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Comparison of viability assays for Cryptosporidium parvum oocysts after disinfection.

In order to test various viability assays for Cryptosporidium parvum oocysts were used to infect HCT-8 cells in vitro or baby mice. Infected cells were either stained with fluorescent anti-Cryptosporidium-antibody or lysed and subjected to C. parvum-specific PCR after 48 h. Titrations with infective oocysts were performed and compared to oocysts disinfected with Neopredisan for 2 h at varying concentrations. Caecal smears and histological sections from infected animals were examined in parallel. The number of foci of parasite development in vitro after immunofluorescent staining correlated well with the infection dose. PCR was less quantifiable and the results were not always reproducible, especially when low infection doses were used. Disinfection resulted in a dose-dependent reduction of oocyst infectivity when compared to the controls in all three assays. The infection of cells cultured in vitro with oocysts of C. parvum provides a suitable tool for the estimation of viability after treatment with chemical disinfectants. Immunofluorescence is easy to perform and gives quantitative results, while PCR-based detection of parasite DNA, although possible, requires the use of more sophisticated tools for quantification.

Animals↗

Phenolic household disinfectants--further precautions required.

Phenolic disinfectants (e.g. Meytol, Dettol, etc.) are widely used for domestic purposes. Instructions on the bottles are clearly given with regards to the dilutions that should be used. In domestic cleaning, these instructions are often ignored and higher concentrations are used with the thinking that 'the more I pour, the cleaner it gets!'. Furthermore, cleaning equipment is sometimes stored without prior rinsing with fresh water. As water evaporates much faster than phenol, the solution on stored mops/ brushes, etc. becomes progressively more and more concentrated and can cause chemical burns when these utensils are handled at a later time. We therefore suggest that two further instructions should be added to the usual instructions on bottles of household phenolic disinfectants, namely: 'wear gloves when performing domestic cleaning' and 'wash all cleaning equipment with plenty of fresh water after use'. We support this by a case report of a 65-year-old man who sustained full-thickness, painless chemical burns to his right hand after handling a moist mop which had been used for cleaning a carpet with a phenolic household disinfectant solution 2 days earlier.

Aged↗

Ethnic differences in the psychosocial antecedents of needle/syringe disinfection.

This study examined psychosocial antecedents of needle/syringe disinfection by 209 injection drug users in three ethnic groups. Among Whites, high perceived self-efficacy for risk reduction had a positive effect on subsequent disinfection attempts. Among African Americans and Mexican Americans, peer norms favorable to risk reduction had a positive effect on subsequent disinfection attempts, while self-efficacy had no effect. These results suggest that risk-reduction capabilities may be rooted in individualistic perceptions of the self among White drug users, while 'collective self' perceptions are more relevant to these capabilities among African American and Mexican American drug users. HIV risk intervention may have more impact in specific ethnic groups if these distinctions are taken into account. Results also demonstrate the importance of comparing models of behavior change across ethnic groups.

Acquired Immunodeficiency Syndrome↗

Material properties of ophthalmic sutures after sterilization and disinfection.

PURPOSE: To assess the effects that sterilization and disinfection have on the tensile properties of commonly used ophthalmic sutures. SETTING: University of Bristol, Bristol, United Kingdom. METHODS: The sutures 10-0 nylon, 10-0 polypropylene (Prolene), 8-0 virgin silk, and 8-0 polyglactin 910 (Vicryl) were subjected to thermal or chemical sterilization/disinfection including autoclaving, boiling, and immersion in alcohol or glutaraldehyde. Measurements of tensile strength, suture extension to the point of failure, and suture stiffness were then performed. RESULTS: Nylon and Prolene were little affected by all sterilization and disinfection methods. Virgin silk and Vicryl were weakened by thermal methods of sterilization and disinfection. Both Vicryl, and to a lesser extent virgin silk, appeared to be strengthened by immersion in alcohol or glutaraldehyde. CONCLUSION: The casual reuse of ophthalmic sutures is not recommended. However, when there is no alternative, nylon and Prolene monofilaments can be autoclaved or immersed in fresh activated glutaraldehyde, and Vicryl and virgin silk can be immersed in fresh activated glutaraldehyde without significant loss of tensile strength.

Disinfection↗

The effect of new disinfectant substances on the metabolism of Enterobacter cloacae.

The antimicrobial mechanism of 16 new commercially manufactured disinfectant substances on an Enterobacter cloacae strain was studied. The substances tested represent 11 quaternary ammonium salts (QAS) and five combinated QAS with other ingredients. The antimicrobial efficacy was characterized by influencing the growth of bacterial cells expressed by MIC and ED50 values as well as by the inhibition of the incorporation rate of [14C] adenine and [14C] leucine. The disinfectants are divided into three groups according to their efficacy. The first group comprised substances with strong inhibitory effect (MIC 0.006-0.048 mg l(-1)) such as triquart, topax 91, benzalkonium chloride, neoquat S, ID 213, and antibacteric P. The second group represented substances with good antibacterial efficacy (MIC 0.048-0.15 mg l(-1)), and the third group were substances with MIC values up to 0.195-0.39 mg l(-1). Cetrimide had low activity (MIC 3.12-6.25 mg l(-1)). The effect of substances studied on the biosynthetic processes expressed by R values (IC50 Ade:IC50 Leu) showed that these values were < 1 except ADL 007. Much lower IC50 Ade and IC50 Leu values of the disinfectant substances studied suggested interference of these substances with nucleic acid synthesis and proteins synthesis which was expressed by inhibition of both precursors. All substances except cetrimide caused an inhibition of the endogenous respiration. The highest inhibition was caused by benzalkonium chloride. This affected the respiration significantly in the presence of intermediators of the Krebs' cycle (glycerol, aspartate). The tested substance suppressed the growth of E. cloacae probably through interference with energy-yielding and energy-requiring processes of the cells.

Carbon Radioisotopes↗

[Respiratory distress in three newborns after mask disinfection with Endosporine. Probable role of glutaraldehyde].

BACKGROUND: Disinfectants for medical devices are uncommonly a cause of iatrogenic adverse effects. Nevertheless, when misused, they can induce severe complications. Three cases of acute respiratory distress in newborns probably induced by glutaraldehyde are reported. CASE REPORTS: Three children born by Caesarean section between 8 and 19 May 1999 in the same hospital presented acute respiratory distress requiring hospitalization in the neonatal intensive care unit; one child was premature. The clinical appearance, which was initially normal, deteriorated with a respiratory distress in 30 to 60 minutes. Recovery was uneventful in all cases. The diagnosis considered was a hyaline membrane disease. The enquiry conducted after this cluster onset identified, as a main contributing factor, the disinfection procedure recently introduced in the surgical theater. CONCLUSION: Review of toxicologic data on glutaraldehyde shows this is a highly irritating chemical for the respiratory tract, even at low concentrations. Clinical and radiologic features in these three neonates are compatible with a pulmonary sub-edema on an immature alveolar setting. The hypothesis proposed is that glutaraldehyde, the active ingredient of the biocidal formula used to disinfect the respiratory masks, was massively desorbed from the rubber and foam of which masks are made.

Disinfectants↗

The development and evaluation of electrolysis in conjunction with power ultrasound for the disinfection of bacterial suspensions.

There is an increasing incidence in health problems related to environmental issues that originate from inadequate treatment of potable waters. This has compelled scientists and engineers to engage in innovative technologies to achieve a maximum disinfection at affordable costs. Some species of bacteria produce colonies and spores that can agglomerate in spherical clusters and thus protect organisms on the inside of the cluster against biocidal attack. Flocs of fine particles (e.g., clay) can entrap bacteria and this can also protect them against the biocides. Other bacteria have the ability to mutate, thus building up resistance to conventional biocides (e.g., chlorine). Ultrasound has been shown to be effective in improving the effectiveness of biocides such as chlorine. The aim of this present study was to investigate the effect of electrolysis and power ultrasound as a disinfection treatment and to provide a greater knowledge of the fundamentals of disinfection through the production of hypochlorite in situ from saline solution via electrolysis. The electrode materials investigated were, carbon (felt and graphite), copper and stainless steel rods. The results show that sonication appears to amplify the effect of electrolysis. A combination of both treatments is significantly better than sonication or electrolysis alone.

Disinfection↗

Audit of nasendoscope disinfection practice.

INTRODUCTION: Several options exist with regard to flexible pharyngo-laryngoscope sterilisation. We audited the use of disposable sheaths in our department over a six-month period. METHODS: A cost-analysis was performed and the advantages and disadvantages of this system were compared with several alternative options. RESULTS: We found that the overall cost of disposable sheaths averaged ł4008 per month over a six-month period. We subsequently introduced chlorine dioxide (ClO2) wipes as a means of disinfection. Chlorine dioxide wipes have enabled a monthly saving of ł3145 over sheath usage. Additionally, they meet health regulation requirements and are a convenient, cost-effective alternative to sheaths. DISCUSSION: The limiting factors, including time and financial issues, involved in nasendoscope disinfection are discussed. CONCLUSIONS: We have found chlorine dioxide wipes to be a satisfactory alternative means of nasendoscope disinfection. Possible time constraints aside, there are no advantages of sheath use over our current method. Chlorine dioxide wipes are also preferable from a financial point of view.

Cost Savings↗

The efficacy of a filtered handheld far-ultraviolet disinfection device for decontamination of high-touch surfaces in healthcare settings: a genomic bacterial analysis.

BACKGROUND AND OBJECTIVES: Enhanced environmental disinfection is linked to reduced hospital-acquired infection rates. In this study, we aimed to evaluate the efficacy of an emerging disinfection technology, a filtered far-UV-C handheld (FFUHH) device, for reducing bacterial loads on high-touch surfaces in shared clinical workrooms, and to isolate, identify and characterize clinically significant environmental pathogens. METHODS: We compared samples from high-touch items (dictation device, mouse, armchair, desk, and keyboard) before and after FFUHH treatment. Samples were collected weekly: contact plates for colony counts and swabs before and after intervention on standardized adjacent areas for each surface, respectively. The swabs were enriched and cultured on selective media to isolate pathogens. Environmental samples, as well as clinical samples collected from patients during the study period, were validated using MALDI-TOF and whole genome sequencing. RESULTS: Among the 440 collected plates (220 before and 220 after treatment), the highest mean colony count pre-treatment was detected from armchairs, and the lowest from keyboards. The mean reduction of colony-forming units ranged 53% and 83% and was statistically significant (P < 0.05) across all surfaces except for the keyboard. We characterized multidrug-resistant Staphylococcus epidermidis ST5 and ST16 strains, a carbapenem-resistant Acinetobacter baumannii, and a Klebsiella pneumoniae genetically related to a clinical isolate with a rare sequence type not previously detected in our institution. CONCLUSION: The FFUHH effectively reduced the microbial burden on high-touch surfaces. It can offer an advantage for surface disinfection and an alternative to routinely used biocides.

Humans↗

Effect of a disinfectant udder wash and a post-milking teat dip on the bacterial population of the teat end and on the rate of new intramammary infection.

A pre-milking wash disinfectant procedure employing a 2% (w/v) chlorhexidine solution in a detergent basic did not reduce the rate of new intramammary infection in a lactating herd challenged with Staphylococcus aureus. Teat-end swabs showed no significant difference in the number of Staph. aureus isolated from the teat-ends pre-washed with either water, or water and chlorhexidine. In contrast, disinfecting teats after milking with a solution containing 5000 mg available iodine/l significantly reduced the staphylococcal population of the teat-ends and the rate of new intramammary infection, compared with teats not disinfected.

Animals↗

Use of lyophilized skin for testing the bactericidal activity of teat disinfectants.

The bactericidal activities of various concentrations of 3 disinfectants commonly used for teat disinfection were compared in vitro using small discs of pig skin previously contaminated with Staphylococcus aureus. Solutions containing 40 g/l Na hypochlorite, 25 or 50 g/l chlorhexidine digluconate or iodophor containing 5 g/l iodine were found to have equivalent or superior bactericidal activity to a solution containing 10 g/l Na hypochlorite. This in vitro technique offers a convenient alternative to in vivo tests for teat disinfectants and with minor modifications could be applicable to the testing of skin antiseptics in general.

Animals↗

Effectiveness of hand washing and disinfection methods in removing transient bacteria after patient nursing.

The effectiveness of various hand washing and disinfection methods in removing transient skin bacteria was studied in hospital after dry or moist contamination of the hands when nursing burn patients. The results were compared with those of laboratory tests with volunteers. A fairly good correlation of the bacterial reductions existed between hospital and laboratory tests. All other methods removed Staph. aureus from the hands more effectively than liquid soap. Gram-negative bacilli were more easily removed than staphylococci, even with soap wash alone. In hospital, none of the washing and disinfection methods always removed all patient-borne bacteria from the hands. After dry or moist contamination and subsequent washing with soap only, colonies of Staph. aureus were often detected in finger-print samples. Staphylococci were more often completely removed by a 4% chlorhexidine detergent scrub and alcoholic solutions (either with or without previous soap wash) than by liquid soap, hexachlorophene or iodophor preparations. Gram-negative bacilli were more easily removed by all the washing and disinfection methods. After moist contamination, Gram-negative bacilli were more often completely removed from the hands by ethanol than by other treatments. The results of the present study emphasize the importance of always using gloves when nursing a profuse spreader of bacteria or one who must be protected from infection.

Chlorhexidine↗

Persistent isolation of an unusual Pseudomonas species from a phenolic disinfectant system.

A well-characterized unusual Pseudomonas species contaminated the piped disinfectant system of a newly-opened laminar air flow intensive care facility. This organism was frequently isolated (10(4)-10(6) cfu/ml) from phenolic diluted 1:256 in the system, and could also be recovered (0.01-0.2 cfu/ml) from undiluted phenolic. During the 20-month period when this unusual Pseudomonas was present, none of the severely compromised, granulocytopenic oncology patients treated in the intensive care facility were either colonized or infected with this Pseudomonas sp. Eradication of the organism from the system proved difficult and was accomplished by removing a contaminated reservoir of diluted phenolic disinfectant followed by transient cleansing of the system with very high concentrations (84,000 ppm) of chlorine. This experience demonstrates that phenolics should be added to the list of disinfectants which can harbor Pseudomonas spp. in the clinical setting.

Air Microbiology↗

70% alcohol disinfection of transducer heads: experimental trials.

We investigated the feasibility of transducer head disinfection with 70% alcohol wipes. In the initial trial, nine gas-sterilized transducers were inoculated with an estimated 5 X 10(6) organisms of a clinical isolate of Enterobacter cloacae, mimicking a contaminated fluid couple. A sterile disposable transducer dome was attached to each transducer. The units were allowed to sit for 24 hours at room temperature; the domes were then removed. Three transducer heads were cultured prior to disinfection to ensure that viable organisms remained. Each transducer head was wiped clean with a single alcohol wipe, allowed to dry, and then cultured. All nine cultures showed growth of E. cloacae. A second series of trials with 54 transducers employed an identical protocol, except that each transducer head received not one, but two, applications of alcohol. In addition to E. cloacae (26 runs), Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were employed in nine, nine and ten runs, respectively. Cultures of 53 of 54 transducer heads showed no growth; the single positive culture was attributed to an error in technique. These preliminary results suggest that the double-alcohol-wipe technique may be an easy, cost-effective, alternative or supplemental method of transducer head disinfection. However, we do not advocate routine implementation of this technique in patient care settings until clinical trials confirm its safety and efficacy.

1-Propanol↗

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↗

Irritancy of the skin disinfectant n-propanol.

Hand disinfection with short-chain aliphatic alcohols, so-called "rub-ins" is the method of choice for cross-infection prevention in health care environments, but their irritant potential is not well known. Skin tolerance is a major compliance factor, and a high proportion of health care workers suffer from low-grade irritant contact dermatitis. Therefore, assessment of the irritancy of the skin disinfectant n-propanol 60%, and comparative 100% and 0% solutions, was performed in the setting of experimental low-grade ICD. ICD was induced by overnight patch exposure to H2O, and to 0.3% sodium dodecyl sulfate (SDS), in 12 probands, followed by repeated open exposure to the test substances. Outcome variables were transepidermal water loss (TEWL), and skin surface capacitance. On skin sites pre-irritated by SDS, all n-propanol concentrations (100%, 60%, 0%) increased TEWL. However, a clear divergence appeared between pure n-propanol, and the lower concentrations. In contrast to pure n-propanol, n-propanol 60% and 0% had no significant effect on TEWL on H2O-pre-irritated skin sites. Capacitance of pre-irritated skin sites was increased by exposure to H2O-containing n-propanol solutions (60% and 0%). These results show a clear difference between the irritant potential of n-propanol 100% on one side, and n-propanol 60% and 0% on the other side. The level of pre-existent skin irritation is a pertinent factor in susceptibility to irritation, as the irritant potential of n-propanol 60%, the concentration used in daily practice, and n-propanol 0% (water) became significant only on detergent-irritated skin. Thus, preventive skin care may be a constructive approach in increasing tolerance of modern hand disinfection practices.

1-Propanol↗

Anaphylaxis due to formaldehyde released from root-canal disinfectant.

A 50-year-old woman developed anaphylaxis 8 h after application of a paraformaldehyde-containing root canal disinfectant. Radioallergosorbent test showed that she had a high level of formaldehyde-specific IgE in her serum. Prick tests to formaldehyde and paraformaldehyde showed immediate-type responses to both. We reviewed the literature describing cases with anaphylaxis/angioedma caused by formaldehyde in root canal disinfectants and found that about 1/2 of the reported cases developed symptoms over 2 h after dental treatment. We speculated that the delay in the manifestation of her symptoms was possibly due to gradual formaldehyde release from paraformaldehyde and time lag of penetrating and diffusing of formaldehyde outside the dentin. Patch testing showed that she also had delayed-type allergy to formaldehyde, paraformaldehyde and eugenol. Physicians should pay attention to root canal disinfectants, even if anaphylaxis occurs several hours after dental treatment.

Allergens↗

Evaluation of the efficacy of Alpron disinfectant for dental unit water lines.

AIMS: To assess the efficacy of a disinfectant, Alpron, for controlling microbial contamination within dental unit water lines. METHODS: The microbiological quality of water emerging from the triple syringe, high speed handpiece, cup filler and surgery hand wash basin from six dental units was assessed for microbiological total viable counts at 22 degrees C and 37 degrees C before and after treatment with Alpron solutions. RESULTS: The study found that the use of Alpron disinfectant solutions could reduce microbial counts in dental unit water lines to similar levels for drinking water. This effect was maintained in all units for up to six weeks following one course of treatment. In four out of six units the low microbial counts were maintained for 13 weeks. CONCLUSIONS: Disinfectants may have a short term role to play in controlling microbial contamination of dental unit water lines to drinking water quality. However, in the longer term attention must be paid to redesigning dental units to discourage the build up of microbial biofilms.

Amines↗