Stanley P M
Minntech Corporation, Minneapolis, MN 55447, USA.
Am J Infect Control. 1999 Aug;27(4):339-43. doi: 10.1016/s0196-6553(99)70054-4.
To prevent cross-infection of patients, semicritical devices must be high-level disinfected by a product capable of destroying mycobacteria. Glutaraldehyde is commonly used; however, recent studies showed that glutaraldehyde-resistant mycobacteria could survive treatment with this chemical for extended exposure times. Our study tested hydrogen peroxide, peracetic acid, and a germicide (Cidex PA, Advanced Sterilization Products, Irvine, Calif) containing a mixture of the 2 peroxygen compounds for their ability to kill both glutaraldehyde-resistant and nonresistant (control) mycobacteria.
Bacterial suspensions were exposed to the test chemicals for various periods followed by neutralization and enumeration of survivors.
Hydrogen peroxide at 10% and acidified hydrogen peroxide at 6% had low activity (<4 log reduction in 60 minutes exposure) against glutaraldehyde-resistant strains and slightly higher activity (4 log to 6 log reduction in 60 minutes) against the control strains. Peracetic acid at 0.07% had low to moderate activity (0.6 log to 6 log reduction in 60 minutes) against the resistant organisms and moderate to high activity (4 log to 6 log reduction in 10 minutes) against the control strains. Cidex PA, which contains a mixture of 0.07% peracetic acid and 1% hydrogen peroxide, had high activity (6 log reduction in 10 minutes) against all organisms. Efficacy of 0.8% phenol, a standard reference solution, did not correlate with efficacy of the peroxygen compounds.
Hydrogen peroxide and peracetic acid had much higher activity toward mycobacteria when combined as a synergistic mixture than when evaluated individually.
为防止患者发生交叉感染，半关键器械必须使用能够杀灭分枝杆菌的产品进行高水平消毒。戊二醛是常用的消毒剂；然而，最近的研究表明，耐戊二醛的分枝杆菌在长时间接触这种化学物质后仍能存活。我们的研究测试了过氧化氢、过氧乙酸以及一种含有这两种过氧化物混合物的杀菌剂（Cidex PA，Advanced Sterilization Products，加利福尼亚州欧文市）对耐戊二醛和非耐戊二醛（对照）分枝杆菌的杀灭能力。
将细菌悬液暴露于测试化学物质中不同时间段，随后进行中和并计数存活菌数。
10%的过氧化氢和6%的酸化过氧化氢对耐戊二醛菌株的活性较低（暴露60分钟减少<4个对数级），对对照菌株的活性略高（暴露60分钟减少4至6个对数级）。0.07%的过氧乙酸对耐药菌的活性低至中等（暴露60分钟减少0.6至6个对数级），对对照菌株的活性中等至高（暴露10分钟减少4至6个对数级）。含有0.07%过氧乙酸和1%过氧化氢混合物的Cidex PA对所有菌株均具有高活性（暴露10分钟减少6个对数级）。标准参考溶液0.8%苯酚的效力与过氧化物化合物的效力不相关。
过氧化氢和过氧乙酸作为协同混合物组合时，对分枝杆菌的活性比单独评估时高得多。
