Which disinfectant was bactericidal

Selection of the ideal disinfectant. Sievert, D. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National healthcare safety network at the centers for disease control and prevention, — Biometals 30 , — McGowan, J.

Substituted sulfonamide bioisosteres of 8-hydroxyquinoline as zinc-dependent antibacterial compounds. Houston, D. Wei, Z. Antiviral activity of zinc salts against transmissible gastroenteritis virus in vitro. Berglin, E. Potentiation by L-cysteine of the bactericidal effect of hydrogen peroxide in Escherichia coli.

Scozzafava, A. Agents that target cysteine residues of biomolecules and their therapeutic potential. Patents 11 , — Kawahara, T. Inactivation of human and avian influenza viruses by potassium oleate of natural soap component through exothermic interaction. Mousavi, S. Immunomodulatory and antimicrobial effects of vitamin C. Bp 9 , 73—79 Shintaro, S.

Alcohol abrogates human norovirus infectivity in a pH-dependent manner. Sci Rep. Min, J. Chlorine dioxide inactivation of enterovirus 71 in water and its impact on genomic targets. Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment. Contact Dermat. The Ministry of Health, Labour and Welfare. The 17th revised Japanese pharmacopoeia. Kawamura, T. Basic studies on standardization of patch tests. A 80 , — Google Scholar.

Download references. The authors thank the Kitasato Research Center for Environmental Science and DRC corporation for testing the effectiveness and safety of this disinfectant. Shiniryouzaidan, Matsuzaki-cho, Abeno-ku, Osaka, , Japan. You can also search for this author in PubMed Google Scholar. Study design: T. Data analysis and drafting manuscript: T.

All authors read and approved the final manuscript. Correspondence to Tokuhiro Matsubara. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Reprints and Permissions. Matsubara, T. The effectiveness of a nonalcoholic disinfectant containing metal ions, with broad antimicrobial activity.

Sci Rep 11, Download citation. Received : 19 September Accepted : 21 December Published : 13 January Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. Advanced search. Skip to main content Thank you for visiting nature. Download PDF. Subjects Antimicrobials Antiviral agents.

Abstract Disinfectants have different efficacies depending on their use and the target microorganism. Introduction The spread of nosocomial pathogens, which is a major source of healthcare-associated infections HAIs , contributes to patient morbidity and mortality 1. Results The results of experiment 1 are presented in Table 1. Table 1 Time taken to completely inactivate microorganisms following contact with the disinfectant.

Full size table. Table 2 Evaluation of the cytotoxicity of the disinfectant. Table 3 Skin reaction in the human patch test. Discussion Disinfection is an important method to prevent infection and cuts off infection routes. Methods Disinfectant To prepare the disinfectant, the bacteriostatic action was verified for each component, and the optimum concentration was confirmed.

Experiment 1 Preparation of bacterial test solutions The efficacy of this disinfectant was tested on 9 bacteria 1: E. Preparation of viral test solutions The viruses tested are presented in Table 1.

Evaluation of bactericidal efficacy suspension test The suspension test was performed according to the 17th revised Japanese Pharmacopoeia 4. Inactivator validation Since our disinfectant is at a low pH, it was judged that the action cannot be stopped in MEM medium, which has almost no pH-buffering capacity.

Measurements of bacterial counts and viral infection titers The medium and reagents used are shown in Supplementary Table S3. Experiment 2 The cytotoxicity of this disinfectant for each cultured cell line for the cell lines used for determining infectious titer, see Table 1 for details was investigated. Experiment 3 This safety study was performed by the human open patch test at the DRC corporation. Figure 1. Flow chart of patient selection and patch test schedule.

Full size image. Data availability Please contact the author for data requests. References 1. Article Google Scholar 2. Article Google Scholar 3. PubMed Google Scholar 7. Article Google Scholar 8. Article Google Scholar 9. Article Google Scholar In a study conducted by West et al. On another note, surfaces disinfected with hydrogen peroxide based antimicrobials have demonstrated significantly lower chances of bacterial regrowth than those disinfected with quaternary ammonium compounds [ 35 ].

To this effect, the study by Boyce et al. Our data suggest that hydrogen peroxide or sodium hypochlorite products should be used in healthcare facilities for routine use, particularly on surfaces prone to biofilm development.

However, hydrogen peroxide disinfectants have also been reported to be corrosive on medical equipment such as flexible endoscopes [ 36 ] and can discolor metal finishes [ 37 ]. Despite these limitations, Alfa et al. Moreover, hydrogen peroxide disinfectants are neither irritating or malodorous [ 37 ]. The ability of biofilm matrices to prevent contact between disinfectant products and bacterial cells is complex [ 39 ]. Biofilms are characterized by high cell population densities that supply large amounts of polymeric substances, which consequently enables the formation of well-structured, functional matrices [ 39 ].

Moreover, biofilm cells are genetically primed to better tolerate disinfectant products compared to plaktonic cells [ 39 , 40 ].

These features prevent the diffusion of disinfectants and limit bactericidal efficacy [ 41 ]. While our study emphasized the efficacy of disinfectants at label concentration and contact time, it did not investigate the efficacy of disinfectants at off label use or with varying environmental effects.

Monoculture biofilms will be rare in healthcare environments and soil levels and surface type will vary. Further, this work was conducted on glass coupons per the EPA protocol, which does not necessarily represent how cells will grow on other surfaces e. Recognizing these limitations, more work is needed to investigate other variables that can impact disinfectant efficacy e. We found that hydrogen peroxide and sodium hypochlorite products are effective against S. However, quaternary ammonium chloride compounds are not as effective against S.

While further research is warranted to evaluate more complex biofilms in hospital environements, test the efficacy of disinfectants against dry biofilms, and to optimize the bactericidal effects of a combination of different ready to use antimicrobials, infection preventionists should consider the use of hydrogen peroxide and sodium hypochlorite products on surfaces at risk of biofilm development to prevent HAIs.

Center for Disease Control. Healthcare associated infection progress report. Published Accessed 5 July Bloodstream infection in the ICU.

Infect Dis Clin N Am. Article Google Scholar. Stone PW. Economic burden of healthcare-associated infections: an American perspective. Expert Rev Pharmacoecon Outcomes Res.

Bacteria biofilms and associated infections. J Chin Med Assoc. PubMed Article Google Scholar. Presence of biofilm containing viable multiresistant organisms despite terminal cleaning on clinical surfaces in an intensive care unit. J Hosp Infect. Disinfection, sterilization, and control of hospital waste. Elsevier Inc. Cleaning and disinfecting environmental surfaces in health care: toward an integrated framework for infection and occupational illness prevention. Am J Infect Control.

Smith K, Hunter IS. Efficacy of common hospital biocides with biofilms of multi-drug resistant clinical isolates. J Med Microbiol. National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, PubMed Google Scholar. Flushing on the detachment of biofilms attached to the walls of metal pipes in water distribution systems.

J Zhejiang Univ-Sci A. How long do nosocomial pathogens persists on inanimate surfaces? A systemic review. BMC Infect Dis. An introduction to the world of microbiology and biofilmology.

In: Percival S, Cutting K, editors. Microbiology of wounds. Chapter Google Scholar. Impact of growth temperature and surface type on the resistance of Pseudomonas aeruginosa and Staphylococcus aureus biofilms to disinfectants. Int J Food Microbiol. Resistance of bacterial biofilms to disinfectants: a review.

Comparative evaluation of biofilm disinfectant efficacy tests. J Microbiol Methods. Spatial and temporal patterns of biocide action against Staphylococcus epidermidis biofilms.

Antimicrob Agents Chemother. Cleaning and disinfection of biofilms composed of Listeria monocytogenes and background microbiota from meat processing surfaces. Appl Environ Microbiol. Donlan RM. Biofilms: microbial life on surfaces. Emerg Infect Dis. Meyer B, Cookson B. Does microbial resistance or adaptation to biocides create a hazard in infection prevention and control?

Environmental Protection Agency. Methods and guidance for testing the efficacy of antimicrobial products against biofilms on hard, non-porous surfaces. Accessed 2 Nov Effects of contact time and concentration on bactericidal efficacy of 3 disinfectants on hard nonporous surfaces. There is no additional bactericidal efficacy of EPA-registered disinfectant towelettes post-surface drying or beyond label contact time.

Beware biofilms! Dry biofilms containing bacterial pathogens on multiple healthcare surfaces; a multiple center study. Efficacy testing standards for product data call in responses.

EPA; Accessed 1 Aug Effects of quaternary ammonium-based formulations on bacterial community dynamics and antimicrobial susceptibility. Gerba CP. Quaternary ammonium biocides: efficacy in application. Formation of low charge state ions of synthetic polymers using quaternary ammonium compounds.

Anal Chem. Iodophors formulated as antiseptics contain less free iodine than do those formulated as disinfectants Iodine or iodine-based antiseptics should not be used on silicone catheters because they can adversely affect the silicone tubing Ortho-phthalaldehyde is a high-level disinfectant that received FDA clearance in October It contains 0.

OPA solution is a clear, pale-blue liquid with a pH of 7. Tables 4 and 5. Preliminary studies on the mode of action of OPA suggest that both OPA and glutaraldehyde interact with amino acids, proteins, and microorganisms. However, OPA is a less potent cross-linking agent. This is compensated for by the lipophilic aromatic nature of OPA that is likely to assist its uptake through the outer layers of mycobacteria and gram-negative bacteria OPA appears to kill spores by blocking the spore germination process Studies have demonstrated excellent microbicidal activity in vitro 69, , , , For example, OPA has superior mycobactericidal activity 5-log 10 reduction in 5 minutes to glutaraldehyde.

The mean times required to produce a 6-log 10 reduction for M. OPA showed good activity against the mycobacteria tested, including the glutaraldehyde-resistant strains, but 0. Increasing the pH from its unadjusted level about 6. The level of biocidal activity was directly related to the temperature. A greater than 5-log 10 reduction of B.

The influence of laboratory adaptation of test strains, such as P. Resistant and multiresistant strains increased substantially in susceptibility to OPA after laboratory adaptation log 10 reduction factors increased by 0.

Other studies have found naturally occurring cells of P. OPA has several potential advantages over glutaraldehyde. It has excellent stability over a wide pH range pH 3—9 , is not a known irritant to the eyes and nasal passages , does not require exposure monitoring, has a barely perceptible odor, and requires no activation. OPA, like glutaraldehyde, has excellent material compatibility.

A potential disadvantage of OPA is that it stains proteins gray including unprotected skin and thus must be handled with caution Meticulous cleaning, using the correct OPA exposure time e. Personal protective equipment should be worn when contaminated instruments, equipment, and chemicals are handled In April , the manufacturer of OPA disseminated information to users about patients who reportedly experienced an anaphylaxis-like reaction after cystoscopy where the scope had been reprocessed using OPA.

Of approximately 1 million urologic procedures performed using instruments reprocessed using OPA, 24 cases 17 cases in the United States, six in Japan, one in the United Kingdom of anaphylaxis-like reactions have been reported after repeated cystoscopy typically after four to nine treatments. Preventive measures include removal of OPA residues by thorough rinsing and not using OPA for reprocessing urologic instrumentation used to treat patients with a history of bladder cancer Nevine Erian, personal communication, June 4, ; Product Notification, Advanced Sterilization Products, April 23, A few OPA clinical studies are available.

Furthermore, OPA was effective over a day use cycle High-pressure liquid chromatography confirmed that OPA levels are maintained above 0. OPA must be disposed in accordance with local and state regulations.

These label claims differ worldwide because of differences in the test methodology and requirements for licensure. Peracetic, or peroxyacetic, acid is characterized by rapid action against all microorganisms.

Special advantages of peracetic acid are that it lacks harmful decomposition products i. It remains effective in the presence of organic matter and is sporicidal even at low temperatures Tables 4 and 5. Peracetic acid can corrode copper, brass, bronze, plain steel, and galvanized iron but these effects can be reduced by additives and pH modifications. Little is known about the mechanism of action of peracetic acid, but it is believed to function similarly to other oxidizing agents—that is, it denatures proteins, disrupts the cell wall permeability, and oxidizes sulfhydryl and sulfur bonds in proteins, enzymes, and other metabolites In the presence of organic matter, — ppm is required.

For viruses, the dosage range is wide 12— ppm , with poliovirus inactivated in yeast extract in 15 minutes with 1,—2, ppm.

In one study, 3. Peracetic acid 0. With bacterial spores, —10, ppm 0. An automated machine using peracetic acid to chemically sterilize medical e. As previously noted, dental handpieces should be steam sterilized. Simulated-use trials have demonstrated excellent microbicidal activity , , and three clinical trials have demonstrated both excellent microbial killing and no clinical failures leading to infection 90, , The high efficacy of the system was demonstrated in a comparison of the efficacies of the system with that of ethylene oxide.

Only the peracetic acid system completely killed 6 log 10 of M. An investigation that compared the costs, performance, and maintenance of urologic endoscopic equipment processed by high-level disinfection with glutaraldehyde with those of the peracetic acid system reported no clinical differences between the two systems.

Furthermore, three clusters of infection using the peracetic acid automated endoscope reprocessor were linked to inadequately processed bronchoscopes when inappropriate channel connectors were used with the system These clusters highlight the importance of training, proper model-specific endoscope connector systems, and quality-control procedures to ensure compliance with endoscope manufacturer recommendations and professional organization guidelines.

An alternative high-level disinfectant available in the United Kingdom contains 0. Although this product is rapidly effective against a broad range of microorganisms , , , it tarnishes the metal of endoscopes and is unstable, resulting in only a hour use life Two chemical sterilants are available that contain peracetic acid plus hydrogen peroxide i. The bactericidal properties of peracetic acid and hydrogen peroxide have been demonstrated Manufacturer data demonstrated this combination of peracetic acid and hydrogen peroxide inactivated all microorganisms except bacterial spores within 20 minutes.

The 0. The combination of peracetic acid and hydrogen peroxide has been used for disinfecting hemodialyzers Olympus America does not endorse use of 0. This product is not currently available. FDA has cleared a newer chemical sterilant with 0. After testing the 7.

Phenol has occupied a prominent place in the field of hospital disinfection since its initial use as a germicide by Lister in his pioneering work on antiseptic surgery. In the past 30 years, however, work has concentrated on the numerous phenol derivatives or phenolics and their antimicrobial properties.

Phenol derivatives originate when a functional group e. Two phenol derivatives commonly found as constituents of hospital disinfectants are ortho -phenylphenol and ortho -benzyl- para -chlorophenol. The antimicrobial properties of these compounds and many other phenol derivatives are much improved over those of the parent chemical.

Phenolics are absorbed by porous materials, and the residual disinfectant can irritate tissue. In , depigmentation of the skin was reported to be caused by phenolic germicidal detergents containing para -tertiary butylphenol and para -tertiary amylphenol In high concentrations, phenol acts as a gross protoplasmic poison, penetrating and disrupting the cell wall and precipitating the cell proteins. Low concentrations of phenol and higher molecular-weight phenol derivatives cause bacterial death by inactivation of essential enzyme systems and leakage of essential metabolites from the cell wall Published reports on the antimicrobial efficacy of commonly used phenolics showed they were bactericidal, fungicidal, virucidal, and tuberculocidal 14, 61, 71, 73, , , , One study demonstrated little or no virucidal effect of a phenolic against coxsackie B4, echovirus 11, and poliovirus 1 Attempts to substantiate the bactericidal label claims of phenolics using the AOAC Use-Dilution Method occasionally have failed , However, results from these same studies have varied dramatically among laboratories testing identical products.

Many phenolic germicides are EPA-registered as disinfectants for use on environmental surfaces e. Phenolics are not FDA-cleared as high-level disinfectants for use with semicritical items but could be used to preclean or decontaminate critical and semicritical devices before terminal sterilization or high-level disinfection.

The use of phenolics in nurseries has been questioned because of hyperbilirubinemia in infants placed in bassinets where phenolic detergents were used If phenolics are used to clean nursery floors, they must be diluted as recommended on the product label. Phenolics and other disinfectants should not be used to clean infant bassinets and incubators while occupied.

If phenolics are used to terminally clean infant bassinets and incubators, the surfaces should be rinsed thoroughly with water and dried before reuse of infant bassinets and incubators The quaternary ammonium compounds are widely used as disinfectants.

Health-care—associated infections have been reported from contaminated quaternary ammonium compounds used to disinfect patient-care supplies or equipment, such as cystoscopes or cardiac catheters , The quaternaries are good cleaning agents, but high water hardness and materials such as cotton and gauze pads can make them less microbicidal because of insoluble precipitates or cotton and gauze pads absorb the active ingredients, respectively.

Each compound exhibits its own antimicrobial characteristics, hence the search for one compound with outstanding antimicrobial properties. Some of the chemical names of quaternary ammonium compounds used in healthcare are alkyl dimethyl benzyl ammonium chloride, alkyl didecyl dimethyl ammonium chloride, and dialkyl dimethyl ammonium chloride.

The newer quaternary ammonium compounds i. A few case reports have documented occupational asthma as a result of exposure to benzalkonium chloride The bactericidal action of the quaternaries has been attributed to the inactivation of energy-producing enzymes, denaturation of essential cell proteins, and disruption of the cell membrane Evidence exists that supports these and other possibilities The poor mycobactericidal activities of quaternary ammonium compounds have been demonstrated 55, No functional damage or cosmetic changes occurred to the computer keyboards after applications of the disinfectants However, test results have varied extensively among laboratories testing identical products , The quaternaries commonly are used in ordinary environmental sanitation of noncritical surfaces, such as floors, furniture, and walls.

EPA-registered quaternary ammonium compounds are appropriate to use for disinfecting medical equipment that contacts intact skin e.

Skip directly to site content Skip directly to page options Skip directly to A-Z link. Infection Control.