León Clara Inés, Pardo Yenny Patricia, Ramírez Claudia Ximena
Laboratorio de Micobacterias, Subdirección de Investigación y Desarrollo, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
Biomedica. 2002 Jun;22(2):133-40.
The incidence of disease and nosocomial infections produced by non tuberculosis mycobacteria (NTM) has increased in immunocompetent patients, but also and more frequently, in immunosuppressed patients. Several studies have disclosed that mycobacteria are more resistant to biocides than non-sporulating bacteria; in addition, some species are particularly resistant. The biocide action of sodium hypochloride and glutaraldehyde on Mycobacterium aviumintracellulare, Mycobacterium gordonae, Mycobacterium fortuitum and Mycobacterium chelonae was studied, using a modified Kelsey Maurer test. For the different species, both the minimal inhibitory concentration (MIC) and the minimal action time were determined. Effectiveness of sodium hypochloride and glutaraldehyde against the different mycobacterial species varied. The same was true for different isolates of the same species. Sodium hypochloride effective MIC and exposure time (killing of 99.99% of all NTM) were 0.2% and 5 minutes, respectively. In order to achieve 100% killing, 0.5% MIC and 15 minute exposure were needed. In the case of glutaraldehyde, 99.99% of the bacteria were killed with 1% MIC and a 15 minute exposure. An effectiveness of 100% was achieved with a 2% MIC of glutaraldehyde and a 15 minute exposure. Sodium hypochloride and glutaraldehyde are effective biocides for mycobacteria. The first biocide is cheap and effective at low concentrations, but its corrosive and oxidant nature makes it impossible for use in hospitals or with laboratory equipment. Glutaraldehyde (neither corrosive nor oxidant) is a safe alternative for disinfection of this type of equipment. However, it is important to bear in mind that these pathogens may develop resistance to biocides.
非结核分枝杆菌(NTM)引起的疾病和医院感染的发生率在免疫功能正常的患者中有所增加,但在免疫抑制患者中更为常见。多项研究表明,分枝杆菌比非芽孢形成细菌对杀菌剂更具抗性;此外,某些菌种具有特别强的抗性。使用改良的凯尔西 - 莫勒试验,研究了次氯酸钠和戊二醛对鸟分枝杆菌、戈登分枝杆菌、偶然分枝杆菌和龟分枝杆菌的杀菌作用。针对不同菌种,测定了最低抑菌浓度(MIC)和最短作用时间。次氯酸钠和戊二醛对不同分枝杆菌菌种的有效性各不相同。同一菌种的不同分离株也是如此。次氯酸钠的有效MIC和暴露时间(杀灭所有NTM的99.99%)分别为0.2%和5分钟。为了实现100%杀灭,需要0.5%的MIC和15分钟的暴露时间。对于戊二醛,1%的MIC和15分钟的暴露可杀灭99.99%的细菌。2%的戊二醛MIC和15分钟的暴露可实现100%的有效性。次氯酸钠和戊二醛是有效的分枝杆菌杀菌剂。第一种杀菌剂价格便宜且在低浓度下有效,但其腐蚀性和氧化性使其无法用于医院或实验室设备。戊二醛(既无腐蚀性也无氧化性)是这类设备消毒的安全替代品。然而,必须牢记这些病原体可能会对杀菌剂产生抗性。