Brown L, Marshall A, Conway L, Otter J, Norville P, Clarke J
Fellows Research Centre, Gama Healthcare Ltd, North Dean Business Park, Stainland Rd, Greetland, Halifax, UK.
Fellows Research Centre, Gama Healthcare Ltd, North Dean Business Park, Stainland Rd, Greetland, Halifax, UK.
J Hosp Infect. 2024 Jul;149:22-25. doi: 10.1016/j.jhin.2024.04.010. Epub 2024 May 3.
The role of the healthcare environment in the transmission of clinical pathogens is well established. EN 17126:2018 was developed to address the need for regulated sporicidal product testing and includes a realistic medical soil to enable validation of products that claim combined cleaning and disinfection efficacy.
To investigate the chemical stability and sporicidal efficacy of oxidizing disinfectant products in the presence of simulated clean and medical dirty conditions.
Disinfectant stability and sporicidal efficacy were evaluated in like-for-like ratios of soil:product. Disinfectants were exposed to simulated test soils and free chlorine, chlorine dioxide or peracetic acid concentrations were measured using standard colorimetric methods. Efficacy of disinfectants against C. difficile R027 endospores was assessed as per EN 17126:2018. Comparisons of performance between clean and medical dirty conditions were performed using one-way analysis of variance. Correlation analysis was performed using Pearson product-moment correlation.
Performance of chlorine-releasing agents (sodium dichloroisocyanurate, chlorine dioxide and hypochlorous acid) was concentration dependent, with 1000 ppm chlorine showing reduced stability and efficacy in dirty conditions. By contrast, peracetic acid product demonstrated stability and consistently achieved efficacy in dirty conditions.
These results have implications for clinical practice, as ineffective environmental decontamination may increase the risk of transmission of pathogens that can cause healthcare-associated infections.
医疗环境在临床病原体传播中的作用已得到充分证实。制定EN 17126:2018是为了满足对受监管的杀孢子产品测试的需求，其中包括一种逼真的医用污垢，以便对声称具有清洁和消毒综合功效的产品进行验证。
研究在模拟清洁和医疗脏污条件下氧化消毒剂产品的化学稳定性和杀孢子效果。
按照污垢与产品的相似比例评估消毒剂的稳定性和杀孢子效果。将消毒剂暴露于模拟测试污垢中，使用标准比色法测量游离氯、二氧化氯或过氧乙酸的浓度。根据EN 17126:2018评估消毒剂对艰难梭菌R027芽孢的效果。使用单因素方差分析对清洁和医疗脏污条件下的性能进行比较。使用Pearson积矩相关进行相关性分析。
含氯释放剂（二氯异氰尿酸钠、二氧化氯和次氯酸）的性能取决于浓度，1000 ppm的氯在脏污条件下稳定性和效果降低。相比之下，过氧乙酸产品表现出稳定性，并在脏污条件下始终能达到效果。
这些结果对临床实践具有启示意义，因为无效的环境去污可能会增加可导致医疗相关感染的病原体传播风险。
