Survival of enveloped and non-enveloped viruses on surfaces compared with other micro-organisms and impact of suboptimal disinfectant exposure
Introduction
Survival of micro-organisms on environmental surfaces and medical devices leads to nosocomial disease transmission and is thought to contribute to the 90 000 deaths annually from nosocomial pathogens.1, 2 Nosocomial infections are frequently associated with resistant organisms including vancomycin-resistant Enterococcus spp. (VRE), meticillin-resistant Staphylococcus aureus, multidrug-resistant Pseudomonas aeruginosa and Mycobacterium tuberculosis.3, 4 Viable pathogens in the environment have a significant role in nosocomial transmission, especially for immunocompromised patients and can be sheltered by organic/inorganic debris, protein, blood and body fluids.5, 6, 7
Effective disinfection of healthcare equipment and surfaces is critical for preventing transmission of potential pathogens.8 Suboptimal biocide exposure may facilitate their survival. Infection transmission from flexible endoscopes is mainly attributed to inadequate reprocessing: suboptimal disinfectant exposure time or concentration.9 Cracks and crevices in complex narrow lumens can protect organisms from exposure to disinfectant and lead to infection transmission.10, 11 Surface tests for efficacy of disinfectants using carriers represent use in healthcare settings better than the suspension tests usually performed.12, 13 Only a few studies have compared survival of viruses with that of bacteria, yeasts and mycobacteria in an organic matrix on surface test carriers.
The primary objectives of this study were to compare surface survival of enveloped and non-enveloped viruses with that of bacteria, yeast and mycobacteria and to determine the killing efficacy of optimal and suboptimal disinfectant concentrations.
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Micro-organisms
The test organisms represent those associated with contamination of medical devices and/or healthcare environments (Table I). Bacteria were passaged on tryptic soy agar (TSA) at 35 °C. M. chelonae and C. albicans were subcultured on TSA supplemented with 5% whole sheep blood (Oxoid, Toronto, Canada) and incubated at 30 °C. Bacterial, mycobacterial and yeast strains were subcultured three times from frozen stocks (held in skim milk at −70 °C) before use. Bacterial and yeast cultures that were 24 h
Results
Preliminary testing confirmed that the neutralisation/elution protocols were effective (Table III). A 1:100 dilution of either disinfectant in neutraliser did not cause any apparent cytotoxicity nor was there any interference with plaque formation by neovirus or CPE caused by SVHR. Preliminary testing of microbial survival showed that survival in ATS for a period of 30 days was higher by a factor of ∼10 than in PBS.
When dried in ATS, only Enterococcus faecalis survived for ≥30 days (Figure 1a).
Discussion
Our data confirm that non-enveloped viruses and enterococci can survive in the healthcare environment, particularly in the presence of organic material. Reovirus when dried in an organic matrix survived for a period of 30 days (RF = 2) as did E. faecalis (RF = 4).
Mammalian reoviruses belong to the Reoviridae, which include rotavirus, a leading cause of hospitalisation for young children, responsible for 6% of all diarrhoeal episodes and 20% of associated deaths in children in developing countries.16
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