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[The effectiveness of different disinfectants based on p-chloro-m-cresol against Ascaris suum eggs under laboratory conditions].

The devitalizing effectiveness of 5 patterns of the disinfectant Neopredisan (active principle: p-chlorine-m-cresol) was tested to eggs of Ascaris suum in coincidence with the "guidelines for the testing of chemical disinfectants" of the German Veterinary Society (GVS). In the suspension-test all examined patterns indicated a 100% inhibition of development Ascaris suum-eggs. In the germ carrier test all patterns were in conformity with the necessities of the GVS-guidelines. Also in the modified testing method with a temperature in the refrigerator of +10 degrees C Neopredisan showed a reliable (100%) efficacy. The inhibition of development was clearly delayed with an admixture of 20% faeces to the suspension of eggs. In a suspension-test with Neopredisan 140 in 3% solution after 15 minutes with embryonated eggs a nearly 100% ovicide and larvicide respectively efficacy was proved. The investigations show, Neopredisan is of value as a suitable disinfectant in the complex of the combat against ascariasis in the breeding of pigs.

Animals↗

[Disinfection and sterilization of reusable devices].

Official of quality assurance requirements for the disinfection and sterilization of reusable medical devices in health care facilities has been reminded recently. These requirements concern good manufacturing practices, essential to avoid adverse events. Identification of non critical and invasive devices, protocols for pre-disinfection, cleaning, high level disinfection and sterilization for thermosensitive materials must be evaluated. Monitoring and process control of these operations are defined by French regulations and European standards, and every health professional has to become aware of these limits.

Cross Infection↗

[Colorimetric cleck of the working dilutions of disinfectants on an aldehyde and phenol basis (author's transl)].

The applicability of 2 colour reactions were tested for the monitoring of the working concentration of disinfectant solutions containing aldehyde or phenol. The red coloration of Schiff's acid solution (Schiff's reagent to aldehydes) can be used with limitations. The formation of a red dye by the reaction of phenols with 1-phenyl-2,3-dimethyl-4-amino-pyrazolone-(5) in the p-esence of alkali and potassium hexacyano-ferrate (III) is unequivocal and is not influenced by contaminations in the water. Evaluation is made in either case by comparison with standard dilutions of the respective commercially available preparation. The samplest procedure for this a visual colour comparison in test tubes with calibration spectrum. Pyrazolone dye can be analysed photometrically. Thus this colour reaction can be regarded as an analytic method of satisfactory accuracy. A frequent monitoring of the disinfectant concentrations by means of simple chemical procedures is expected to help limit the improper use of disinfectants and to check hospital infections.

Aldehydes↗

[Sensitivity of Pseudomonas sp. strain isolated from distilled water to disinfectants].

The aim of the study was to compare Pseudomonas sp. strain isolated from distilled water and grown on the sterile filtrate from this water with the referent strain of Pseudomonas aeruginosa NCTC 6749 grown under the standard conditions, with the respect to their sensitivity to eight common disinfectants. Partly modified EN 1040 method was applied. The reduction factor (RF) for at least five concentrations of each of the products were determined. The linear relationship between concentration of the disinfectants and RF was established in a graphic form. Sensitivity of the strains was compared at the RF = 4. The WS strain was found to be more sensitivity than the referent strain to the disinfectants. The ratio concentrations of the solutions that were effective during 15 minutes against both the strains were; 1.3 for ethyl alcohol; 2.1 for glutaraldehyde; 1.7 for formalin; 1.85 for phenol. In the case of chloramine-T, the sodium salt of dichloroisocyanuric acid, and peracetic acid the ratios of concentrations were 156.0; 96.5 and 21.5 respectively. They indicate much higher sensitivity of the strain isolated from distilled water to these chemicals.

Disinfectants↗

A microbiological study of various food premises with an assessment of cleaning and disinfection practices.

A study of cleaning and disinfection methods in a variety of types of catering premises has been carried out. The level of bacterial contamination of the hands and of equipment was related to cleaning methods and to the type of catering establishment. Wiping cloths were frequently contaminated with Escherichia coli, and these may be important reservoirs of bacteria for contamination of the hands of catering staff. Regular and efficient cleaning of food surfaces and equipment was found to be more important than the use of a disinfectant as part of the cleaning process. Methods for reducing the risks of cross-contamination in catering premises are discussed.

Cooking and Eating Utensils↗

Spray dispensing of antiseptics is effective for hand disinfection.

The effectiveness of three hand antiseptics administered using a spray dispenser (Nebucid 840) was studied together with that of conventional hand disinfection. The tests were carried out by a group of 20 dental students. To obtain baseline samples, the subjects washed their hands with unmedicated Sterisol liquid soap under running water for 30s and dried them on sterile-packed paper towels. Microbiologic samples were taken from fingerprints pressed gently onto blood agar plates, which were then incubated aerobically and analyzed. The hand disinfection efficacy of 3 ml Isosept solution rubbed onto the hands for 30 s, followed by air drying for 60 s, was studied as a conventional control method. Dermocol, HD 410, and Hibisol antiseptics were sprayed onto the subjects' hands for 3 s using the automatic dispenser, after which the hands were gently rubbed for 30 s and air-dried for 60 s, before fingerprint contact sampling. All the tests were performed three times, with a minimum of 3 days between the series. The results showed Hibisol applied with the spray dispenser to be significantly more effective in reducing bacterial growth than the other methods. No growth was observed on 51 plates out of 60, while bacterial growth was observed in 29 cases out of 60 in the Isosept series. In most cases the spray-dispensed antiseptics proved to be more efficient than the conventional hand antiseptic. All the antiseptics were significantly more effective than the liquid soap.

Adult↗

Chemical disinfection in the prevention of infection in hospital.

Much cross-infection can be prevented by using chemical disinfectants to reduce the numbers of pathogens in sources such as superficial lesions and carrier sites, and by interrupting routes of spread. Examples are given to show the value of using disinfectants in the light of epidemiological knowledge.

Cross Infection↗

Evaluation of povidone-iodine as a disinfectant solution for contact lenses: antimicrobial activity and cytotoxicity for corneal epithelial cells.

Povidone-iodine (PVP-I) possesses broad-spectrum antimicrobial activity and is used clinically as a disinfectant. We evaluated the disinfectant properties and safety of PVP-I for use as a contact lens solution. The concentrations of PVP-I required to reduce the number of Staphylococcus aureus or Candida albicans by 3 log units were lower than were those of hydrogen peroxide, polyhexamethylene biguanide (PHMB), and benzalkonium chloride (BAK). The cytotoxicity of PVP-I for cultured human corneal epithelial (HCE) cells was less than that of the other three agents. The safety margin for PVP-I was thus greatest among the tested compounds. PVP-I appears suited for use as a contact lens disinfectant.

Anti-Infective Agents, Local↗

Comparison of media for enumeration of coliform bacteria and Escherichia coli in non-disinfected water.

In this work alternative media for detection and enumeration of E. coli and coliform bacteria were compared to the reference method ISO 9308-1 (LTTC) using non-disinfected water samples with background flora. The alternative media included LES Endo agar medium (LES Endo), Colilert-18 with 51-well Quanti-tray (Colilert), Chromocult Coliform agar (CC), Harlequin E. coli/Coliform medium (HECM) and Chromogenic Escherichia coli/Coliform medium (CECM). A total of 110 samples of groundwater, bathing water and spiked water was used. Our results revealed that confirmation of coliform bacteria counts is necessary, not only on lactose-based LTTC and LES Endo media, but also on the chromogenic agar media tested, due to the growth of oxidase positive colonies. LTTC and CC media also allowed the growth of some morphologically typical coliform colonies containing gram-positive bacteria. The recovery of coliform bacteria was lower on LES Endo than on LTTC. In most cases Colilert, CC, HECM and CECM gave higher coliform counts than LTTC. The use of the LTTC medium led to higher E. coli counts than obtained with any of the alternative mediums. There are three explanations for this: (1) high sensitivity of LTTC, (2) false positives on LTTC or (3) false negatives especially with Colilert, but also with chromogenic agar media. Although LTTC was found to be a very sensitive medium, the high degree of background growth of non-disinfected waters disturbed substantially the use of it. In conclusion, our results suggest that Colilert, CC and CECM are potential alternative media for detection of coliform bacteria and E. coli from non-disinfected water.

Bacteriological Techniques↗

Wastewater disinfection by ozone: main parameters for process design.

Wastewater disinfection by ozone was investigated at pilot scale on different wastewater effluents. Variations in operating conditions showed that a very low hydraulic retention time (2 min) was sufficient for efficient fecal coliform inactivation, provided a sufficient ozone dose was transferred to the effluent. Therefore, the transferred ozone dose appeared to be the critical parameter for the design of wastewater disinfection. As a consequence, the "Ct" approach commonly applied in drinking water treatment should not be used for wastewater ozonation. Design parameters of ozonation were proposed for two types of regulations, and for effluents of different qualities. It was demonstrated that only with an efficient filtration step one can meet stringent standards such as the California Title 22 criteria. In all cases, viruses were totally inactivated; consequently, viruses do not constitute a limiting factor in wastewater disinfection by ozone. The standard drinking water model failed to match the experimental data obtained on real wastewater effluents. A modified approach was successfully developed, based on the simultaneous consumption of ozone by the microorganisms and the organic matrix.

Bioreactors↗

Dental instrument and device sterilization and disinfection practices.

Dental instruments and devices require sterilization or high-level disinfection. An evaluation of the implementation of such processes was undertaken. Eleven thousand questionnaires on methods used to sterilize and disinfect dental instruments were sent to dental practices and 1391 (13%) were returned for evaluation. Sixty-eight percent of respondents believed they were sterilizing their instruments, however, some of the liquid chemical products used were not suitable for sterilizing instruments, and 12% of respondents used incorrect contact times. Forty-nine percent of respondents did not challenge autoclaves with biological spores to check their function at an acceptable frequency. There were similar product and timing problems when a high-level liquid chemical disinfection was attempted. Although the return sample was small, problems were identified that can and should be corrected. This study demonstrates that the potential for person-to-person transmission of infectious agents such as the human immunodeficiency virus (HIV) and hepatitis B and C viruses via inadequately sterilized dental instrument exists depending on the prevalence of HIV in the dental practice area.

Dental Equipment↗

Resistance to the migration of microorganisms of a needle-free disinfectable connector.

The aim of this study was to assess the efficacy of a disinfectable needle-free connector in reducing the pass of micro-organisms to the lumen of the catheter. A prospective, controlled, experimental trial was performed in which a laboratory model simulated the insertion of a peripheral venous catheter. Catheters inserted in sterile conditions in a hemoculture bottle were closed with the disinfectable needle-free connector (study group) or with a cap (control group). After 9 days of contamination and manipulation of the connector and cap external surfaces, 100% of bottles in the control group were contaminated whereas 60% remained sterile in the study group. The disinfectable needle-free connector showed more resistance to the pass of microorganisms than the conventional cap according to our experimental model.

Catheterization, Central Venous↗

Vaginal disinfection with chlorhexidine during childbirth.

The purpose of this study was to determine whether chlorhexidine vaginal douching, applied by a squeeze bottle intra partum, reduced mother-to-child transmission of vaginal microorganisms including Streptococcus agalactiae (streptococcus serogroup B = GBS) and hence infectious morbidity in both mother and child. A prospective controlled study was conducted on pairs of mothers and their offspring. During the first 4 months (reference phase), the vaginal flora of women in labour was recorded and the newborns monitored. During the next 5 months (intervention phase), a trial of randomized, blinded placebo controlled douching with either 0.2% chlorhexidine or sterile saline was performed on 1130 women in vaginal labour. During childbirth, bacteria were isolated from 78% of the women. Vertical transmission of microbes occurred in 43% of the reference deliveries. In the double blind study, vaginal douching with chlorhexidine significantly reduced the vertical transmission rate from 35% (saline) to 18% (chlorhexidine), (P < 0.000 1, 95% confidence interval 0.12-0.22). The lower rate of bacteria isolated from the latter group was accompanied by a significantly reduced early infectious morbidity in the neonates (P < 0.05, 95% confidence interval 0.00-0.06). This finding was particularly pronounced in Str. agalactiae infections (P < 0.0 1). In the early postpartum period, fever in the mothers was significantly lower in the patients offered vaginal disinfection, a reduction from 7.2% in those douched using saline compared with 3.3% in those disinfected using chlorhexidine (P < 0.05, 95% confidence interval 0.01-0.06). A parallel lower occurrence of urinary tract infections was also observed, 6.2% in the saline group as compared with 3.4% in the chlorhexidine group (P < 0.01, 95% confidence p interval 0.00-0.05). This prospective controlled trial demonstrated that vaginal douching with 0.2% chlorhexidine during labour can significantly reduce both maternal and early neonatal infectious morbidity. The squeeze bottle procedure was simple, quick, and well tolerated. The beneficial effect may be ascribed both to mechanical cleansing by liquid flow and to the disinfective action of chlorhexidine.

Adult↗

Comparison of in-vivo antibacterial activity of two skin disinfection procedures for insertion of peripheral catheters: povidone iodine versus chlorhexidine.

Skin disinfection is a key step in the prevention of nosocomial infections especially prior to invasive procedures such as the insertion of peripheral catheters. Alcohol-based antiseptics improve bactericidal activity and decrease the time needed for skin disinfection in emergencies. A randomized study was performed in two groups of 22 volunteers to compare the in vivo bactericidal effect of two rapid disinfection procedures using povidone iodine (PVP-I) in scrub formulation followed by alcoholic PVP-I, or chlorhexidine in scrub formulation followed by alcoholic chlorhexidine. Bacteria were recovered using the cylinder scrub method. Comparison of reductions in the aerobic and anaerobic flora from baseline levels to each of the three sampling times (30 sec, 3 min, 2 h) showed no significant difference between the two procedures Log(10)reduction after 30 seconds was around 1.5 for the aerobic flora and 1.1 for the anaerobic flora. After 3 minutes the corresponding values were 2.1 and 1.8, and after 2 hours 2.0 and 1.3. The products were well tolerated in both groups. The two procedures had comparable rapid bactericidal activity in vivo.

Adult↗

The emerging nosocomial pathogens Cryptosporidium, Escherichia coli O157:H7, Helicobacter pylori, and hepatitis C: epidemiology, environmental survival, efficacy of disinfection, and control measures.

New and emerging infectious diseases pose a threat to public health and may be responsible for nosocomial outbreaks. Cryptosporidium parvum and Escherichia coli are gastrointestinal pathogens that have caused nosocomial infections via person-to-person transmission, environmental contamination, or contaminated water or food. Helicobacter pylori has been transmitted via inadequately disinfected endoscopes. Finally, hepatitis C may be acquired by healthcare personnel by percutaneous or mucous membrane exposure to blood or between patients by use of contaminated blood products or via environmental contamination. Rigorous adherence to Standard Precautions, Contact Precautions for patients with infectious diarrhea, disinfection of environmental surfaces, and appropriate disinfection of endoscopes are adequate to prevent nosocomial acquisition of these pathogens.

Animals↗

Transcutaneous iodine absorption in adult patients with thyroid cancer disinfected with povidone-iodine at operation.

Povidone-iodine is used as disinfection in patients undergoing many kinds of operations. Several cases of thyroid dysfunction induced by transcutaneous absorption of povidone-iodine have been reported in small infants. However, transcutaneous absorption was not clearly reported in adults. The aim of this study was to assess transcutaneous absorption of iodine in patients who received single topical application with povidoneiodine and serial changes of urinary iodine excretion under the condition with a simple iodine-restricted diet in Japan, an iodine-sufficient area. Sixty-eight patients with thyroid carcinoma undergoing total thyroidectomy received single skin disinfection with either povidone-iodine (group A; n = 47) or chlohexidine gluconate, a noniodine containing biguanide (group B; n = 21). In group A, urinary iodine excretion on the first day after operation increased up to 7 times that of the preoperative value. The amounts of urinary iodine correlated positively with operating time. Increased urinary iodine, however, returned to preoperative values on the third or fifth day after operation. In group B, there was no increase in urinary iodine excretion and urinary iodine excretion was ranged from 54 to 193 microg/g of creatinine on the third day of operation. In conclusion, a large amount of povidone-iodine was absorbed through healthy skin even in adults. This may possibly interfere with scintigraphy or radioactive iodine treatment, or cause thyroid disinfection in susceptible patients.

Administration, Cutaneous↗

Povidone iodine and skin disinfection before initiation of epidural anesthesia.

BACKGROUND: Povidone iodine (PI) solution is used commonly for skin disinfection before epidural and spinal anesthesia. Although there have been reports indicating the presence of microbial contaminants in PI solution, none have evaluated the prevalence of PI contamination. The aims of this study were to assess the frequency of bacterial contamination of previously opened bottles of PI solution and to compare the effectiveness of new and previously opened bottles of PI solution for skin disinfection. METHODS: Twenty previously opened and ten previously unopened multiple-use bottles of PI solution were evaluated for microbial contamination. In addition, final swabs and PI solution used for skin disinfection in 80 patients undergoing elective epidural analgesia were evaluated. RESULTS: The inside of the bottle cap or the PI solution from 40% of the multiple-use PI bottles in use were contaminated. There was no growth from any previously unused PI bottles. Povidone iodine from newly opened bottles provided more effective skin decontamination than did solution from previously opened bottles. CONCLUSIONS: Multiple-use PI bottles in normal use may become contaminated by bacteria. In addition, PI solution from previously opened bottles was less effective than PI from previously unopened bottles. Based on these findings, if PI solution is chosen for skin antisepsis before initiation of epidural and spinal anesthesia, only single-use containers should be used.

Anesthesia, Epidural↗

Disinfectant colitis. Rinse as well as you wash.

Commercially available endoscope disinfecting solutions readily cause colonic damage if allowed to contact mucosa. The two most common cleaning solutions differ in their initial toxic effect (glutaraldehyde directly injuries crypt epithelium, and hydrogen peroxide compromises mucosal stroma), but both ultimately result in tissue necrosis over time. Within 12-48 h after colonoscopy, patients show signs of bloody diarrhea, cramping, and fever--symptoms that may be confused with an infectious process. Based on a literature review and our own experimental studies, we conclude that hydrogen peroxide alone is responsible for a unique form of colitis commonly referred to as pseudolipomatosis by pathologists. This controversial lesion becomes visible as opaque plaques or pseudomembranes even while colonoscopy is in progress and is almost assuredly due to the effervescent release of molecular oxygen. Diligent rinsing is necessary to minimize patients' exposure to residual disinfecting chemicals in the endoscope. When an automatic disinfecting machine is employed, it may require strict adherence to proper maintenance and volume adjustments in the rinse cycle. Forced air drying and an additional preprocedure rinse of channels and the exterior of the scope should ensure a chemical-free examination.

Animals↗