A review of wipes used to disinfect hard surfaces in health care facilities

Boyce, John M.

doi:10.1016/j.ajic.2020.06.183

Cited by 23 publications

(21 citation statements)

References 132 publications

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“…Chlorine-based disinfectants have been reported to show e cacy against C. di cile spores due to their oxidation activity while QACs and alcohols are ineffective against HuNoV and bacterial spores in several studies (8,17,30). Of the products studied in this analysis, only product D, a H In agreement with a previous study (17), TuV was more resistant to acids than FCV likely due to differences in their viral capsid structures (44).…”

Section: Discussionsupporting

confidence: 86%

“…Disinfectants are an essential tool for e cient environmental cleaning and several hundred disinfectants with an array of active ingredients and formulations are commercially available. The most common active ingredients include chlorine, quaternary ammonium chemicals (QACs), alcohols, and peroxides (8), with each having limitations. For example, chlorine-based disinfectants are highly e cacious against bacteria and viruses but because they are strong oxidizers, they can damage surfaces when used at high concentrations or after prolonged use (9,10).…”

Section: Introductionmentioning

confidence: 99%

“…For example, chlorine-based disinfectants are highly e cacious against bacteria and viruses but because they are strong oxidizers, they can damage surfaces when used at high concentrations or after prolonged use (9,10). QACs and alcohols are less likely to damage surfaces but have weak activity against non-enveloped viruses [e.g., human norovirus (HuNoV)] and bacterial spores (e.g., Clostridioides di cile) (8). Peroxides, including accelerated hydrogen peroxide (H 2 O 2 ), can denature viral proteins, but e cacy data from published studies are limited (8).…”

Section: Introductionmentioning

confidence: 99%

“…QACs and alcohols are less likely to damage surfaces but have weak activity against non-enveloped viruses [e.g., human norovirus (HuNoV)] and bacterial spores (e.g., Clostridioides di cile) (8). Peroxides, including accelerated hydrogen peroxide (H 2 O 2 ), can denature viral proteins, but e cacy data from published studies are limited (8).…”

Section: Introductionmentioning

confidence: 99%

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WITHDRAWN: Efficacy of commercially available disinfectants against human norovirus surrogates and Clostridioides difficile endospores

Huang

Park²,

Jones

et al. 2021

Preprint

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Background Routine disinfection of environmental surfaces is essential to control the spread of pathogens that cause healthcare-associated infections. The aim of this study was to determine the efficacy of a panel of disinfectants against two human norovirus surrogates [feline calicivirus (FCV) and Tulane virus (TuV)] and Clostridioides difficile endospores. Methods Nine products on EPA’s List G were selected using four criteria: 1) ready-to-use, 2) nonchlorine-based active ingredient, 3) commercially available, and 4) limited known health risks. Active ingredients of the products included hydrogen peroxide (H2O2), peracetic acid, quaternary ammonium compounds, or alcohols. The efficacy of the products against FCV, TuV and C. difficile spores was tested using the ASTM suspension test and on stainless steel coupons for 1, 5 and 10 min (FCV, TuV) and 10 min (C. difficile spores). Results On stainless steel carriers, seven of the nine products reduced FCV > 5.1 log after 5 min of contact time and eight products after 10 min. One product reduced TuV > 3.1 log after 5 min while 8 products could not achieve this level of reduction even after 10 min. Only one product achieved > 6.0 log reduction of C. difficile spores after 10 min while other 8 products could not achieve this acceptable efficacy. The two most efficacious products contained H2O2 as active ingredient and resulted in > 5.1 log reduction of FCV and ≥ 2.4 log reduction of TuV after 5 min contact time on stainless steel carriers. However, among the five products containing H2O2, no strong correlation (R2 = 0.25, p = 0.03) between log reduction and H2O2 concentration was detected using the ASTM suspension test, suggesting product formulation, not active ingredient concentration, impacts efficacy. Conclusion A panel of nine EPA-approved disinfectants was tested against two HuNoV surrogates (FCV and TuV) and C. difficile endospores. The most efficacious products contained hydrogen peroxide as active ingredient. TuV was confirmed to be the more conservative surrogate for HuNoV than FCV. No strong correlation between log reduction and hydrogen peroxide concentration was detected, suggesting that product formulation has a significant impact on the efficacy of a product.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

WITHDRAWN: Efficacy of commercially available disinfectants against human norovirus surrogates and Clostridioides difficile endospores

Huang

Park²,

Jones

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…As a result, hundreds of disinfectants with an array of active ingredients and formulations are commercially available. The most common active ingredients used are chlorine, quaternary ammonium chemicals (QACs), alcohols and peroxides (Boyce, 2021), with each having limitations. For example, chlorine‐based disinfectants are highly efficacious against bacteria and viruses because they are strong oxidizers, but they can damage surfaces when used at high concentrations or after prolonged use (Luijkx et al, 2004; Tyan et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of EPA-registered disinfectants against two human norovirus surrogates and Clostridioides difficile endospores

Huang

Park

Jones

et al. 2022

Journal of Applied Microbiology

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Aims To determine the efficacy of a panel of nine EPA‐registered disinfectants against two human norovirus (HuNoV) surrogates (feline calicivirus [FCV] and Tulane virus [TuV]) and Clostridioides difficile endospores. Methods and Results Nine EPA‐registered products, five of which contained H2O2 as active ingredient, were tested against infectious FCV, TuV and C. difficile endospores using two ASTM methods, a suspension and carrier test. Efficacy claims against FCV were confirmed for 8 of 9 products. The most efficacious product containing H2O2 as ingredient achieved a >5.1 log reduction of FCV and >3.1 log reduction of TuV after 5 min, and >6.0 log reduction of C. difficile endospores after 10 min. Of the five products containing H2O2, no strong correlation (R2 = 0.25, p = 0.03) was observed between disinfection efficacy and H2O2 concentration. Addition of 0.025% ferrous sulphate to 1% H2O2 solution improved efficacy against FCV, TuV and C. difficile. Conclusion Disinfectants containing H2O2 are the most efficacious disinfection products against FCV, TuV and C. difficile endospores. Product formulation, rather than the concentration of H2O2 in a product, impacts the efficacy of a disinfection product. Significance and Impact of Study H2O2‐based disinfectants are efficacious against surrogate viruses for HuNoV and C. difficile endospores.

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An Enhanced Strategy for Daily Disinfection in Acute Care Hospital Rooms

et al. 2022

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ImportanceEnvironmental contamination is a source of transmission between patients, health care practitioners, and other stakeholders in the acute care setting.ObjectiveTo compare the efficacy of an enhanced daily disinfection strategy vs standard disinfection in acute care hospital rooms.Design, Setting, and ParticipantsThis randomized clinical trial (RCT) was conducted in acute care hospital rooms at Duke University Hospital in Durham, North Carolina, from November 2021 to March 2022. Rooms were occupied by patients with contact precautions. Room surfaces (bed rails, overbed table, and in-room sink) were divided into 2 sides (right vs left), allowing each room to serve as its own control. Each side was randomized 1:1 to the intervention group or control group.InterventionsThe intervention was a quaternary ammonium, salt-based, 24-hour continuously active germicidal wipe. It was applied in addition to routine disinfection for the intervention group. The control group received no intervention beyond routine disinfection.Main Outcomes and MeasuresThe primary outcome was the total contamination, measured in colony-forming units (CFUs) on the bed rails, overbed table, and sink on study day 1. The secondary outcomes were the proportion of sample areas with positive test results for clinically important pathogens, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and carbapenem-resistant Enterobacteriaceae; the similarity in baseline contamination between sample area sides on study day 0 before application of the intervention, and the proportion of sample areas with removed UV luminescent gel on study day 1.ResultsA total of 50 study rooms occupied by 50 unique patients (median [IQR] age, 61 [45-69] years; 26 men [52%]) with contact precautions were enrolled. Of these patients, 41 (82%) were actively receiving antibiotics, 39 (78%) were bedridden, and 28 (56%) had active infections with study-defined clinically important pathogens. On study day 1, the median (IQR) total CFUs for the intervention group was lower than that for the control group (3561 [1292-7602] CFUs vs 5219 [1540-12 364] CFUs; P = .002). On study day 1, the intervention side was less frequently contaminated with patient-associated clinically important pathogens compared with the control side of the room (4 [14%] vs 11 [39%]; P = .04).Conclusions and RelevanceResults of this RCT demonstrated that a quaternary ammonium, salt-based, 24-hour continuously active germicidal wipe decreased the environmental bioburden in acute care hospital rooms compared with routine disinfection. The findings warrant large-scale RCTs to determine whether enhanced daily disinfection strategies can decrease patient acquisition and adverse patient outcomes.Trial RegistrationClinicalTrials.gov Identifier: NCT05560321

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A review of wipes used to disinfect hard surfaces in health care facilities

Cited by 23 publications

References 132 publications

WITHDRAWN: Efficacy of commercially available disinfectants against human norovirus surrogates and Clostridioides difficile endospores

WITHDRAWN: Efficacy of commercially available disinfectants against human norovirus surrogates and Clostridioides difficile endospores

Efficacy of EPA-registered disinfectants against two human norovirus surrogates and Clostridioides difficile endospores

An Enhanced Strategy for Daily Disinfection in Acute Care Hospital Rooms

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