the scanning electron microscope, the number of bacteria deposited on the surface and the production of extracellular material on polypropylene by Pseudomonas aeruginosa ATCC 15442 would explain the observed differences. The applicability of the AOAC method or other techniques for the evaluation of the disinfecting capacity on different surfaces is discussed.

Acids↗

Disinfecting properties of performic acid against bacteriophage phi X 174 as a model of small envelope--free viruses.

Performic acid HCOOH (PFA) is a wide-spectrum disinfectant. It inactivates viruses, bacteria and bacterial spores, mycobacteria as well as microscopic fungi. Its main drawback is its instability, which makes it a logical necessity that it is to be prepared prior to use from its components HCOOH and H2O2. The mixing of 8 ml HCOOH of the concentration 850 ml/l and 17 ml H2O2 of the concentration 300 ml/l in a 100 ml-volume reagent bottle with a ground-in glass stopper gives, after an 1-hour rest at room temperature and after another 1 hour in a refrigerator, a stock solution that contains about 50 ml/l of PFA the actual concentration of which is determined iodometrically. Bacteriophage phi X 174 (host E. coli C) is characterized by cubic ikosahedral-type symmetry of particles free of envelope, has 27 mm in diameter and contains single-strand cyclic DNA; formerly was classed among Parvoviridae. The possibility of plaque assay-based quantitative determination of the number of infectious particles makes if it a feasible model for assessing disinfectant action on small hydrophilic viruses under conditions close to those of practical disinfection procedures. PFA stock solution diluted to 1 X 10(-3) (0.05 ml/l of effective component) inactivates the model virus of a concentration 10(8) pfu/ml aqueous suspension within 5 min so that no virus is detectable; the drop in the number of pfu amounts to 7 log orders of magnitude. In the presence of 400 ml/l of serum, the identical effect is achieved within 5 min by PFA stock solution diluted to 5 X 10(-3). The lowest PFA concentration that reliably inactivates bacteriophage phi X 174 in aqueous suspension is identical with the lowest concentration inactivating Coxsackie B 1 virus in tissue cultures. On textile, glass, plastic, rubber and metal carriers contaminated by swabbing or by a dried drop of bacteriophage suspension containing about 1 X 10(9) pfu/ml, the lowest reliably effective concentrations of PFA range within 0.25-0.025 ml/l, i.e. PFA stock solutions diluted to 5 X 10(-3)-5 X 10(-4), depending on the type of carrier and the type of contamination.

Bacteriophage phi X 174↗

[Method of disinfecting plague-infected fleas in preparation for electron microscopic study].

During fixation of fleas infected with plague agent (with preliminary cut heads, limbs and posterior part of the abdomen) in 2.5% glutaric dialdehyde or 2% osmium tetroxide their disinfection was obtained in two days. After double fixation with 2-hour exposure in each of these fixators disinfection of the material was acheived only after additional 2-day maintenance in 70% ethyl alcohol. Fleas, which had been placed into fixators or in 70% ethyl alcohol after double fixation without preliminary dissection, were disinfected completely only in 10 days.

Animals↗

Two in-vivo protocols for testing virucidal efficacy of handwashing and hand disinfection.

Whole-hands and fingerpads of seven volunteers were contaminated with poliovirus type 1 Sabin strain in order to evaluate virucidal efficacy of different forms of handwashing and handrub with alcohols and alcohol-based disinfectants. In the whole-hand protocol, handwashing with unmedicated soap for 5 min and handrubbing with 80% ethanol yielded a log reduction factor (RF) of > 2, whereas the log RF by 96.8% ethanol exceeded 3.2. With the fingerpad model ethanol produced a greater log RF than iso- or n-propanol. Comparing five commercial hand disinfectants and a chlorine solution (1.0% chloramine T-solution) for handrub, Desderman and Promanum, both composed of ethanol, yielded log RFs of 2.47 and 2.26 respectively after an application time of 60 s, similar to 1.0% chloramine T-solution (log RF of 2.28). Autosept, Mucasept, and Sterillium, based on n-propanol and/or isopropanol, were found to be significantly less effective (log RFs of 1.16, 1.06 and 1.52 respectively). A comparison of a modified whole-hand and the fingerpad protocol with Promanum showed similar results with the two systems suggesting both models are suitable for testing the in-vivo efficacy of handwashing agents and hand disinfectants which are used without any water.

Adult↗

Immersion disinfection of irreversible hydrocolloid impressions. Part 2: Effects on gypsum casts.

This study evaluated the quality of gypsum casts recovered from disinfected irreversible hydrocolloid impressions. Four disinfectants were evaluated: 0.525% sodium hypochlorite, Alcide LD, Iodofive, and OMC II. Water served as the control. Specimens were evaluated for roughness, surface detail, and dimensional stability. Impressions disinfected with NaOCI or Alcide produced gypsum casts with physical properties that were generally equal or superior to casts from impressions rinsed with water. OMC II and Iodofive generally produced casts inferior to the controls.

Analysis of Variance↗

[Disinfection of sewage waters from rendering plants by means by peracetic acid].

In our experiments, peracetic acid -- known in commerce as "Wolfasteril" was tested as a new and efficient disinfectant to disinfect sewage waters from rendering plants. Peracetic acid was used in experiments in concentration of 0.1 to 1.0% for 30 sec. to 60 min. As a comparative agent, 5% chloramine was used. Results obtained in preliminary and main experiments proved that peracetic acid is fully appropriate to disinfect biologically cleaned sewage waters in rendering plants. Sewage waters supplying the main stream has to pass mostly a short section after having left the water clariflier. Consequently, the concentration of 1% peracetic acid acting for 30 sec. is the optimum one. The recommendation of this application norm for peracetic acid in water clarifiers from rendering plants being at least suitable in controlling disasters.

Acetates↗

Disinfection and sterilization of composite polishing instruments.

PURPOSE: To evaluate the efficacy of several methods of sterilization and disinfection on two different types of composite finishing and polishing instruments. MATERIALS AND METHODS: The instruments consisted of a proprietary light-cured resin cup impregnated with an abrasive and a silicon dioxide-impregnated rubber cup. Chemical and physical methods included treatment with iodophor, synthetic phenol, glutaraldehyde, microwaving, autoclaving, and chemiclaving. RESULTS: Glutaraldehyde (Vital Defense-S) was an effective disinfectant; however, other chemical (cold) disinfectants overall, were not reliable. Autoclaving, chemiclaving, and microwaving all provided to be effective means of sterilization.

Composite Resins↗

Immersion disinfection of irreversible hydrocolloid impressions in pH-adjusted sodium hypochlorite. Part 2: Effect on gypsum casts.

Lowering the pH of sodium hypochlorite has been shown to greatly improve its efficacy as a disinfectant for irreversible hydrocolloid. This study evaluated the surface roughness and detail reproduction of gypsum casts recovered from impressions disinfected with sodium hypochlorite at altered pH levels. The experimental disinfectants were sodium hypochlorite 0.525% (10-minute immersion) at pH 11.5 (unaltered), pH 10, and pH 8. An additional group was tested at pH 10 for 5 minutes. There was a trend toward increased surface roughness as the pH was lowered, but a 5-minute immersion of impressions in sodium hypochlorite at pH 10 produced casts of equivalent surface roughness to impressions rinsed in water and poured immediately. The test for surface detail reproduction produced similar results.

Analysis of Variance↗

Comparative disinfection of secondary-treated sewage with chlorine dioxide and bromine chloride.

A comparison was made of the inactivation rates of Arcobacter butzleri, coliphages, total coliforms, fecal coliforms, fecal streptococci and heterotrophic plate count in secondary sewage effluent using chlorine dioxide (2 and 4 ppm) and bromine chloride (4 or 8 and 12 ppm) as disinfecting agents. Using these doses the ClO2 gave higher reduction percentages (on average more than 99% at 4 ppm) than those obtained with BrCl. The average values of the fecal indicators are well within the legal limits. Arcobacter butzleri was more sensitive to the disinfectants than other bacteria while fecal streptococci were seen to be more resistant. From the chemical point of view no differences were seen between the two disinfectants except that the action of ClO2 was stronger regarding BOD5 than that of BrCl. With the exception of dichloromethane, the concentration of volatile halogenated compounds showed little variation and values were often lower than detection limits.

Bromides↗

Disinfection of eyelid speculums for retinopathy of prematurity examination.

OBJECTIVE: To evaluate the effectiveness of 70% isopropyl alcohol swabs in disinfecting eyelid speculums after examination for retinopathy of prematurity. METHODS: Two phases. Phase 1: 46 autoclave-sterilized eyelid speculums randomized into either a cleaned or control group following examination for retinopathy of prematurity. Speculums in the cleaned group were disinfected with a 70% isopropyl alcohol swab while control speculums were not cleaned. Bacterial and fungal cultures were then obtained. Phase 2: 20 autoclave-sterilized eyelid speculums inoculated with a clinically relevant dilution of adenovirus serotype 5 or herpes simplex virus type 2. Inoculated speculums were randomized into either a cleaned or control group. RESULTS: Phase 1: 17 (70.8%) of 24 cultures from the cleaned group yielded bacteria compared with 21 (95.5%) of 22 controls. Fungi were isolated from only 1 control and from no cleaned speculums. Phase 2: all speculums inoculated with adenovirus supported growth of the organism irrespective of cleaning with 70% isopropyl alcohol swabs. None of 5 cleaned speculums inoculated with herpes simplex virus type 2 supported viral growth, compared with 3 (60%) of 5 cultures positive for growth in the control group. CONCLUSION: Cleaning eyelid speculums with 70% isopropyl alcohol swabs provided inadequate disinfection against bacteria following examination for retinopathy of prematurity and against adenovirus in a laboratory simulation.

2-Propanol↗

Effectiveness of a procedure for disinfecting the vaginal photoplethysmograph contaminated with herpes simplex virus type 2.

To test the effectiveness of a disinfecting procedure involving 2% glutaraldehyde, a vaginal photoplethysmograph was contaminated with a known amount of herpes simplex type 2 (HSV-2). The vaginal photoplethysmograph was then put through the disinfection procedure. Two virus solutions were tested, one designed to approximate the concentration found in a naturally occurring infection (low inoculum), the other with 100 times more virus (high inoculum). Varying lengths of exposure to glutaraldehyde were tested. Results of assays for the virus after the device was disinfected showed that no measurable infectious virus remained even at the shortest exposure to glutaraldehyde, 1 min. A second experiment was conducted in which glutaraldehyde was added directly to a virus solution. Results confirmed those of the first experiment.

Aldehydes↗

In vitro activity of commercially manufactured disinfectants against Pseudomonas aeruginosa.

The in vitro activity of 17 commercially manufactured disinfectants routinely used in a large teaching hospital was tested against 128 strains of Pseudomonas aeruginosa isolated from hospitalized patients and the hospital environment. Except for quaternary ammonium salts, all the disinfectants at dilutions higher or equalling those recommended by the manufacturer were adequate to suppress P. aeruginosa. Chlorhexidine-, povidone-iodine- and glutaraldehyde-based disinfectants at dilutions 4 to 8-fold lower than the normal use dilution had a marked bactericidal effect ( > 3 log10 reduction of viable cells) within a short time (10 to 120 min). Similar formulations produced by different manufacturers exhibited comparable activity against P. aeruginosa.

Disinfectants↗

The effect of thorough preoperative disinfection on the incidence of postoperative mediastinitis.

This study was conducted to evaluate the effectiveness of scrubbing the skin of patients scheduled to undergo elective cardiac surgery with disinfectant solutions in an attempt to reduce the incidence of the potentially fatal postoperative complication of mediastinitis. Since April 1991, we have routinely disinfected the skin of all such patients three times preoperatively. A retrospective comparison of the incidence of mediastinitis before and after April 1991 was carried out. Microbiological examinations of the anterior chest were conducted in ten patients admitted for elective operations, and in four patients admitted for emergency surgery. Specimens were obtained before each scrubbing, before the operation, and just after skin closure. There was a significant decrease in the general incidence of mediastinitis after April 1991 (P < 0.01). Microbiologically, significant decreases in colony counts were also observed after the first (P < 0.05) and second scrubbing (P < 0.05) in the ten patients specifically studied before elective surgery. No colonies grew in the postoperative specimens from any of these patients, but colony formations were observed in two of the four patients who underwent emergency surgery (P = 0.066). Thus, we conclude that our thorough disinfection method effectively achieves adequate, prolonged suppression of the skin flora, which explains the marked decrease in the incidence of mediastinitis in our hospital since its institution.

Adult↗

[Inactivation of HIV-1 in human femur heads using a heat disinfection system (Lobator SD-1)].

The use of allogenic bone transplants in surgery has been greatly diminished owing to the risk of transmitting infectious diseases. This risk can be reduced by the use of a thermal disinfection system (Lobator SD-1). This is achieved by increasing the temperature to 80 degrees C, inactivating a number of bacterial and viral agents. In this study the decay of HIV at high temperature in the Lobator SD-1 was researched. In the center of human femoral heads 100 microliters of a highly concentrated suspension of free and cell-bound HIV (10(10)) was exposed to the thermal process at intervals of 5, 10, 20, 30, 40, 50 and 62 min. For the recultivation HUT-78 cells were used through titration of the virus suspension in ten-fold dilutions over ten dilution steps and incubation up to a maximum of 21 days. Evidence of the virus was checked through observing giant cell formations and quantitative determination of p24 antigen using an Elisa test. Linear virus inactivation was found based upon the time the virus was exposed to heat. After a treatment of 40 min in the disinfection system, total virus inactivation was achieved. The normal disinfection process time using Lobator SD-1 is 92 min. A temperature of 80 degrees C is reached after approximately 45 min. The results prove that this system totally inactivates HIV in human femoral heads.

Bone Transplantation↗