Survival of enveloped and non-enveloped viruses on surfaces compared with other micro-organisms and impact of suboptimal disinfectant exposure

doi:10.1016/j.jhin.2008.04.024

Journal of Hospital Infection

Volume 69, Issue 4, August 2008, Pages 368-376

https://doi.org/10.1016/j.jhin.2008.04.024 Get rights and content

Summary

Survival of enveloped and non-enveloped viruses was compared with that of bacteria, yeasts and mycobacteria when dried on the surface of polyvinyl chloride test carriers in the presence or absence of an organic matrix. The efficacy of glutaraldehyde and accelerated hydrogen peroxide (AHP) disinfectants was evaluated. Reovirus, a non-enveloped virus, persisted and had a RF of 2 after 30 days whereas Enterococcus faecalis had an RF of 4 over the same time period. The other test organisms (Sindbis virus, Pseudomonas aeruginosa, Mycobacterium chelonae and Candida albicans) had variable survivals but none survived as long as 30 days. Both glutaraldehyde and AHP were effective at manufactures' recommended dilutions for high-level disinfection. However, only 7% AHP eliminated a glutaraldehyde-resistant strain of M. chelonae. Breakthrough survival was detected at 0.1% glutaraldehyde and 0.05% AHP for all organisms tested. Our data emphasise the need for effective cleaning and disinfection in nosocomial settings to prevent pathogen transmission.

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.

Section snippets

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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Survival of enveloped and non-enveloped viruses on surfaces compared with other micro-organisms and impact of suboptimal disinfectant exposure

Summary

Introduction

Section snippets

Micro-organisms

Results

Discussion

Am J Infect Control

Am J Infect Control

J Virol Methods

Virology

Am J Infect Control

Am J Infect Control

Chest

Am J Infect Control

Aust Infect Control

Infection control problem for patient safety

N Engl J Med

How long do nosocomial pathogens persist on inanimate surfaces? A systematic review

BMC Infect Dis

Use of germicides in the home and healthcare setting: is there a relationship between germicide use and antibiotic resistance?

Infect Control Hosp Epidemiol

Survival of Enterococci and Staphylococci on hospital fabrics and plastic

J Clin Microbiol

Disinfection of endoscopes: review of new chemical sterilants used for high-level disinfection

Infect Control Hosp Epidemiol

APIC guideline for infection prevention and control in flexible endoscopy

Am J Infect Control