       Document 0418
 DOCN  M9610418
 TI    Mycobactericidal testing of disinfectants: an update.
 DT    9601
 AU    Sattar SA; Best M; Springthorpe VS; Sanani G; Faculty of Medicine,
       University of Ottawa, Ontario, Canada.
 SO    J Hosp Infect. 1995 Jun;30 Suppl:372-82. Unique Identifier : AIDSLINE
       MED/96035367
 AB    Tuberculosis, a major killer in developing countries, is on the rise
       again in industrialized nations. AIDS, increased use of
       immunosuppression and the emergence of multiple drug-resistant
       Mycobacterium tuberculosis (MDR-TB) have further enhanced its
       significance. TB is projected to cause 3.5 million deaths per year by
       2000. Also, other types of mycobacteria are being incriminated in human
       infections with increasing frequency. Thus, the enhanced risk of
       nosocomial and iatrogenic spread of mycobacteria is forcing a review of
       infection control in general and claims of mycobactericidal activity of
       disinfectants in particular. Mycobacteria are more resistant to
       disinfection than enveloped viruses and other types of vegetative
       bacteria, but a proper comparison with non-enveloped viruses requires
       more data. Flaws in currently used protocols for mycobacterial activity
       are: (i) a lack of proper quantitation; (ii) unrealistically long
       contact times at higher than ambient temperatures; (iii) absence of a
       suitable organic load; (iv) ineffective neutralizers; (v) unsuitable
       surrogates for M. tuberculosis; (vi) improper recovery media; and (vii)
       inappropriate types of carriers. Furthermore, we have recently found a
       product meant for 14 day reuse to become non-mycobactericidal after only
       a week under actual use in an endoscopy unit. These considerations make
       the available data on product efficacy unreliable, especially in view of
       the increasing threat from MDR-TB. Recent findings suggest that the use
       of Mycobacterium terrae as a surrogate, better recovery media, flat
       surfaces as carriers, elimination of neutralizers, proper removal of
       cell clumps and a required > or = 4 log10 reduction in the number of
       colony forming units of the test bacterium after disinfectant treatment
       should make mycobacteridal tests more precise and reliable, thus making
       product registration and selection easier. There is also an urgent need
       to develop standardized protocols to determine the mycobactericidal
       activity of disinfectants under conditions of reuse.
 DE    Disease Reservoirs  Disinfectants/*PHARMACOLOGY/STANDARDS  Human
       Mycobacterium tuberculosis/DRUG EFFECTS  Mycobacterium Infections,
       Atypical/MICROBIOLOGY/PREVENTION &  CONTROL/*TRANSMISSION
       Mycobacterium, Atypical/DRUG EFFECTS
       Tuberculosis/MICROBIOLOGY/*TRANSMISSION  Tuberculosis,
       Multidrug-Resistant/TRANSMISSION  JOURNAL ARTICLE  REVIEW  REVIEW,
       TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

