Objective
Activated alkaline glutaraldehyde remains one of the most widely used
high-level disinfectant across the world. Yet, several reports have
highlighted the potential for nontuberculous mycobacteria to develop
high-level resistance to this product. Because aldehyde resistance may lead
to cross-resistance to other biocides, we set out to investigate the
susceptibility profile of glutaraldehyde-resistant Mycobacterium
chelonae and Mycobacterium abscessus isolates
to various disinfectant chemistries.
Methods
High-level disinfectants commonly used in the reprocessing of
endoscopes and other heat-sensitive, semicritical medical equipment,
including different formulations of aldehyde-based products and oxidizing
agents, were tested against ten slow- and fast-growing,
glutaraldehyde-susceptible and glutaraldehyde-resistant,
Mycobacterium isolates in suspension and carrier tests
at different temperatures.
Results
While peracetic acid- and hydrogen peroxide-based disinfectants
(S40™, Resert™ XL, Reliance™ DG) efficiently killed
all of the Mycobacterium isolates, glutaraldehyde- and
ortho-phthalaldehyde-based products (Cidex®,
Aldahol®, Cidex® OPA) showed variable efficacy against
glutaraldehyde-resistant strains despite the ability of some formulations
(Aldahol®) to overcome the resistance of some of these isolates,
especially when the temperature was increased from 20 to 25°C.
Conclusions
Application permitting, oxidizing chemistries may provide a safe
alternative to aldehyde-based products, particularly in the case of
GTA-resistant mycobacterial outbreaks.