Testing
of Disinfectant
Introduction
Disinfection describes a process that eliminates many or
all pathogenic microorganisms, except bacterial spores, on inanimate objects.
In health-care settings, objects usually are disinfected by liquid chemicals or
wet pasteurization. Each of the various factors that affect the efficacy of
disinfection can nullify or limit the efficacy of the process. Factors that
affect the efficacy of both disinfection and sterilization include prior
cleaning of the object; organic and inorganic load present; type and level of
microbial contamination; concentration of and exposure time to the germicide;
physical nature of the object (e.g., crevices, hinges, and lumens); presence of
biofilms; temperature and pH of the disinfection process; and in some cases,
relative humidity of the sterilization process (e.g., ethylene oxide). Unlike
sterilization, disinfection is not sporicidal. A few disinfectants will kill
spores with prolonged exposure times (3–12 hours); these are called chemical
sterilants. At similar concentrations but with shorter exposure periods (e.g.,
20 minutes for 2% glutaraldehyde), these same disinfectants will kill all
microorganisms except large numbers of bacterial spores; they are called
high-level disinfectants. Low level disinfectants can kill most vegetative
bacteria, some fungi, and some viruses in a practical period of time.
Intermediate-level disinfectants might be cidal for mycobacteria, vegetative
bacteria, most viruses, and most fungi but do not necessarily kill bacterial
spores. Germicides differ markedly, primarily in their antimicrobial spectrum
and rapidity of action.
Disinfectants are antimicrobial agents that are applied to
non-living objects to destroy microorganisms that
are living on the objects. Disinfection does not necessarily kill all
microorganisms, especially resistant bacterial spores; it is less effective than sterilization, which is an extreme physical and/or chemical
process that kills all types of life. Disinfectants are different from other
antimicrobial agents such as antibiotics, which destroy microorganisms within the body, and antiseptics, which destroy microorganisms on living tissue.
Disinfectants are also different from biocides — the latter are intended to destroy all forms
of life, not just microorganisms. Disinfectants work by destroying the cell
wall of microbes or interfering with the metabolism.
Sanitizers are
substances that simultaneously clean and disinfect. Disinfectants are
frequently used in hospitals, dental surgeries, kitchens, and bathrooms to kill
infectious organisms.
Bacterial endospores are most resistant to disinfectants, but some
viruses and bacteria also possess some tolerance. In wastewater treatment, a disinfection step
with chlorine, ultra-violet (UV)
radiation or ozonation can be included as tertiary treatment to
remove pathogens from wastewater, for example if it is to be reused
to irrigate golf courses. An alternative term used in the sanitation sector for disinfection of waste streams, sewage sludge or fecal sludge is sanitisation or sanitization.
Disinfectants
used in hospitals and laboratories must be tested periodically to ascertain its
potency and efficacy.
Properties
A perfect disinfectant would also offer complete and full
microbiological sterilisation, without harming humans and
useful form of life, be inexpensive, and noncorrosive. However, most
disinfectants are also, by nature, potentially harmful (even toxic) to humans or animals. Most
modern household disinfectants contain Bitrex, an exceptionally bitter substance added to
discourage ingestion, as a safety measure. Those that are used indoors should
never be mixed with other cleaning products as chemical
reactions can occur. The choice of disinfectant to be used
depends on the particular situation. Some disinfectants have a wide spectrum
(kill many different types of microorganisms), while others kill a smaller
range of disease-causing organisms but are preferred for other properties (they
may be non-corrosive, non-toxic, or inexpensive). There are arguments for
creating or maintaining conditions that are not conducive to bacterial survival
and multiplication, rather than attempting to kill them with chemicals.
Bacteria can increase in number very quickly, which enables them to evolve rapidly. Should some bacteria
survive a chemical attack, they give rise to new generations composed
completely of bacteria that have resistance to the particular chemical used.
Under a sustained chemical attack, the surviving bacteria in successive generations
are increasingly resistant to the chemical used, and ultimately the chemical is
rendered ineffective. For this reason, some question the wisdom of impregnating
cloths, cutting
boards and worktops in the home with bactericidal chemicals.
Measurements
of effectiveness
One way to compare
disinfectants is to compare how well they do against a known disinfectant and
rate them accordingly. Phenol is the standard, and the corresponding rating
system is called the "Phenol coefficient". The disinfectant to be tested is compared with
phenol on a standard microbe (usually Salmonella typhi or Staphylococcus
aureus). Disinfectants that are more
effective than phenol have a coefficient > 1. Those that are less effective
have a coefficient < 1.
The standard European
approach for disinfectant validation consists of a basic suspension test, a
quantitative suspension test (with low and high levels of organic material
added to act as ‘interfering substances’) and a two part simulated-use surface
test. A less specific measurement of effectiveness is the United States Environmental Protection Agency (EPA) classification into either high, intermediate or low levels of disinfection.
"High-level disinfection kills all organisms, except high levels of
bacterial spores" and is done with a chemical germicide marketed as a
sterilant by the U.S. Food and Drug Administration (FDA). "Intermediate-level disinfection kills
mycobacteria, most viruses, and bacteria with a chemical germicide registered
as a 'tuberculocide' by the Environmental Protection Agency. Low-level
disinfection kills some viruses and bacteria with a chemical germicide
registered as a hospital disinfectant by the EPA."
An alternative assessment
is to measure the Minimum inhibitory concentrations (MICs) of disinfectants
against selected (and representative) microbial species, such as through the use
of microbroth dilution testing.
Properties
A perfect disinfectant would also offer complete and full
microbiological sterilisation, without harming humans and
useful form of life, be inexpensive, and noncorrosive. However, most
disinfectants are also, by nature, potentially harmful (even toxic) to humans or animals. Most
modern household disinfectants contain Bitrex, an exceptionally bitter substance added to
discourage ingestion, as a safety measure. Those that are used indoors should
never be mixed with other cleaning products as chemical
reactions can occur. The choice of disinfectant to be used
depends on the particular situation. Some disinfectants have a wide spectrum
(kill many different types of microorganisms), while others kill a smaller
range of disease-causing organisms but are preferred for other properties (they
may be non-corrosive, non-toxic, or inexpensive). There are arguments for
creating or maintaining conditions that are not conducive to bacterial survival
and multiplication, rather than attempting to kill them with chemicals.
Bacteria can increase in number very quickly, which enables them to evolve rapidly. Should some bacteria
survive a chemical attack, they give rise to new generations composed
completely of bacteria that have resistance to the particular chemical used.
Under a sustained chemical attack, the surviving bacteria in successive generations
are increasingly resistant to the chemical used, and ultimately the chemical is
rendered ineffective. For this reason, some question the wisdom of impregnating
cloths, cutting
boards and worktops in the home with bactericidal chemicals.
Measurements
of effectiveness
One way to compare
disinfectants is to compare how well they do against a known disinfectant and
rate them accordingly. Phenol is the standard, and the corresponding rating
system is called the "Phenol coefficient". The disinfectant to be tested is compared with
phenol on a standard microbe (usually Salmonella typhi or Staphylococcus
aureus). Disinfectants that are more
effective than phenol have a coefficient > 1. Those that are less effective
have a coefficient < 1.
The standard European
approach for disinfectant validation consists of a basic suspension test, a
quantitative suspension test (with low and high levels of organic material
added to act as ‘interfering substances’) and a two part simulated-use surface
test. A less specific measurement of effectiveness is the United States Environmental Protection Agency (EPA) classification into either high, intermediate or low levels of disinfection.
"High-level disinfection kills all organisms, except high levels of
bacterial spores" and is done with a chemical germicide marketed as a
sterilant by the U.S. Food and Drug Administration (FDA). "Intermediate-level disinfection kills
mycobacteria, most viruses, and bacteria with a chemical germicide registered
as a 'tuberculocide' by the Environmental Protection Agency. Low-level
disinfection kills some viruses and bacteria with a chemical germicide
registered as a hospital disinfectant by the EPA."
An alternative assessment
is to measure the Minimum inhibitory concentrations (MICs) of disinfectants
against selected (and representative) microbial species, such as through the use
of microbroth dilution testing.
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