Table 3.
Efficacy of several chemical agents in hospital disinfection
| Disinfectant | Microorganism | Method/test | Efficiency |
|---|---|---|---|
| Nu-Cidex® (0.35% peracetic acid) | Mycobacterium (5 strains) | suspension and surface test | complete inactivation after 5 min of exposure129 |
| Nu-Cidex® (0.35% peracetic acid) | Bacillus subtilis spores | suspension test | >5 log10 reduction in 5 min with 10% serum130 |
| Cidex Long-Life® (2% glutaraldehyde) | B. subtilis spores | suspension test | >5 log10 reduction in 2 h with 4% blood130 |
| Titan Sanitizer® (sodium dichloroisocyanurate with Cl content of 2.2%) | B. subtilis spores | suspension test | >5 log10 reduction (disinfectant at 5% in 3 h); no reduction in the presence of 2% blood130 |
| Presept® disinfectant granules (sodium dichloroisocyanurate with Cl content of around 30%) | B. subtilis spores | suspension test | >5 log10 reduction (disinfectant at 1% in 1 h in the absence of blood and in 2 h in the presence of 2% blood)130 |
| Haz-Tab® disinfectant granules (sodium dichloroisocyanurate with Cl content of around 60%) | B. subtilis spores | suspension test | >5 log10 reduction (disinfectant at 1% in 5 and 30 min in the presence of 2% blood)130 |
| Virkon® (peroxygen) | B. subtilis spores | suspension test | 5 log10 reduction (disinfectant at 1% in 2–3 h in the absence of blood, but little kill in 3 h in the presence of 2% blood)130 |
| Sporicidin® (2% glutaraldehyde, 7.05% phenol, 1.2% sodium phenate) | B. subtilis spores | suspension test | 4 log10 reduction in 10 h and 2 log10 reduction in 10 h in the presence of 2% blood130 |
| Sterilox® (9 : 1 v/v) (hypochlorous acid at a concentration of 144 mg/L and free chlorine radicals) | C. difficile spores, Helicobacter pylori, VRE, C. albicans and 4 Mycobacterium species | suspension test | >5 log10 reduction in 2 min with 5% horse serum (except for C. difficile spores since the disinfectant activity diminished in the presence of organic load)131 |
| 10% Povidone iodine | 10 MRSA, 10 methicillin-susceptible S. aureus (MSSA), 9 VRE and 10 vancomycin-susceptible Enterococcus faecalis | European surface test method132 | 3.14, 3.49, 3.47 and 3.78 log10 reduction, after 1.5 min for VRE, VSE, MRSA and MSSA, respectively133 |
| Perasafe® (peroxygen system equivalent to peracetic acid at 0.26%) | C. difficile and Bacillus atrophaeus spores | surface test on stainless steel and polyvinyl chloride floor covering | 5.5–6 log10 reduction in 10 min134 |
| Perasafe® | S. aureus ATCC 25923, MRSA, MSSA, E. faecalis, Enterobacter cloacae, K. pneumoniae, P. aeruginosa, Acinetobacter anitratus, C. albicans, Mycobacterium fortuitum ATCC 609 and B. subtilis (spore strips). | suspension, surface, sporicidal, endoscope model test, capacity and corrosion tests | complete inactivation except for Mycobacterium and spores; resistance to inactivation after repeated inoculation; did not corrode clean instruments; when organic matter was added, it cleaned without corrosion135 |
| 2% Glutaraldehyde | S. aureus ATCC 25923, MRSA, MSSA, E. faecalis, E. cloacae, K. pneumoniae, P. aeruginosa, A. anitratus, C. albicans, M. fortuitum ATCC 609 and B. subtilis (spore strips) | suspension, surface, sporicidal, endoscope model test, capacity and corrosion tests | complete inactivation except for Mycobacterium and spores; resistance to inactivation after repeated inoculation; did not corrode clean instruments; when organic matter was added it fixed the matter to the scalpel, causing corrosion within 2 h135 |
| Sodium dichloroisocyanurate | C. difficile and B. atrophaeus spores | surface test on stainless steel and polyvinyl chloride floor covering | 0.7–1.5 log10 reduction in 10 min134 |
| Monopercitric acid (peroxy-acid-based disinfectant) | Clostridium spores | suspension test | 0.5% disinfectant is sporicidal within 5 min136 |
| 0.2% Alkyl-diaminoethylglycine and 80% (v/v) ethyl alcohol | S. aureus, MRSA and MSSA | wiping and membrane filtration technique | reduction of bacteria to an undetectable level75 |
| 0.01% Sodium hypochlorite and 0.1% sodium hypochlorite | S. aureus, MRSA and MSSA | wiping and membrane filtration technique | reduction of bacteria to a minimal detectable level75 |
| Ortho-phthalaldehyde | Pseudomonas fluorescens (planktonic) | respirometry; adenosine triphosphate release; outer membrane protein expression and bacterial colour changes | complete inactivation (MBC 0.5 mM)137 |
| Ortho-phthalaldehyde | P. fluorescens (planktonic) | respiratory activity, membrane permeabilization and integrity, and physico-chemical characterization | MIC 1500 mg/L24 |
| Ortho-phthalaldehyde | S. aureus, E. coli, P. aeruginosa | suspension and carrier tests | ≥5 log reduction in viability within 1 min of exposure138 |
| Ortho-phthalaldehyde | bacteria found in 100 endoscopes | surface test | 5 log10 reduction of bacteria with an exposure time of 5 min139 |
| Glutaraldehyde | P. fluorescens (planktonic) | respirometry; adenosine triphosphate release; outer membrane protein expression and bacterial colour changes | no bacterial inactivation was detected137 |
| Cetyltrimethyl ammonium bromide | P. fluorescens (planktonic) | respirometry; adenosine triphosphate release; outer membrane protein expression and colony colour changes | complete inactivation (MBC 5 mM)137 |
| Polyhexamethylene guanidine hydrochloride | S. aureus, P. aeruginosa, Salmonella choleraesuis, MRSA and E. coli | phenol coefficient (PC)a value (for S. aureus, P. aeruginosa and S. choleraesuis); MIC and MBC (for MRSA and E. coli) | PC values for S. aureus, S. choleraesuis and P. aeruginosa were 7.5, 6.1 and 5, respectively; the MIC value for MRSA and E. coli was 0.04% and 0.005% (w/v), respectively, in 1.5 min140 |
| Allrent® (2-propanol: 1%–5% weight; tensides 1%–5% weight; 60%–100% weight water) | B. subtilis, S. aureus, C. albicans | colony counting in agar plates and bioluminescence detection of adenosine triphosphate | final residual cfu percentage of 35.7%141 |
| Appeartex® (active polymer A-200, polyhexamethylene biguanide and a surfactant solution) | S. aureus, Enterococcus hirae | contact agar plates; direct agar inoculation using swabs; swab rinse technique (on a laboratory scale and in a hospital ward) | reduction in magnitude of 10–103,142 |
| Aqueous chlorine dioxide solution | B. anthracis spores | quantitative bacteriological culture methods | 8 log10 reduction in 3 min in sealed microfuge tubes and 1 log10 reduction for spraying or spreading the disinfectant onto surfaces (when using the solution in 5% bleach—0.3% sodium hypochlorite—its full activity is restored)143 |
| Dismozon® pur; Kohrsolin® extra; Kohrsolin® FF | C. difficile ribotype 027 | suspension test in different concentrations at various exposure times | ≥4 log10 (Dismozon pur at 1.5% and 2 h exposure time; Kohrsolin extra at 2% and 4 h exposure time; and Kohrsolin FF at 2% and 6 h exposure time)144 |
aA measure of the bactericidal activity of a chemical compound in relation to phenol.