Griffiths P A, Babb J R, Fraise A P
Hospital Infection Research Laboratory, City Hospital NHS Trust, Birmingham.
J Hosp Infect. 1999 Feb;41(2):111-21. doi: 10.1016/s0195-6701(99)90048-8.
In this study, a quantitative suspension test carried out under both clean and dirty conditions was used to assess the activity of various instrument and environmental disinfectants against the type strain NCTC 946 and an endoscope washer disinfector isolate of Mycobacterium chelonae, Mycobacterium fortuitum NCTC 10,394, Mycobacterium tuberculosis H37 Rv NCTC 7416 and a clinical isolate of Mycobacterium avium-intracellulare (MAI). The disinfectants tested were; a chlorine releasing agent, sodium dichloroisocyanurate (NaDCC) at 1000 ppm and 10,000 ppm av Cl; chlorine dioxide at 1100 ppm av ClO2 (Tristel, MediChem International Limited); 70% industrial methylated spirits (IMS); 2% alkaline glutaraldehyde (Asep, Galan); 10% succinedialdehyde and formaldehyde mixture (Gigasept, Schulke & Mayr); 0.35% peracetic acid (NuCidex, Johnson & Johnson); and a peroxygen compound at 1% and 3% (Virkon, Antec International). Results showed that the clinical isolate of MAI was much more resistant than M. tuberculosis to all the disinfectants, while the type strains of M. chelonae and M. fortuitum were far more sensitive. The washer disinfector isolate of M. chelonae was extremely resistant to 2% alkaline activated glutaraldehyde and appeared to be slightly more resistant than the type strain to Nu-Cidex, Gigasept, Virkon and the lower concentration of NaDCC. This study has shown peracetic acid (Nu-Cidex), chlorine dioxide (Tristel), alcohol (IMS) and high concentrations of a chlorine releasing agent (NaDCC) are rapidly mycobactericidal. Glutaraldehyde, although effective, is a slow mycobactericide. Gigasept and Virkon are poor mycobactericidal agents and are not therefore recommended for instruments or spillage if mycobacteria are likely to be present.
在本研究中，通过在清洁和污染条件下进行的定量悬浮试验，评估了各种器械和环境消毒剂对标准菌株NCTC 946以及一株从内镜清洗消毒机分离出的龟分枝杆菌、偶然分枝杆菌NCTC 10394、结核分枝杆菌H37 Rv NCTC 7416和鸟分枝杆菌-胞内分枝杆菌临床分离株（MAI）的活性。所测试的消毒剂包括：一种含氯释放剂，1000 ppm和10000 ppm有效氯的二氯异氰尿酸钠（NaDCC）；1100 ppm有效二氧化氯（Tristel，MediChem国际有限公司）；70%工业甲醇（IMS）；2%碱性戊二醛（Asep，Galan）；10%丁二醛和甲醛混合物（Gigasept，舒尔茨&迈尔公司）；0.35%过氧乙酸（NuCidex，强生公司）；以及1%和3%的过氧复合剂（Virkon，安特克国际公司）。结果表明，MAI临床分离株对所有消毒剂的耐药性远高于结核分枝杆菌，而龟分枝杆菌和偶然分枝杆菌的标准菌株则更为敏感。从清洗消毒机分离出的龟分枝杆菌对2%碱性活化戊二醛具有极强的耐药性，并且似乎比标准菌株对Nu-Cidex、Gigasept、Virkon和较低浓度的NaDCC的耐药性略高。本研究表明，过氧乙酸（NuCidex）、二氧化氯（Tristel）、酒精（IMS）和高浓度的含氯释放剂（NaDCC）具有快速杀分枝杆菌作用。戊二醛虽然有效，但杀分枝杆菌作用缓慢。Gigasept和Virkon是效果不佳的杀分枝杆菌剂，因此，如果可能存在分枝杆菌，不建议用于器械或溢出物消毒。
