A new hydrogen peroxide–based medical-device detergent with germicidal properties: Comparison with enzymatic cleaners

doi:10.1067/mic.2001.113616

American Journal of Infection Control

Volume 29, Issue 3, June 2001, Pages 168-177

Portions of this project were presented at the Canadian Hospital Infection Control Association annual conference in Toronto, Ontario; May 28-31, 2000.

https://doi.org/10.1067/mic.2001.113616 Get rights and content

Abstract

Background: The objective of this study was to evaluate the efficacy of the cleaning and bacterial killing ability of a new non–enzyme-based formulation (killing detergent solution [KDS]) compared with commercially available enzymatic detergents that included Metrizyme (Metrex Research Division of Sybron Canada Ltd. Morrisburg, Ontario) and Gzyme (Germiphene Corp, Brantford, Ontario). KDS is a hydrogen peroxide–based detergent formulation that combines cleaning efficacy with the ability to kill microorganisms. The KDS formulation helps ensure the protection of the health care worker from infectious risk during the soaking and cleaning stages of medical device reprocessing and reduces the bioburden on devices before sterilization/disinfection. Methods: Test organisms that included Enterococcus faecalis , Salmonella choleraesuis , Staphylococcus aureus , and Pseudomonas aeruginosa were suspended in artificial test soil (ATS-B; patent submitted), inoculated at 10⁶ colonyforming units per carrier and dried overnight before detergent exposure. The ATS-B mimics the blood, protein, carbohydrate, and endotoxin levels of patient-used medical devices. Plastic lumen carriers and a flexible colonoscope were used for surface and simulated-use testing, respectively. Results: The results for the microbial challenge dried onto polyvinyl chloride (PVC) carriers demonstrated that the ability of KDS to remove protein, blood, carbohydrate, and endotoxin from surface test carriers was as effective as the enzyme detergents that were evaluated. Furthermore, KDS was able to effect approximately a 5-Log₁₀ reduction in microbial loads with a 3-minute exposure at room temperature, whereas none of the other detergents were as effective. In simulated-use testing of a soiled colonoscope, KDS was significantly better at ensuring microbial killing compared with Gzyme and Metrizyme and was equivalent to the enzymatic detergents in cleaning ability. Conclusions: In summary the KDS has excellent microbial-killing ability in 3-minute exposures at room temperature and cleans as well as the existing enzymatic detergent formulations that were tested. (Am J Infect Control 2001;29:168-77)

Section snippets

Detergents tested

Killing detergent solution (KDS) is an aqueous solution of hydrogen peroxide of 0.5% (weight/weight) strength at the use concentration. The pH of the in-use solution is within the range of 3.5 to 4.0 and appears as a colorless, odorless liquid. For the present work, a concentrate stock (7% w/w hydrogen peroxide) solution was diluted 1:16 (8 oz/gal) with potable tap water.

The Metrizyme (Metrex Research Division of Sybron Canada Ltd, Morrisburg, Ontario, Canada) label indicates “Metrizyme is a

Results

The KDS formulation was optimized for the reprocessing of medical devices to provide good microbial killing and good cleaning ability. Although every attempt is made to ensure that patient-material does not dry onto patient-used medical devices, time in transit is a variable factor. Efficacy of germicide killing may be reduced in the presence of dried organic material. To determine how effective KDS was compared with other commercially available detergents for the killing of bacteria that had

Discussion

Hydrogen peroxide acts as an oxidant whose hydroxyl free radicals kill a wide range of microorganisms by attacking essential cell components, which include lipids, proteins, and DNA.¹⁸ This compound does have sporocidal activity at high concentrations and prolonged contact times and is widely used as a biocide.3, 4, 5, 18 The value of stabilized hydrogen peroxide as an environmentally friendly cleaning agent has been reported,4, 19 although it can be corrosive to aluminum, copper, brass, or

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^*: Funds for this study were provided by Virox Technologies Inc, Mississauga, Ontario.

^**: Reprint requests: Michelle J. Alfa, PhD, Wayne State University, Department of Clinical Laboratory Science, College of Pharmacy and Allied Health Professions, Detroit, MI 48202.

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ArticlesA new hydrogen peroxide–based medical-device detergent with germicidal properties: Comparison with enzymatic cleaners*,**

Abstract

Section snippets

Detergents tested

Results

Discussion

Am J Infect Control

Am J Infect Control

J Hosp Infect

Gastroenterology

Am J Infect Control

Am J Infect Control

Am J Infect Control

Am J Infect Control

J Hosp Infect

Standards for infection control and reprocessing of flexible gastrointestinal endoscopes

Infection control guidelines: hand washing, cleaning, disinfection and sterilization in health care

Health Canada

Safety and cleaning of medical materials and devices

J Biomed Mater Res (Appl Biomater)

Decontamination of reusable medical devices

Articles
A new hydrogen peroxide–based medical-device detergent with germicidal properties: Comparison with enzymatic cleaners*,**