Disinfection of heat-sensitive material by low-temperature steam and formaldehyde

Alder, V. G.; Brown, Anne M.; Gillespie, W. A.

doi:10.1136/jcp.19.1.83

Cited by 46 publications

(13 citation statements)

References 3 publications

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“…A wide variety of instruments can be processed without damage (Alder et al, 1966;Gibson and Johnston, 1967;Alder et al, 1971). They can be processed and used in a rapid turnover, as the apparatus required can be sited locally and as toxic residues are unlikely to constitute a serious problem with ordinary metal instruments.…”

Section: Discussionmentioning

confidence: 99%

“…It is important, therefore, that a method should be introduced which can be used to process all normal endoscopes. A modified method of moist heat sterilisation using lowtemperature steam or low-temperature steam and formaldehyde was first advocated for use in hospital 269 by Alder and Gillespie in 1961 and was soon applied to a wide variety of instruments and apparatus (Alder et al, 1966;Gibson and Johnston, 1967). Recently the standard working temperature of the process has been reduced from 80°C to 73°C and this has been carried further by Weymes (1975) to 65°C and below.…”

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confidence: 99%

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Processing urinary endoscopes in a low-temperature steam and formaldehyde autoclave.

Gibson¹

1977

J Clin Pathol

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Ideally they always should be used in a sterile condition but it may be argued reasonably that it is sufficient that they should have undergone a process of disinfection, rendering them safe and free from organisms likely to be harmful in the urinary tract. They should be readily available for rapid turnover, and any disinfection process adopted should be available locally at the point of use so that instruments are not removed, transported, and delayed, requiring large numbers of duplicate instruments to provide a service. If necessary, the endoscope ought to be available in sterile or disinfected condition in a package suitable for storage. Mitchell and Alder (1975), reviewing these criteria together with the obvious requirement that the method of processing should not damage the instrument or cause deterioration of the optical system, considered three possible methods of disinfection-immersion in chemical fluids, exposure to a disinfecting vapour, and exposure to a moist heat process at less than 100°C.The first of these must always be suspect because actual contact between the fluid and the organisms cannot be guaranteed throughout the instrument.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Processing urinary endoscopes in a low-temperature steam and formaldehyde autoclave.

Gibson¹

1977

J Clin Pathol

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“…In addition, cystoscopes and other endoscopic instruments are delicate items of equipment, since the lens mountings are liable to damage when heated to 100°C or higher, so that something less than a full sterilizing heat process may need to be accepted. Pasteurization in water (Francis, 1959) or in steam at subatmospheric pressure (Alder, Brown, and Gillespie, 1966) have been used as well as various methods of chemical disinfection, including alcoholic chlorhexidine (Miller, Gillespie, Linton, Slade, and Mitchell, 1960), and buffered glutaraldehyde (Borick, Dondershine, and Chandler, 1964;Rubbo and Gardner, 1965;O'Brien, Mitchell, Haberman, Rowan, Winford, and Pellet, 1966;Ross, 1966). In the present study, aqueous Resiguard (at 1 25%) proved effective in eliminating Pseudomonas aeruginosa from a grossly contaminated cystoscope, no organisms being recovered after exposure to the disinfectant for 30 minutes, while immersion of this type of instrument for up to three weeks in Resiguard had no apparent effect on the lens cement and no corrosive action on the metal of the instrument.…”

Section: Discussionmentioning

confidence: 99%

Observations on a new disinfectant

Gordon

1969

J Clin Pathol

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SYNOPSIS A disinfectant formula (Resiguard) containing picloxydine digluconate, benzalkonium chloride, and a detergent was examined for antibacterial activity.Studies in vitro with simulated organic contamination were followed by realistic in-use tests employing items of anaesthetic and urological equipment heavily infected with Pseudomonas aeruginosa and contaminated with blood. These showed that a dilution of 1/80 was reliably bactericidal to this resistant organism.It is concluded that Resiguard is a valuable disinfectant which may reliably be employed in the cleaning and disinfection of items of delicate, non-autoclavable, hospital equipment.Hospital-acquired infections present a continuing challenge to clinical and laboratory personnel. There is evidence that the patterns of such infections have been undergoing important changes within recent years, infections by the Gram-negative organisms having become more frequent (Finland, Jones, and Barnes, 1959;William, Williams, and Hyams, 1960;Barber, 1961;Selwyn, MacCabe, and Gould, 1964; Williams, Blowers, Garrod, and Shooter, 1966). This is especially relevant to Pseudomonas aeruginosa, a notoriously 'opportunistic' pathogen for debilitated patients in hospital, which possesses a high intrinsic resistance to many currently available antibiotics, and to the majority of traditional hospital disinfectants. Furthermore, recent developments in medical technology have been associated with the introduction of highly intricate equipment many components of which, being non-autoclavable, must be cleaned and disinfected by chemical methods.Despite the magnitude of these problems, it is apparent that chemical disinfection is a somewhat neglected subject. Previous authoritative reports (Public Health Laboratory Service Committee, 1965; Kelsey and Maurer, 1967) active principles. These are picloxydine digluconate, a broad-spectrum antibacterial compound possessing a biguanide structure: octylphenoxy-polyethoxyethanol, a nonionic detergent: and the quaternary ammonium compound, benzalkonium chloride. (Lowbury, 1951;Burdon and Whitby, 1967; Brit. med. J., 1967) that bacteria, especially pseudomonas, may proliferate in solutions of some disinfectants, preliminary experiments in vitro were undertaken to establish whether resistant Gram-negative bacilli would survive and multiply in dilutions of Resiguard stored over prolonged periods. The organisms chosen were Pseudomonas aeruginosa NCTC 6749 and Klebsiella aerogenes NCTC 8172, and the method employed was similar to that of Burdon and Whitby (1967). METHODS INVESTIGATIONS IN VITRO In view of previous reportsDuplicate doubling dilutions of a stock concentrate of the disinfectant were made, in 10 ml aliquots, with distilled water in laboratory glassware, and these were inoculated with a straight wire from single colonies of the two strains grown overnight on nutrient agar at 37°C. Dilutions ranging from 1/10 to 1/2,560 were tested. At intervals of 48 hours, 0-2 ml amounts of each disinfectant dilution were subcultured to 5 ...

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“…Bruch and Bruch'j7 quote levels of between 2 and 10 mgfliter; Dar10w~~ used 18 mgfliter for room sterilization. Alder et al 73 used 150 mgfliter for sterilizing hospital 1370 BAKER equipment and, for deep penetration, exposure was 2 hr at 80°C or 1.5 hr at 90°C. Gibson and J o h n~t o n '~ used a still higher level of formaldehyde, 250 mgfliter, for 2 hr at 80°C, and reported complete sterilization even of narrow tubes.…”

Section: A Fermentor Sterilizationmentioning

confidence: 99%