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[Usability of three alcohols for a standard disinfection method to be employed for the evaluation of procedures for the hygienic disinfection of hands (author's transl)].

Following a former suggestion (4) always to evaluate, the efficacy of procedures for Hygienic disinfection of hands in comparison with the results of a certain standard disinfection method, Ethanol, iso- and n-Propanol were tested in various concentrations and for various times of action on their usability in such a standard method. The disinfecting power was dependent upon (i) the alcohol (Ethanol less than iso-Propanol less than n-Propanol), (ii) the concentration (Ethanol: 60 less than 70 less than 80% ml/ml, iso-Propanol: 50 less than 60 less than 70, n-Propanol: 40 less than 50 less than 60 = 70) and (iii) the time of action (0,5 less than 1 less than 2 min). n-Propanol proved to be the fastest acting disinfectant. However, as standard disinfection method iso-Propanol (60% ml/ml) being used for 1 min has been proposed. Furthermore, the following results that have been obtained also in former investigations (8) could be confirmed: (i) there is no systematic difference between the release of test-bacteria from the fingertips of right and left hands of test-persons (ii). The efficacy of procedures for Hygienic disinfection of hands is besides other factors influenced by the testpersons. This factor may be eliminated by using the same testpersons for both, the disinfection procedure under investigation and the standard method. The results of both may, then, be related to each other and the efficacy of the former may be evaluated in comparison to the latter.

1-Propanol

[Testing a disinfectant used for chemothermic disinfection (author's transl)].

Experiments were carried out to test the bacteriological effectiveness of an aldehyde-based disinfectant used for the chemothermic disinfection of instruments. The product is designed to be added to instrument washing machines whereby the temperature should be 65 degrees C. The death rate by means of heat (65 degrees C) of 4 different species of bacteria (Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Proteus vulgaris), which were all suspended in four different media, was determined. E. coli proved to be the most thermoresistant. It was not possible to destroy all the bacteria within one hour. The disinfectant alone was also not sufficient. The suspension, the instrument-disinfection- and the carrier-tests were based upon the "DGHM-Richtlinien". They were, however, carried out in the water bath at 65 degrees C so that the influence of the temperature and the disinfectant could be determined simultaneously. Good results were obtained with this combination of heat and disinfectant. Fungi and mycobacteria were also destroyed.

Bacteria

Bacterial contamination of heat-sterilized, heat-disinfected and chemically-disinfected haemodialysis monitors.

The bacterial contamination of one heat-sterilized, three heat-disinfected and four chemically-disinfected monitor types was evaluated before and after dialysis. All monitor types were contaminated. In the heat-treated monitors the level of contamination varied with the intensity of the heat treatment and the technical design. They were less contaminated than the chemically-disinfected recirculating single-pass monitors. The latter were contaminated to a marginal degree, irrespective of the quality of the water supply. Each monitor showed a characteristic microbial flora, indicating that recontamination occurred from the same persistent focus. Aquired antibiotic resistance characters were rare among the potential human pathogens isolated from the dialysate. The level of contamination during dialysis is determined by a complex of factors, including the mode of disinfection, the technical design of the dialysis equipment, the duration of the dialyses, and the flora of the dialysate.

Anti-Bacterial Agents

Factors influencing the assessment of the pseudomonacidal activity of disinfectants by a quantitative suspension test. II. The post-disinfection recovery of surviving organisms.

Bacteria which have been treated by a disinfectant may be partially damaged so that they will be able to survive and to multiply only if all environmental factors are kept as optimal as possible. Otherwise no growth at all is obtained and the disinfectant solution will be wrongly considered as active. Therefore the technique of the post-medication recovery of surviving microorganisms is a matter of great importance. Since our aim is to elaborate a quantitative test, the counting technique using pour or streak plates is investigated here. In contrast to the results of viable counts of normally cultivated P. aeruginosa (Tables 1 and 2), the colony counts of phenol-treated bacteria gain higher figures when the spread plate method is used instead of the pour plate technique (Table 3). - Out of nine solid media examined (Table 4), four culture media are considered to be superior to the others (Table 5). They are Davis Agar, the Nutrient Agar of the German pharmacopoeia, the Nutrient Agar proposed by the APHA, and Tryptone Soy bean peptone Agar. Further investigation on the influence of the recovery medium is needed since there is stated that significant differences are obtained when three preparations of the same formulation are compared (Table 6). Finally the author observed that the volume of the culture medium affects the survival rate (Table 8). The recovery of disinfectant-treated bacteria is found to be very complex; further research on this domain should be encouraged.

Bacteriological Techniques

[Experiments on disinfection of vaccinia virus embedded in scabs and/or at the hand].

Vaccinia viruses embedded in rabbit dermal scabs were subjected to physical and chemical disinfection procedures. Scabs were suspended in vitro without saline or in physiological saline, and left for 1 hour at 70 to 90 degrees C. A complete inactivation was achived only in those scab samples which had been incubated at 90 degrees C for 1 hour and suspended in physiological saline. Scabs which had been placed in a disinfecting apparatus (Vacudes 4000) filled with mattrasses consistently proved to be free of infectious vaccinia viruses in each of the chosen programs. In addition scabs were subjected to disinfection by means of chemical disinfecting agents. The scabs had been placed in a chemical disinfecting suspension and left there for 90 minutes. Complete disinfection was obtained with glutaraldehyde 2%, formaldehyde 2%, Lysoformin 2% or 3%, phenol 5% and chloramine T 2%. Complete disinfection was likewise achieved after 3 hours treatment with some alchohols (ethylalcohol 80%, isopropylalcohol 7%, n-propylalcohol 60%), Amocid 5% and formaldehyde 1%.0.5% formaldehyde caused complete disinfection when applied for 6 hours. The only exception was a Quat which did not disinfect fully even after 18 hours application. Concerning the tests to disinfect the hands complete disinfection occurs when using chloramine T (1.5%) or isopropylalcohol (70%) in 2 to 5 minutes. Further tests were performed with scabs which were placed in sick rooms that were terminally disinfected with formaline vapor. It could be confirmed that the usual terminal disinfection with formaldehyde vapor was unable to completely disinfect the scabs. It is necessary to double the amount of formaldehyde (10 g formaldehyde per cubic metre of space) and prolong the period of treatment to 24 hours to achieve a greater degree of disinfection rate.

Animals

[Virucidal activity of the disinfectant "gigasept" against different enveloped and non-enveloped RNA-and DNA-viruses, pathogenic for men. I. Investigation in the suspension test (author's transl)].

"Gigasept" is a highly efficient chemical disinfectant on the basis of succine dialdehyde and form aldehyde. The virucidal capacity was assayed in the suspension test procedure with different representative RNA and DNA viruses with and without an envelope, such as polio wild virus type I, coxsackie virus type B 3, adeno virus type 3, herpes virus type ) and vaccinia virus. Parameter for disinfectant activity was the virus inactivation kinetic, i. e. interdependence of titer reduction vs. disinfectant concentration and disinfectant contact time. A "minimal disinfection" was defined as a greater than or equal to 99.9% virus inactivation. A "disinfection per definitionem" must gain a titer reduction of greater than or equal to 10(3) ID 50 and absence of virus. According to these criteria all virus strains were inactivated by Gigasept regardless of absence or presence of serum, which was tested in a concentration of 40% calf serum. Disinfection per definitionem was achieved with Gigasept concentrations of 3% after 60 min. or 5% after 30 min. except for enteroviruses. This group of viruses has to be disinfected with a 10% solution for 4 hours or with a 5% solution overnight. Gigasept, on the basis of these results, can be classified as a highly effective virucidal disinfectant. As to the hepatitis virus group however, no data so far are available. An enterovirus - disinfection procedure is recommended in hepatitis risk areas, as long as test systems for hepatitis viruses are not developed.

Adenoviridae

Limits to progressive reduction of resident skin bacteria by disinfection.

Antiseptic preparations used repeatedly to disinfect the skin caused a reduction in yield of resident flora to a low equilibrium level beyond which further reduction did not occur. This equilibrium varied with the antiseptic preparation used. In a comparison of three preparations, the lowest equilibrium level was obtained with 95% ethyl alcohol. The further reduction in yield of skin bacteria on using alcohol after repeated disinfection with an antiseptic detergent preparation ('two-phase' disinfection) was not paralleled by a further reduction when the preparations used in the two phases were reversed, the antiseptic detergent being used after repeated disinfection with ethyl alcohol. 'Two-phase' disinfection was therefore seen to be due to further reduction in skin bacteria from the low equilibrium obtained with the antiseptic detergent to the lower level obtainable by alcohol disinfection. When repeated disinfection to equilibrium with alcohol was followed by a 'second-phase' handwash with a non-antiseptic detergent and water, there was a large increase in the yield of skin bacteria. This finding supports the view that a low equilibrium level occurs when the reduction in density of accessible bacteria through disinfection is balanced by the emergence of bacteria drawn from deeper layers of the skin.

Bacteria

Effect of disinfectants with and without usage of detergent for the flexible fiberoptic bronchoscope.

The purpose of this study was to find a safer, more rapid and easier disinfection process for the flexible fiberoptic bronchoscope (F.F.B.) by using ordinary disinfectants and a detergent. Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aures, E. coli, Serratia marcescens and Candida albicans were used as sources of contamination. The mixed bacterial growth preparations for contamination of the F.F.B. were the same as those previously mentioned in our study. Comparative bacteriological studies, between glutaraldehyde (GA) ethylalcohol (AL) and chlorhexidine (CHX) with and without usage of benzalkonium chloride (B.C.) solution and sterile water (W) as the detergent were performed and the following conclusions were obtained: 1. Contaminating microorganisms were reduced from 10(-3)/ml to 10(-4)/ml colony count after flushing with W and B.C. This procedure is very helpful for consecutive rapid disinfections or sterilizations of the F.F.B. 2. The effect of disinfectants with usage of a detergent was much better than without a detergent. Required immersion time in the disinfectants with detergent was reduced to periods as short as 60 seconds. 3. Of the three disinfectants, the most effective was CHX, GA next, and AL third. 4. Unsatisfactory disinfection occurred in some instances when there were functional disorders with the F.F.B. despite adequate amounts of disinfectant and detergent.

Bronchoscopes

Involvement of cross-genus phages in bacterial resistance to chlorine disinfection.

Chlorine disinfection resistance in pathogenic microorganisms poses severe environmental concerns and public health risks. While phages play critical roles in host adaptation to environmental stress, how poly-host phages contribute to bacterial resistance to chlorine disinfectants remains poorly understood. Here, we investigated shifts in the population dynamics, transcriptional profiles, and function potentials of cross-genus phage-bacterial communities under exposure to chlorine disinfectants in a continuously operated anaerobic-anoxic-oxic system over a 92-day period, using integrated metagenomic and metatranscriptomic approaches. In the presence and absence of chlorine disinfectants, the genomic abundance and diversity of phage and bacterial communities showed similar variation trends, and the community structures of both exhibited clear differences. A strong significant positive correlation was observed between phage and bacterial diversity under chlorine exposure (R&#x202f;=&#x202f;0.975, p&#x202f;=&#x202f;0.00,057), whereas no significant correlation was detected in the absence of chlorine disinfection (R&#x202f;=&#x202f;-0.314, p&#x202f;=&#x202f;0.613), suggesting that chlorine disinfectants may enhance phage-bacteria interactions. Host-associated phages exhibited high consistency with their corresponding putative hosts in terms of genomic abundance (M2&#x202f;=&#x202f;0.0945, p&#x202f;=&#x202f;0.001) and transcript abundance (M2&#x202f;=&#x202f;0.3668, p&#x202f;=&#x202f;0.001), and they were also significantly correlated with cross-genus phages in both genomic abundance (R&#x202f;=&#x202f;0.97, p&#x202f;<&#x202f;2.2e-16) and transcript abundance (R&#x202f;=&#x202f;0.83, p&#x202f;<&#x202f;2.2e-16), which collectively suggests the critical role of cross-genus phages in the resistance of microbial communities to chlorine disinfectants. Bipartite association network analysis shows that cross-genus phages carry highly homologous genes to their putative hosts and may be involved in the horizontal transfer of these genes among bacteria. These homologous genes are involved in DNA repair, redox balance regulation, environmental stress adaptation and efflux pump functions, suggesting a synergistic role between cross-genus phages and their putative hosts in chlorine resistance. Our findings reveal that cross-genus phages can contribute to the resistance of bacterial communities to chlorine disinfectants, providing the theoretical foundation for evaluating the role of poly-host phages in microbial communities.

Chlorine resistance

[Test methods for surgical hand disinfection (author's transl)].

As exemplified by a test preparation, methods for assessing the effect of hand disinfection on the resident flora are put up for discussion. The test of a method for hand disinfection must make allowance for conditions prevailing in practice. Accordingly, the following steps should be taken into consideration: A. Single use 1. Immediate disinfecting effect 2. Duration of the disinfecting effect B. Repeated use 3. Course of the initial colony count 4. Immediate disinfecting effect 5. Behaviour of colony count after interruption of the disinfecting method applied. For the purpose of comparing the total count, as with all other disinfecting methods, the colony count must be determined by fractional collection methods; to this end, Traub's procedure may be modified, possibly using the plastic bag method described by Gaschen. A careful statistical evaluation with appropriate transformation of the results is indispensable.

Bacteria