From Emerging Infectious Diseases

New Disinfection and Sterilization Method

William A. Rutala, David J. Webe, University of North Carolina (UNC) Health Care System and UNC School of Medicine, Chapel Hill, North Carolina, USA.

Published: 03/01/2001

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Abstract and Introduction

Abstract

New disinfection methods include a persistent antimicrobial-drug coating that can be applied to inanimate and animate objects (Surfacine), a high-level disinfectant with reduced exposure time (ortho-phthalaldehyde), and an antimicrobial drug that can be applied to animate and inanimate objects (superoxidized water). New sterilization methods include a chemical sterilization process for endoscopes that integrates cleaning (Endoclens), a rapid (4-hour) readout biological indicator for ethylene oxide sterilization (Attest), and a hydrogen peroxide plasma sterilizer that has a shorter cycle time and improved efficacy (Sterrad 50).

Introduction

The need for appropriate disinfection procedures is highlighted by the multitude of outbreaks resulting from improperly decontaminated patient-care items. Because sterilizing all such items is unnecessary, hospital policies need to identify whether cleaning, disinfection, or sterilization is indicated based primarily on an item's intended use but considering other factors including cost. We review new methods of disinfection and sterilization. Criteria for inclusion were technologies cleared in 1999 or 2000 by the Food and Drug Administration (FDA) or submitted to the FDA or Environmental Protection Agency (EPA) but not yet cleared (Table 1). These technologies have the potential to improve patient care, but in general their antimicrobial activity has not been independently validated.

 
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References

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  2. Rutala WA, Weber DJ. Disinfection of endoscopes: review of new chemical sterilants used for high-level disinfection. Infect Control Hosp Epidemiol 1999;20:69-76.
  3. Advanced Sterilization Products, Johnson & Johnson. Cidex OPA high level disinfection solution: technical information. Irvine (CA): Advanced Sterilization Products; 1999.
  4. Gregory AW, Schaalje B, Smart JD, Robison RA. The mycobactericidal efficacy of ortho-phthalaldehyde and the comparative resistances of Mycobacterium bovis, Mycobacterium terrae, and Mycobacterium chelonae. Infect Control Hosp Epidemiol 1999:20:324-30.
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  7. Chen X. A comparison of the useful life of Cidex activated dialdehyde solution and Cidex OPA in AER system. Irvine (CA): Advanced Sterilization Products; 1999.
  8. Weber DJ, Rutala WA. Role of environmental contamination in the transmission of vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 1997;18:306-9.
  9. Rutala WA, Stiegel MM, Sarubbi FA, Weber DJ. Susceptibility of antibiotic-susceptible and antibiotic-resistant hospital bacteria to disinfectants. Infect Control Hosp Epidemiol 1997;18:417-21.
  10. Anderson RL, Carr JH, Bond WW, Favero MS. Susceptibility of vancomycin-resistant enterococci to environmental disinfectants. Infect Control Hosp Epidemiol 1997;18:195-9.
  11. Rutala WA, Gergen MF, Weber DJ. Evaluation of a new surface germicide (SurfacineTM) with antimicrobial persistence. Infect Control Hosp Epidemiol 2000;21:103.
  12. Fraise AP. Choosing disinfectants. J Hosp Infect 1999;43:255-64.
  13. Tanaka H, Hirakata Y, Kaku M, Yoshida R, Takemura H, Mizukane R, et al. Antimicrobial activity of superoxidized water. J Hosp Infect 1996;34:43-9.
  14. Selkon JB, Babb JR, Morris R. Evaluation of the antimicrobial activity of a new super-oxidized water, Sterilox®, for the disinfection of endoscopes. J Hosp Infect 1999;41:59-70.
  15. Shetty N, Srinivasan S, Holton J, Ridgway GL. Evaluation of microbicidal activity of a new disinfectant: Sterilox® 2500 against Clostridium difficile spores, Helicobacter pylori, vancomycin resistant Enterococcus species, Candida albicans and several Mycobacterium species. J Hosp Infect 1999;41:101-5.
  16. Advanced Sterilization Products new automated endoscope reprocessing system with NSX sterilant. Technical report. Irvine (CA): Advanced Sterlization Products; 2000.
  17. Rutala WA, Weber DJ. Clinical effectiveness of low-temperature sterilization technologies. Infect Control Hosp Epidemiol 1998;19:798-804.
  18. Rutala WA, Gergen MF, Weber DJ. Evaluation of a rapid readout biological indicator for flash sterilization with three biological indicators and three chemical indicators. Infect Control Hosp Epidemiol 1993;14:390-4.
  19. Rutala WA, Jones SM, Weber DJ, Comparison of a rapid readout biological indicator for steam sterilization with four conventional biological indicators and five chemical indicators. Infect Control Hosp Epidemiol 1996:17:423-8.
  20. 3M Attest Rapid Readout Ethylene Oxide Biological Indicator. Product Profile. Minneapolis (MN): 3M.
  21. Rutala WA, Gergen MF, Weber DJ. Sporicidal activity of a new low-temperature sterilization technology: the Sterrad 50 sterilizer. Infect Control Hosp Epidemiol 1999; 20:514-16.
  22. Rutala WA, Gergen MF, Weber DJ. Comparative evaluation of the sporicidal activity of new low-temperature sterilization technologies: ethylene oxide, 2 plasma sterilization systems, and liquid peracetic acid. Am J Infect Control 1998;26:393-8.
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Authors and Disclosures

Dr. Rutala is director of the Hospital Epidemiology, Occupational Health and Safety Program at the University of North Carolina (UNC) Health Care System and professor of medicine at UNC School of Medicine, Chapel Hill, NC.

Dr. Weber is medical director of the Hospital Epidemiology, Occupational Health and Safety Program at UNC Health Care System and professor of medicine, epidemiology, and pediatrics at the UNC Schools of Medicine and Public Health. Their research interests include prevention of nosocomial infections, disinfection, and sterilization.

Address for correspondence: William A. Rutala, 547 Burnett-Womack, CB #7030, Division of Infectious Diseases, UNC at Chapel Hill, Chapel Hill, NC 27599-7030; fax: 919-966-6714; e-mail: brutala@unch.unc.edu.

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Emerging Infectious Diseases. 2001;7(2) © 2001 Centers for Disease Control and Prevention (CDC)

 
 
 
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