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Disinfectants and antiseptics lead in reducing the number of microorganisms, including pathogenic ones, thus limiting the number of infections. In the veterinary field, disinfection prevents the transfer of pathogenic microorganisms from animals to humans and vice versa , as well as among animals. Several assays of disinfectant antimicrobial activity testing, often not standardized, without appropriate controls, and not validated, have been used and published. To unify these methods, nine European Standards (ENs) for the veterinary area have been prepared. These tests make it possible to examine whether a given disinfectant has bactericidal, fungicidal, or virucidal activity by the standard. This publication discusses ENs regarding the assessment of the above-mentioned antimicrobial activity of disinfectants used in veterinary medicine. Recent research on this topic has also been cited. According to ENs, tests are carried out using the suspension method or carriers in clean and dirty conditions. The decontamination of high-risk animal and zoonotic pathogens is also discussed. Selected publications on cattle, pig, poultry, and aquaculture farm disinfection are presented. Only valid methods of the described studies with appropriate statistical analysis can prove adequate antimicrobial activity. So far, the role of international standards in investigating the antimicrobial activity of disinfectants and antiseptics to reduce infections has been underestimated. This publication highlights gaps and irregularities in conducted research and aims to inform about existing EN standards dedicated to testing the biocidal activity of disinfectants and antiseptics intended for use in the veterinary area., (© 2024 Stefan Tyski et al., published by Sciendo.)

This study investigated the potential of olanexidine gluconate as environmental disinfectant against enveloped viruses in the suspension test and three non-porous surface tests. In the suspension test, olanexidine gluconate showed immediate virucidal activity. In addition, non-porous surface tests demonstrated that, although the immediate effect of aqueous formulations was weak, the final virucidal efficacy outcompeted that of ethanol for disinfection. Furthermore, the effectiveness of olanexidine gluconate persisted even after drying on environmental surfaces. This study demonstrated the potential usage of olanexidine gluconate formulations as an environmental disinfectant in the infection control of enveloped viruses., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

In the ongoing SARS CoV-2 pandemic, effective disinfection measures are needed, and guidance based on the methodological framework of the European Committee for Standardization (CEN) may enable the choice of effective disinfectants on an immediate basis. This study aimed to elucidate whether disinfectants claiming 'virucidal activity against enveloped viruses' as specified in the European Standard EN 14476 as well as in the German Association for the Control of Viral Diseases/Robert Koch Institute (DVV/RKI) guideline are effectively inactivating SARS-CoV-2. Two commercially available formulations for surface disinfection and one formulation for hand disinfection were studied regarding their virucidal activity. Based on the data of this study the enveloped SARS-CoV-2 is at least equally susceptible compared to the standard test virus vaccinia used in the EN 14476 and DVV/RKI guidelines. Thus, chemical disinfectants claiming 'virucidal activity against enveloped viruses' based on the EN 14476 and DVV/RKI guidelines will be an effective choice to target enveloped SARS-CoV-2 as a preventive measure., (Copyright © 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)

The wiping of high-touch healthcare surfaces made of metals, ceramics and plastics to remove bacteria is an accepted tool in combatting the transmission of healthcare-associated infections (HCAIs). In practice, surfaces may be repeatedly wiped using a single wipe, and the potential for recontamination may be affected by various factors. Accordingly, we studied how the surface to be wiped, the type of fibre in the wipe and how the presence of liquid biocide affected the degree of recontamination. Experiments were conducted using metal, ceramic and plastic healthcare surfaces, and two different wipe compositions (hygroscopic and hydrophilic), with and without liquid biocide. Despite initially high removal efficiencies of >70% during initial wiping, all healthcare surfaces were recontaminated with E. coli , S. aureus and E. faecalis when wiped more than once using the same wipe. Recontamination occurred regardless of the fibre composition of the wipe or the presence of a liquid biocide. The extent of recontamination by E. coli , S. aureus and E. faecalis bacteria also increased when metal healthcare surfaces possessed a higher microscale roughness (<1 μm), as determined by Atomic Force Microscopy (AFM). The high propensity for healthcare surfaces to be re-contaminated following initial wiping suggests that a "One wipe, One surface, One direction, Dispose" policy should be implemented and rigorously enforced.

For manufacturers of both sterile and nonsterile pharmaceuticals, there is an expectation that the manufacturing process is performed in a manner that prevents extraneous contamination so that the products are provided in a safe, integral, pure, and unadulterated form. As part of that process, cleaning and disinfection are an absolute necessity. Although cleaning and disinfection support control of microbial contamination through preventive and corrective action, specific compendia methods do not currently exist. The intent of this paper is to provide a general guidance on how to perform disinfectant efficacy validation and implementation. This includes how to make sure the concepts are understood, how to interpret facility data and utilize it to demonstrate control awareness for your facilities, and how to leverage the data to reduce redundancies in validation or verification. This paper represents the thoughts and best practices of the authoring team and their respective companies and provides an efficient way to qualify disinfectants without impacting the quality of the study. If you choose to follow the recommendations in this paper, you must ensure that the appropriate rationale is sound and the scientific data is documented. It is the belief of the authoring team that only then will this approach meet regulatory requirements., (© PDA, Inc. 2020.)

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) continues to spread globally. It has become a major cause of concern for health care professionals all over the world., Objective: The aim of this study was to assess knowledge, awareness and hygiene practices regarding COVID-19 among private dental practitioners practicing in Tricity (Chandigarh, Panchkula and Mohali) in India during these critical times., Materials and Methods: A total of 245 private dentists participated in this cross-sectional survey and finally 215 constituted the final sample size. A self-administered, multiple choice type questionnaire (verified by a specialist) was administered to obtain information from the subjects. The questionnaire was divided into two parts and included 15 questions on knowledge and awareness regarding COVID-19. Statistical analysis was done using ANOVA and Student’s t-test., Results: Percentage of subjects who answered correctly regarding main symptoms of COVID-19 and primary mode of transmission was 87% and 82.5% respectively. One-third of the subjects were not aware regarding Personal Protective Equipment (PPE) to be used while rendering dental treatment. 75% of subjects were of the opinion that supportive care is the current treatment regime for COVID-19. Less than one-third of subjects (30.2%) reported high scores. Education level (p=0.018) and health sector profile (p=0.024) of the subjects were significantly associated with mean knowledge scores., Conclusion: The findings of the present study showed that some notable deficiencies in knowledge existed among dental professionals regarding some vital aspects of COVID-19. Therefore, there is an urgent need for improving dentists’knowledge via health education and training programs. Further studies on the subject are also warranted once the situation normalizes., (© Copyright by the National Institute of Public Health - National Institute of Hygiene)

Toxocara canis (Werner, 1782) is a zoonotic nematode commonly parasitizing dogs worldwide with great public health importance as the aetiological agent of human toxocariasis. In this respect, the aim of this study was to evaluate the effect of six disinfectant products commonly used in kennels, veterinary clinics and as household cleaning products on the embryogenesis and viability of T. canis eggs. The composition of active ingredients in these commercial disinfectants was sodium hypochlorite (A); a mix of N-(3-aminopropyl)-N-dodecylpropan-1.3-diamine and didecyldimethylammonium chloride (B); sodium dichloroisocyanurate dehydrate (C); a mix of glutaraldehyde, quaternary ammonium compounds, benzyl-c12-18-alkyldimethyl and chlorides (D); a mix of 2-propanol, ethanol, benzalkonium chloride and glucoprotamin (E); a mix of pentapotassium bis (peroxymonosulphate) bis (sulphate), sodium C10-13-alkylbenzenesulphonate, malic acid, sulphamidic acid, sodium toluenesulphonate, dipotassium peroxodisulphate and dipentene (F). After dilution, the tested disinfectants had the maximal concentration recommended by the manufacturer in order to achieve a biocidal effect. Each product was tested on approximately 10,000 T. canis eggs, having five different contact times (5, 10, 15, 30, 60 min). Three replicates were tested for each diluted disinfectant and for each contact time. After the treatment, eggs were washed and incubated in distilled water at 27 °C for 2 weeks. None of the tested products had a significant inhibitory effect on the embryogenesis and viability of T. canis eggs, regardless of the contact time. Moreover, after 2 weeks, in all tested samples, eggs containing motile infective larvae were identified, showing that routinely used disinfectants do not eliminate risk of infection by T. canis.

Trial-and-error chlorination as a conventional practice for swimming pool water disinfection may fail to consistently maintain the pool's residual chlorine within regulatory limits. This study explored the variability of residual chlorine and other common water quality parameters of two sample swimming pools and examined the potential of using a mass balance model for proactive determination of chlorine consumption to better secure the hygienic safety of bathers. A lightly loaded Pool 1 with a normalized bather load of 0.038 bather/m 3 /day and a heavily loaded Pool 2 with a normalized bather load of 0.36 bather/m 3 /day showed great variances in residual free and combined chlorine control by trial-and-error methods due to dynamic pool uses. A mass balance model based on chemical and physical chlorine consumption mechanisms was found to be statistically valid using field data obtained from Pool 1. The chlorine consumption per capita coefficient was determined to be 4120 mg/bather. The predictive method based on chlorine demand has a potential to be used as a complementary approach to the existing trial-and-error chlorination practices for swimming pool water disinfection. The research is useful for pool maintenance to proactively determine the required chlorine dosage for compliance of pool regulations.

The Spaulding system recommends sterilization or, at minimum, high-level disinfection for semicritical medical items (ie, items that come into contact with mucous membranes or nonintact skin). High-level disinfection deactivates all types of microorganisms except bacterial spores and prions. If high-level disinfection is not performed correctly, however, contaminated medical or surgical devices could transmit pathogens to patients. Reusable semicritical items may be processed using manual methods when manual chemical high-level disinfection is the only processing method recommended by the manufacturer. The AORN "Guideline for manual chemical high-level disinfection" provides guidance to health care personnel for performing effective manual chemical high-level disinfection and preventing injury associated with the use of high-level disinfectant chemicals. This article focuses on key points of the guideline that address preparation of items for high-level disinfection, use of high-level disinfectants, health care personnel safety, and documentation. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures., (© AORN, Inc, 2018.)

Objective: The aim of this study was to use antimicrobial efficacy endpoint methodology to determine compatibility of multipurpose disinfecting solutions (MPSs), lens cases, and hydrogel lenses for disinfection (AEEMC) against International Organization for Standardization (ISO)-specified microorganisms and clinical ocular isolates of Stenotrophomonas maltophilia., Methods: Six MPSs (PQ/Aldox 1, 2, and 3; PQ/Alexidine; PQ/PHMB; and PHMB) were challenged against ISO-specified microorganisms and S. maltophilia using the AEEMC test. AEEMC tests were performed with and without balafilcon A, etafilcon A, and senofilcon A lenses in lens cases with organic soil. Exposure times included disinfection time (DT) and 24 hr. Additionally, all six MPSs were challenged with two strains of S. maltophilia, based on the ISO Stand-alone test., Results: The efficacy against bacteria for PQ/Aldox and PQ/Alexidine MPSs was not diminished by the presence of lenses. The efficacy of PQ/PHMB and PHMB MPSs against Serratia marcescens was significantly reduced compared with the no-lens control at DT for at least one lens type. The PHMB MPS with lenses present also demonstrated reduced efficacy against Staphylococcus aureus at DT versus the control. PQ/Aldox MPSs retained activity against Fusarium solani with lenses present; however, all other test MPSs demonstrated reduced F. solani efficacy at DT with lenses present. With lenses, all MPSs showed reduced efficacy against Candida albicans., Conclusions: AEEMC antimicrobial efficacy test results vary based on challenge microorganism, contact lenses, and MPS biocide systems. This study highlights the importance of evaluating MPSs for compatibility with lenses and lens cases.

The progressive ability of a six-strains L. monocytogenes cocktail to form biofilm on stainless steel (SS), under fish-processing simulated conditions, was investigated, together with the biocide tolerance of the developed sessile communities. To do this, the pathogenic bacteria were left to form biofilms on SS coupons incubated at 15°C, for up to 240h, in periodically renewable model fish juice substrate, prepared by aquatic extraction of sea bream flesh, under both mono-species and mixed-culture conditions. In the latter case, L. monocytogenes cells were left to produce biofilms together with either a five-strains cocktail of four Pseudomonas species (fragi, savastanoi, putida and fluorescens), or whole fish indigenous microflora. The biofilm populations of L. monocytogenes, Pseudomonas spp., Enterobacteriaceae, H 2 S producing and aerobic plate count (APC) bacteria, both before and after disinfection, were enumerated by selective agar plating, following their removal from surfaces through bead vortexing. Scanning electron microscopy was also applied to monitor biofilm formation dynamics and anti-biofilm biocidal actions. Results revealed the clear dominance of Pseudomonas spp. bacteria in all the mixed-culture sessile communities throughout the whole incubation period, with the in parallel sole presence of L. monocytogenes cells to further increase (ca. 10-fold) their sessile growth. With respect to L. monocytogenes and under mono-species conditions, its maximum biofilm population (ca. 6logCFU/cm 2 ) was reached at 192h of incubation, whereas when solely Pseudomonas spp. cells were also present, its biofilm formation was either slightly hindered or favored, depending on the incubation day. However, when all the fish indigenous microflora was present, biofilm formation by the pathogen was greatly hampered and never exceeded 3logCFU/cm 2 , while under the same conditions, APC biofilm counts had already surpassed 7logCFU/cm 2 by the end of the first 96h of incubation. All here tested disinfection treatments, composed of two common food industry biocides gradually applied for 15 to 30min, were insufficient against L. monocytogenes mono-species biofilm communities, with the resistance of the latter to significantly increase from the 3rd to 7th day of incubation. However, all these treatments resulted in no detectable L. monocytogenes cells upon their application against the mixed-culture sessile communities also containing the fish indigenous microflora, something probably associated with the low attached population level of these pathogenic cells before disinfection (<10 2 CFU/cm 2 ) under such mixed-culture conditions. Taken together, all these results expand our knowledge on both the population dynamics and resistance of L. monocytogenes biofilm cells under conditions resembling those encountered within the seafood industry and should be considered upon designing and applying effective anti-biofilm strategies., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Effluents before disinfection from four wastewater reclamation plants were treated with chlorine (Cl 2 ), ozone (O 3 ), chlorine dioxide (ClO 2 ), medium-pressure ultraviolet (MPUV) and four different combinations of the above, to evaluate the effect of disinfection processes on the genotoxicity removal by the SOS/umu test. Results showed that the genotoxicity increased after MPUV irradiation (10-100 mJ/cm 2 ), but declined when adopting other disinfection processes. The effectiveness of genotoxicity reduction by five chemical disinfectants was identified as: O 3  > pre-ozonation with Cl 2  ≈ ClO 2  > combination of ClO 2 and Cl 2  > Cl 2 . The sequential combination of MPUV, Cl 2 and O 3 reduced the genotoxicity to a level similar to the source water. The influence of differential disinfection process varied on iodinated wastewater, which is closely related to the competitive reactions between disinfectants, iodine and dissolved organic matters. The removal of genotoxic pollutants and the formation of genotoxic disinfection by-products are the two major factors that lead to the change in genotoxicity during disinfection., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objectives: Aim was to investigate hygienic conditions of ultrasound probes before and after hygiene training in radiology institutions in comparison to bacterial contamination in public places., Methods: In three radiology departments, bacterial contamination was evaluated using baseline agar plates for cultures taken from 36 ultrasound probes. Afterwards teams were trained by a hygiene service centre and 36 ultrasound probes were routinely disinfected with regular disinfecting wipes and then evaluated. In comparison, bacterial contamination in public places (bus poles, n = 11; toilet seats, n = 10) were analysed. Plates were routinely incubated and the number of colony forming units (CFU) analysed., Results: Cultures taken from the probes showed a median of 53 CFU before and 0 CFU after training (p < 0.001). Cultures taken from public places showed a median of 4 CFU from toilets and 28 from bus poles and had lower bacterial load in comparison to ultrasound probes before training (p = 0.055, toilets; p = 0.772, bus poles), without statistical significance., Conclusions: Bacterial contamination of ultrasound probes prior to hygiene training proved to be high and showed higher bacterial load than toilets seats or bus poles. Radiologists should be aware that the lack of hygiene in the field of ultrasound diagnostics puts patients at risk of healthcare-associated infections., Key Points: • Hospital-associated infections are a problem for patient care. • Hygiene training of staff prevents bacterial contamination of ultrasound probes. • Disinfection of ultrasound probes is an easy method to protect patients.

Attachment and detachment kinetics of Escherichia coli O157:H7 from baby spinach leaf epicuticle layers were investigated using a parallel plate flow chamber. Mass transfer rate coefficients were used to determine the impact of water chemistry and common bleach disinfection rinses on the removal and inactivation of the pathogen. Attachment mass transfer rate coefficients generally increased with ionic strength. Detachment mass transfer rate coefficients were nearly the same in KCl and AGW rinses; however, the detachment phase lasted longer in KCl than AGW (18 ± 4 min and 4 ± 2 min, respectively), indicating that the ions present during attachment play a significant role in the cells' ability to remain attached. Specifically, increasing bleach rinse concentration by two orders of magnitude was found to increase the detachment mass transfer rate coefficient by 20 times (from 5.7 ± 0.7 × 10 -11  m/s to 112.1 ± 26.8 × 10 -11  m/s for 10 ppb and 1000 ppb, respectively), and up to 88 ± 4% of attached cells remained alive. The spinach leaf texture was incorporated within a COMSOL model of disinfectant concentration gradients, which revealed nearly 15% of the leaf surface is exposed to almost 1000 times lower concentration than the bulk rinse solution., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

For infectious diseases caused by highly pathogenic agents (e. g., Ebola/Lassa fever virus, SARS-/MERS-CoV, pandemic influenza virus) which have the potential to spread over several continents within only a few days, international Health Protection Authorities have taken appropriate measures to limit the consequences of a possible spread. A crucial point in this context is the disinfection of an aircraft that had a passenger on board who is suspected of being infected with one of the mentioned diseases. Although, basic advice on hygiene and sanitation on board an aircraft is given by the World Health Organization, these guidelines lack details on available and effective substances as well as standardized operating procedures (SOP). The purpose of this paper is to give guidance on the choice of substances that were tested by a laboratory of Lufthansa Technik and found compatible with aircraft components, as well as to describe procedures which ensure a safe and efficient disinfection of civil aircrafts. This guidance and the additional SOPs are made public and are available as mentioned in this paper., Competing Interests: Compliance with ethical guidelinesConflict of interestJ. Klaus, P. Gnirs, S. Hölterhoff, A. Wirtz, M. Jeglitza, W. Gaber, and R. Gottschalk declare that they have no competing interests.This article does not contain any studies with human participants or animals performed by any of the authors.

Ultraviolet germicidal (short wavelength UV-C) light was studied as surface disinfectant in an Emergency Sanitation Operation System(®) smart toilet to aid to the work of manual cleaning. The UV-C light was installed and regulated as a self-cleaning feature of the toilet, which automatically irradiate after each toilet use. Two experimental phases were conducted i.e. preparatory phase consists of tests under laboratory conditions and field testing phase. The laboratory UV test indicated that irradiation for 10 min with medium-low intensity of 0.15-0.4 W/m(2) could achieve 6.5 log removal of Escherichia coli. Field testing of the toilet under real usage found that UV-C irradiation was capable to inactivate total coliform at toilet surfaces within 167-cm distance from the UV-C lamp (UV-C dose between 1.88 and 2.74 mW). UV-C irradiation is most effective with the support of effective manual cleaning. Application of UV-C for surface disinfection in emergency toilets could potentially reduce public health risks.

This study evaluated the effectiveness of a Dental Unit Waterline disinfection protocol utilizing two waterline disinfectant tablets in a dental treatment clinic. The water effluent from 47 dental treatment units was sampled to determine bacterial load. Four dental treatment units were shocked with the multivalent Sterilex Ultra liquid biocide, followed by a 5-week course of routine disinfection using either the A-dec ICX or Citrisil effervescing tablets. Aseptic samples were taken twice weekly, and bacterial load was determined. No significant difference was found when comparing A-dec ICX with Citrisil, but a significant difference was seen between the use of either tablet and no tablet. In addition, a survey was conducted to evaluate the effect of user compliance on infection control. The results indicate that proper training, coupled with the use of appropriate disinfectants and shock treatment, are important aspects of maintaining low bacterial burden in dental water lines., (Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.)

Overview: Regardless of whether a pathogen is viral, bacterial, parasitic, fungal or an emerging unknown, the mainstay of infectious disease control is hygiene, and the cornerstone of good hygiene is effective disinfection., Challenges and Current Choices: Certain pathogens present a challenge to kill effectively: parvovirus, protozoal oocysts, mycobacteria, bacterial spores and prions resist most disinfectants but can be eliminated through heat, especially steam, which will kill protozoal oocysts. Heat is the safest and most effective disinfectant, but cannot be universally applied. Temperatures in washing machines and dishwashers should be at least 60 °C to eliminate pathogenic spores and resistant viruses. Enveloped viruses are susceptible to most disinfectants; of the non-enveloped viruses, parvovirus is recognised as being the most difficult to eradicate. Sodium hypochlorite is recommended for many applications: cleaning of floors, laundry, food preparation surfaces and utensils. Skin scrubs and rubs containing alcohols are more effective than those containing chlorhexidine, and less subject to contamination., Disinfectants to Avoid: Deficiency of the enzyme UDP-glucuronosyl transferase renders the cat susceptible to the toxic effects of phenol-based disinfectants (including many essential oils), so these should be avoided in feline environments. Quaternary ammonium compounds (eg, benzalkonium chloride) are also probably best avoided., The Future: Veterinary disinfection approaches in the future may include use of ultraviolet radiation and, increasingly, silver., (© Published by SAGE on behalf of ISFM and AAFP 2015.)

Formaldehyde (FA) fixation of infectious samples is a well-established protocol in diagnostic electron microscopy of viruses. However, published experimental data that demonstrate virus inactivation by these fixation procedures are lacking. Usually, fixation is performed immediately before the sample preparation for microscopy. The fixation procedure should transform viruses in a non-infectious but nonetheless structurally intact form in order to allow a proper diagnosis based on morphology. FA provides an essential advantage in comparison to other disinfectants, because it preserves the ultrastructure of biological material without interfering significantly with the preparation (i.e., the negative staining) and the detection of viruses. To examine the efficiency of FA inactivation, we used Vaccinia virus, Human adenovirus and Murine norovirus as models and treated them with FA under various conditions. Critical parameters for the inactivation efficiency were the temperature, the duration of the FA treatment, and the resistance of the virus in question. Our results show that FA inactivation at low temperature (4 °C) bears a high risk of incomplete inactivation. Higher temperatures (25 °C) are more efficient, although they still require rather long incubation times to fully inactivate a complex and highly robust virus like Vaccinia. A protocol, which applied 2% buffered FA for 60 min and a temperature-shift from 25 to 37 °C after 30 min was efficient for the complete inactivation of all test viruses, and therefore has the potential to improve both biosafety and speed of diagnostic electron microscopy.

Purpose: To determine the susceptibility of Stenotrophomonas maltophilia to various antibiotics and contact lens multipurpose disinfecting solutions., Methods: Forty S. maltophilia strains from contact lens cases, contact lenses, or eye swabs of contact lens wearers including 27 asymptomatic wearers and 13 keratitis patients were examined for their susceptibility to different antibiotics, using a disc diffusion assay, and to multipurpose disinfecting solutions using a broth microdilution method., Results: Certain strains were resistant to aztreonum (15%), imipenem (93%), chroramphenicol (13%), and cefepime (8%). Two of those strains were multidrug resistant. All strains were sensitive to trimethoprim-sulfamethoxazole, tigecycline, ceftazidime, and fluoroquinolones. Overall, the minimum inhibitory concentration (MIC) for all strains was significantly higher (P < 0.05) for AQuify (50% dilution) and OPTI-FREE RepleniSH (25%) than all other multipurpose contact lens disinfecting solutions (MPDS) (3%-14%, except RepleniSH versus MeniCare Soft [14%]). AQuify, OPTI-FREE RepleniSH, and MeniCare Soft had significantly higher minimum bactericidal concentrations (undiluted MPDS) than other disinfecting solutions (P < 0.05)., Conclusions: The Australian ocular isolates of S. maltophilia remain susceptible to trimethoprim-sulfamethozole, tigecycline, and most fluoroquinolones. However, the isolates showed resistance to certain multipurpose disinfecting solutions., (Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.)

Objectives/hypothesis: The use of flexible fiberoptic laryngoscopes (FFLs) is ubiquitous in otolaryngology practices. As with any medical device, there exists a small risk for transmission of pathogenic microorganisms between patients, necessitating high-level decontamination between uses. Most of the literature to date has studied channeled scopes such as those used in esophagogastroduodenoscopy and colonoscopy. A recent study of nonchanneled flexible laryngoscopes suggested that current high-level decontamination practices in use at some institutions, including ours, may be overly aggressive. We sought to evaluate and compare the efficacy of varying techniques of high-level disinfection of FFLs., Study Design: FFLs were used in routine clinical encounters and then disinfected with a variety of techniques. The FFLs were then cultured for bacteria and fungi, and the rates of positive cultures were compared between the techniques and the controls., Methods: In this study, we took FFLs following use in routine clinical practice and disinfected them using one of eight decontamination protocols. We compared the bacterial and fungal culture results to positive and negative controls., Results: We demonstrated that each of the eight cleaning protocols was statistically efficacious at removing bacterial contamination. Our results for fungal cultures did not reach statistical significance., Conclusions: Using in vitro inoculation of FFLs, this study demonstrated that quicker and more cost-effective practices are equally efficacious to more time-consuming and expensive techniques with regard to bacterial contamination of FFLs., Level of Evidence: NA, (© 2014 The American Laryngological, Rhinological and Otological Society, Inc.)

In this study three-dimensional computational fluid dynamics (CFD) models, incorporating appropriately selected kinetic models, were developed to simulate the processes of chlorine decay, pathogen inactivation and the formation of potentially carcinogenic by-products in disinfection contact tanks (CTs). Currently, the performance of CT facilities largely relies on Hydraulic Efficiency Indicators (HEIs), extracted from experimentally derived Residence Time Distribution (RTD) curves. This approach has more recently been aided with the application of CFD models, which can be calibrated to predict accurately RTDs, enabling the assessment of disinfection facilities prior to their construction. However, as long as it depends on HEIs, the CT design process does not directly take into consideration the disinfection biochemistry which needs to be optimized. The main objective of this study is to address this issue by refining the modelling practices to simulate some reactive processes of interest, while acknowledging the uneven contact time stemming from the RTD curves. Initially, the hydraulic performances of seven CT design variations were reviewed through available experimental and computational data. In turn, the same design configurations were tested using numerical modelling techniques, featuring kinetic models that enable the quantification of disinfection operational parameters. Results highlight that the optimization of the hydrodynamic conditions facilitates a more uniform disinfectant contact time, which correspond to greater levels of pathogen inactivation and a more controlled by-product accumulation., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The aim of our study was to evaluate the effectiveness of a 1-step, ready-to-use improved hydrogen peroxide (IHP) cleaner and disinfectant for between-case use in the operating room. We found high cleaning efficacy (84%-96%) and a high compliance rate with the IHP (84%). With good surface compatibility, low toxicity, rapid dwell time, ease of use, and excellent cleaning efficacy, the IHP may be considered an option for between-case cleaning and disinfection in the operating room., (Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)

Salmonella sp. continues to be one of the most important foodborne pathogens. Control measures in terms of cleaning and disinfection on food production plants are very important for limiting the risk of contaminated food products to reach the consumer. In the last decade concern has arisen that bacteria exposed to disinfectants can develop resistance toward disinfectants and can have a higher risk of developing antibiotic resistance. The objectives of this study were to examine the prevalence of biocide resistant Salmonella sp. in Danish pig slaughterhouses, to evaluate if there was a correlation between susceptibilities to biocides and antibiotics, and to examine if cleaning and disinfection select isolates with changed susceptibility toward biocides or antibiotics. Salmonella sp. was isolated from the environment in Danish pig slaughterhouses before and after cleaning and disinfection. The susceptibility toward three different biocides, triclosan and two commercial disinfection products: Desinfect Maxi, a quaternary ammonium compound, and Incimaxx DES, an acetic compound, was determined. We found no resistance toward the biocides tested, but we did find that isolates obtained after cleaning had higher minimum inhibitory concentration (MIC) values toward one of the disinfectants (Incimaxx DES) compared to isolates obtained before cleaning and disinfection. This could indicate selection of strains that are more tolerant, due to the cleaning and disinfection. Furthermore, we found that there was a weak statistical correlation between MICs toward the biocides and some antibiotics, but no difference in log(MIC)s toward antibiotics between isolates obtained before and after cleaning, nor did we find any difference in the number of resistances of isolates obtained before and after cleaning and disinfection., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Surface disinfectants are part of broader preventive strategies preventing the transmission of bacteria, fungi and viruses in medical institutions. To evaluate their virucidal efficacy, these products must be tested with appropriate model viruses with different physico-chemical properties under conditions representing practical application in hospitals. The aim of this study was to evaluate a quantitative carrier assay. Furthermore, different putative model viruses like adenovirus type 5 (AdV-5) and different animal parvoviruses were evaluated with respect to their tenacity and practicability in laboratory handling. To evaluate the robustness of the method, some of the viruses were tested in parallel in different laboratories in a multi-center study. Different biocides, which are common active ingredients of surface disinfectants, were used in the test. After drying on stainless steel discs as the carrier, model viruses were exposed to different concentrations of three alcohols, peracetic acid (PAA) or glutaraldehyde (GDA), with a fixed exposure time of 5 minutes. Residual virus was determined after treatment by endpoint titration. All parvoviruses exhibited a similar stability with respect to GDA, while AdV-5 was more susceptible. For PAA, the porcine parvovirus was more sensitive than the other parvoviruses, and again, AdV-5 presented a higher susceptibility than the parvoviruses. All parvoviruses were resistant to alcohols, while AdV-5 was only stable when treated with 2-propanol. The analysis of the results of the multi-center study showed a high reproducibility of this test system. In conclusion, two viruses with different physico-chemical properties can be recommended as appropriate model viruses for the evaluation of the virucidal efficacy of surface disinfectants: AdV-5, which has a high clinical impact, and murine parvovirus (MVM) with the highest practicability among the parvoviruses tested.

Background: Reusable surface disinfectant tissue dispensers are used in hospitals in many countries because they allow immediate access to pre-soaked tissues for targeted surface decontamination. On the other hand disinfectant solutions with some active ingredients may get contaminated and cause outbreaks. We determined the frequency of contaminated surface disinfectant solutions in reusable dispensers and the ability of isolates to multiply in different formulations., Methods: Reusable tissue dispensers with different surface disinfectants were randomly collected from healthcare facilities. Solutions were investigated for bacterial contamination. The efficacy of two surface disinfectants was determined in suspension tests against two isolated species directly from a contaminated solution or after 5 passages without selection pressure in triplicate. Freshly prepared use solutions were contaminated to determine survival of isolates., Results: 66 dispensers containing disinfectant solutions with surface-active ingredients were collected in 15 healthcare facilities. 28 dispensers from nine healthcare facilities were contaminated with approximately 107 cells per mL of Achromobacter species 3 (9 hospitals), Achromobacter xylosoxidans or Serratia marcescens (1 hospital each). In none of the hospitals dispenser processing had been adequately performed. Isolates regained susceptibility to the disinfectants after five passages without selection pressure but were still able to multiply in different formulations from different manufacturers at room temperature within 7 days., Conclusions: Neglecting adequate processing of surface disinfectant dispensers has contributed to frequent and heavy contamination of use-solutions based on surface active ingredients. Tissue dispenser processing should be taken seriously in clinical practice.

Cleanliness of the clinical environment has a direct impact on healthcare-associated infection (HCAI) incidence and there is increasing evidence of its importance with regard to infection prevention and control. While traditional high-level disinfectants have excellent antimicrobial properties, these are typically offset against issues such as corrosiveness, toxicity, cost and user acceptance. Recent years have seen several user-friendly sporicidal disinfectants emerge onto the market. Antimicrobial profile and user acceptance determine the clinical success of any disinfectant. Therefore, product adoption is often a two-stage process with a tabletop evaluation of the appropriate technical data, including efficacy claims, followed by an in-use product evaluation. The first part of this article demonstrates the importance of the clinical environment with respect to HCAI and examines some of the issues around disinfectants used in health care and considerations when selecting a new disinfectant for use. The second part reports the experiences of the Infection Prevention and Control team at Alder Hey Children's Hospital in their assessment and subsequent adoption of a new user-friendly sporicidal disinfectant into clinical practice.

Control of staphylococci during cleaning and disinfection is important to the food industry. Broad-spectrum bacteriocins with proved anti-staphylococcal activity, such as enterocin AS-48, could open new possibilities for disinfection in combination with biocides. In the present study, enterocin AS-48 was tested singly or in combination with biocides against a cocktail of six Staphylococcus aureus strains (including three methicillin-resistant strains) in planktonic state as well as in biofilms formed on polystyrene microtiter plates. Cells were challenged with enterocin, biocides or enterocin/biocide combinations. Inactivation of planktonic cells increased significantly (p<0.05) when enterocin AS-48 (25mg/l) was tested in combination with benzalkonium chloride (BC), cetrimide (CT) and hexadecylpyridinium chloride (HDP), and non-significantly in combination with didecyldimethylammonium bromide (AB), triclosan (TC), hexachlorophene (CF), polyhexamethylen guanidinium chloride (PHMG), chlorhexidine (CH) or P3-oxonia (OX). In the sessile state (24h biofilms), staphylococci required higher biocide concentrations in most cases, except for OX. Inactivation of sessile staphylococci increased remarkably when biocides were applied in combination with enterocin AS-48, especially when the bacteriocin was added at 50mg/l. During storage, the concentrations of sessile as well as planktonic cells in the treated samples decreased remarkably for BC, TC and PHMG, but OX failed to inhibit proliferation of the treated biofilms as well as growth of planktonic cells. The observed inhibitory effects during storage were potentiated when the biocides were combined with 50 mg/l enterocin AS-48. Results from this study suggest that selected combinations of enterocin AS-48 and biocides offer potential use against planktonic and sessile, methicillin-sensitive and methicillin-resistant S. aureus., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Medical devices that enter body tissues should be sterile, whereas devices that contact mucous membranes should be high-level disinfected between patients. Failure to ensure proper cleaning and sterilization or disinfection may lead to patient-to-patient transmission of pathogens. This paper describes a protocol that can guide an institution in managing potential disinfection and sterilization failures., (Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)

The United States Environmental Protection Agency regulates pesticidal products, including products with antimicrobial activity. Test guidelines have been established to inform manufacturers of which methodology is appropriate to support a specific efficacy claim. This paper highlights efforts designed to improve current methods and the development and assessment of new test methods., (Published by Mosby, Inc.)

Semicritical medical devices are defined as items that come into contact with mucous membranes or nonintact skin (eg, gastrointestinal endoscopes). Such medical devices require minimally high-level disinfection. Because many of these items are temperature sensitive, low-temperature chemical methods must be used rather than steam sterilization. Strict adherence to current guidelines is required because more outbreaks have been linked to inadequately cleaned or disinfected endoscopes undergoing high-level disinfection than any other medical device., (Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)

Contaminated environmental surfaces provide an important potential source for transmission of health care-associated pathogens. In recent years, a variety of interventions have been shown to be effective in improving cleaning and disinfection of surfaces. This review examines the evidence that improving environmental disinfection can reduce health care-associated infections., (Published by Mosby, Inc.)

The testing and label claims of disinfectants to wipe high-touch environmental surfaces rarely reflect their field use where contact times are in seconds with only microliters of the disinfectant deposited on a unit surface area. Therefore, such products must be properly assessed with mechanical/chemical action combined. We critically review current wipe test methods and propose future approaches., (Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)

Bacterial spores are frequently intrinsically resistant to biocides and only a number of alkylating and oxidising biocides are sporicidal under certain conditions. Activity against spores is affected by several key factors such as concentration, exposure time, soiling, and the types of surface to be treated. Sporicidal efficacy is usually achieved after an exposure time of several minutes with a high concentration of a biocide. Failure to understand these factors will result in decreased sporicide activity and spore survival. Sporicides in healthcare settings are used for surface disinfection and for the high level disinfection of certain medical devices (e.g. endoscopes). With efficacy data in mind, sporicidal activity should be achieved for the disinfection of medical devices where both high concentration and long exposure time occur. However, for the disinfection of environmental surfaces, high concentration is not recommended, nor is long exposure time achievable. In this case, sporicidal activity is severely reduced and spore survival following treatment is to be expected and contributes to the explanation of spore persistence on surfaces., (Copyright © 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.)

The proper use of products containing sodium hypochlorite,ammonium salts and triclosan has proved to be effective in the elimination of infectious agents in the household environment. Our objective was to evaluate the immediate, one-week and one-month efficacy of controlled use of five products containing these components, compared to other commonly used products. Within a six month period, thirty two middle-class homes from Buenos Aires City and suburbs were included in this open-label, randomized, parallel-group intervention study. Sixteen homes were randomized to use products containing sodium hypochlorite, ammonia and triclosan in the kitchen and bathroom during one month. The remaining maintained usual practices for domestic cleaning. Bacterial counts and identification were performed from samples taken from each study site. Baseline samples (no group discrimination) contained a mean bacterial count in kitchen of 66.0 CFU/cm2, and in bathroom 40.1 CFU/cm2. Samples taken immediately after-cleaning (no group discrimination) contained: kitchen 0.8 CFU/cm2; bathroom < 1 CFU/cm2. After one week (intervention group vs. control group) contained: kitchen 18.0 vs. 32.5 CFU/cm2; bathroom 12.7 vs. 7.7 CFU/cm2. After one month (intervention group vs. control group): kitchen 60.1 vs. 62.1 CFU/cm2; bathroom 37.0 vs. 42.0 CFU/cm2. A remarkable decrease of bacterial load was observed in both groups, which suggests that not only product quality but also education for suitable use plays a key role in successful house disinfection. This approach could be an important tool for improving prevention of foodborne infections since fecal coliforms widely predominated in all analyzed samples.

Pathogenic organisms can be transmitted orally through drinking water or through skin and mucosae by both direct and indirect contact, and their presence in water thus has a negative impact on public health. In wastewater treatment plants (WWTP), water is disinfected to inactivate pathogens. The quantification of several microbial indicators in aquatic systems is required to estimate the biological quality of such systems. So far, coliform bacteria have been used as traditional indicators world-wide. This study has assessed the resistance of total coliforms, Escherichia coli, Pseudomonas aeruginosa and Enterococcus faecalis to three dosages of sodium hypochlorite (NaClO) at two exposure times. The bacteria were isolated from secondary effluents of a WWTP located in Hidalgo, Mexico. The results show that the number of colony-forming units of all studied bacterial types decreased when both the NaClO concentration and exposure times increased. However, they were not eliminated. The inclusion of the species Pseudomonas aeruginosa in regulations for treated wastewater quality as a new indicator is highly recommended due to its importance as an opportunistic pathogen. The detection of this species along with the traditional organisms could be particulary significant for reclaimed water to be used with direct human contact.