Re-evaluation of current A0 value recommendations for thermal disinfection of reusable human waste containers based on new experimental data

Diab-Elschahawi, Magda; Fürnkranz, Ursula; Alexander, Bryce; Bachhofner, Nicole; Koller, Walter

doi:10.1016/j.jhin.2010.01.020

Cited by 17 publications

(8 citation statements)

References 10 publications

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“…29 Similar results have been reported by others, such as with Enterococcus and Enterobacteriaceae. 30,31 The inactivation of methicillin-resistant S. aureus (MRSA) clinical isolates confirms the work of Rutala et al 32 and suggests that heat disinfection is an effective means of limiting the spread of these organisms when reprocessing heat-stable surgical instruments and equipment. Heat resistance testing was also performed with a mixed culture biofilm of S. aureus, E. coli, and C. albicans.…”

Section: Resultssupporting

confidence: 53%

Moist Heat Disinfection and Revisiting the A ₀ Concept

McCormick¹,

Schoene²,

Dehmler³

et al. 2016

Biomedical Instrumentation & Technology

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Moist heat is employed in the medical device, pharmaceutical, and food processing industries to render products and goods safe for use and human consumption. Applications include its use to pasteurize a broad range of foods and beverages, the control of microbial contamination of blood products, and treatment of bone tissue transplants and vaccines. In the pharmaceutical industry, water heated to 65°C to 80°C is used to sanitize high-purity water systems. In healthcare, it has been employed for decades to disinfect patient care items ranging from bedpans to anesthesia equipment. There is a good understanding of the conditions necessary to achieve disinfection of microorganisms at temperatures ranging from 65°C to 100°C. Based on this information, the efficacy of moist heat processes at a range of exposure times and temperatures can be quantified based on mathematical models such as the A0 calculation. While the A0 concept is recognized within the European healthcare community, it has yet to be widely adopted within the United States. This article provides information regarding the A0 concept, a brief overview of the classification of thermal disinfection for use with healthcare applications within the United States, and recent data on reinvestigating the thermal disinfection of a selected panel of microorganisms and a mixed culture biofilm.

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Section: Resultssupporting

confidence: 53%

Moist Heat Disinfection and Revisiting the A ₀ Concept

McCormick¹,

Schoene²,

Dehmler³

et al. 2016

Biomedical Instrumentation & Technology

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“…In the presence of soiling, there was no reduction in viable spores (5Á05 log 10 CFU per ml), suggesting a protective effect against moist-heat. The mechanism of this protection is not well understood but could be associated with thermal insulation of spores by the presence of additional proteins (Diab-Elschahawi et al 2010). The 20-min exposure time was longer than the thermal disinfection stage of a typical healthcare wash cycle (>3 min + ≥ 8 min mixing time), suggesting that sporicidal and/ or surfactant effects of laundry chemistry contribute to the removal and inactivation of C. difficile spores from textiles during healthcare laundering (Tarrant et al 2018).…”

Section: Resultsmentioning

confidence: 99%

“…The presence of soiling (organic matter such as faeces and bodily fluids) may also affect the resistance of spores during laundering, by preventing contact with chemicals and reducing the effects of high temperatures. Artificial soiling significantly reduced the effectiveness of moist heat on Bacillus subtilis spores, which survived for significantly longer time periods in the presence of soiling at 94-99°C (Diab-Elschahawi et al 2010), and reduced the efficacy of chlorine dioxide, triamine and peracetic acid-based disinfectants against C. difficile spores during 60 min of exposure (<3 log 10 reduction) compared to clean conditions (3 to >4 log 10 reduction; Edwards et al 2016). The effect of soiling on the survival of C. difficile spores during laundering may contribute to thermotolerance, but does not appear to have been reported in the published literature.…”

Section: Introductionmentioning

confidence: 97%

Survival of Clostridioides difficile spores in thermal and chemo-thermal laundering processes and influence of the exosporium on their adherence to cotton bed sheets

Tarrant

Owen

Jenkins

et al. 2022

Letters in Applied Microbiology

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Clostridioides difficile spores were previously demonstrated to survive industrial laundering. Understanding interactions between heat, disinfectants and soiling (e.g. bodily fluids) affecting C. difficile spore survival could inform the optimization of healthcare laundry processes. Reducing spore attachment to linen could also enhance laundering efficacy. This study aimed to compare the sensitivity of C. difficile spores to heat and detergent, with and without soiling and to investigate adherence to cotton. Survival of C. difficile spores exposed to industrial laundering temperatures (71–90°C), reference detergent and industrial detergent was quantified with and without soiling. The adherence to cotton after 0 and 24 h air drying was determined with the exosporium of C. difficile spores partially or fully removed. Clostridioides difficile spores were stable at 71°C for 20 min (≤0·37 log10 reduction) while 90°C was sporicidal (3 log10 reduction); soiling exerted a protective effect. Industrial detergent was more effective at 71°C compared to 25°C (2·81 vs 0·84 log10 reductions), however, specifications for sporicidal activity (>3 log10 reduction) were not met. Clostridioides difficile spores increasingly adhered to cotton over time, with 49% adherence after 24 h. Removal of the exosporium increased adherence by 19–23% compared to untreated spores. Further understanding of the role of the exosporium in attachment to cotton could enhance spore removal and aid decontamination of linen.

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“…were significantly ( P ≤ 0·05) more resistant to thermal disinfection on cotton in the presence of artificial soil than without soiling, with a more pronounced resistance occurring after drying in soiling for 24 h (Diab‐Elschahawi et al . 2010). In the presence of interfering substances, the antimicrobial activity of 1% silver additive alone was significantly ( P ≤ 0·05) reduced against all test species (Table 3) and at a dose of 2% the antimicrobial activity was significantly ( P ≤ 0·05) reduced against E. coli type and clinical isolates (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Development of a silver-based dual-function antimicrobial laundry additive and textile coating for the decontamination of healthcare laundry

Owen

Laird

2021

Journal of Applied Microbiology

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Aims: To repurpose a silver-based antimicrobial textile coating product (Micro-Fresh 1911) as a dual-function antimicrobial laundry additive and textile coating. Methods and Results: Survival of Escherichia coli or Staphylococcus aureus type and clinical isolates in a domestic 40°C wash was assessed with and without soiling and biological detergent. Washing with 2% w/v silver additive (wash phase) reduced E. coli and S. aureus by 7Á14-8Á08 log 10 and no crosscontamination was observed. Under dirty conditions, 0Á5% silver additive in the rinse phase of a wash with biological detergent reduced E. coli and S. aureus by 7Á98-8Á40 log 10 (0Á00-1Á42 log 10 cross contamination). BS EN ISO 20645:2004 and BS EN ISO 20743:2013 methods were used to assess the antimicrobial activity of polycotton washed with 2% w/v silver additive against S. aureus and E. coli. The treated polycotton was antimicrobial against E. coli and S. aureus type and clinical isolates and remains active after at least one further wash cycle at 40 or 73°C. Conclusions: The silver additive exhibits antimicrobial activity in a 40°C domestic wash, preventing cross contamination onto clean textiles and depositing an antimicrobial coating onto polycotton. Significance and Impact of the Study: The survival of microorganisms on healthcare uniforms during domestic laundering presents a potential risk of contaminating the home, cross-contamination of other clothing within the wash and transmitting potential pathogens back into healthcare settings via contaminated uniforms. Silver may be useful as an antimicrobial laundry additive to decontaminate healthcare laundry washed at low temperatures in domestic and industrial settings, to therefore reduce the potential risk of transmitting microorganisms within the domestic and clinical environments.

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Re-evaluation of current A0 value recommendations for thermal disinfection of reusable human waste containers based on new experimental data

Cited by 17 publications

References 10 publications

Moist Heat Disinfection and Revisiting the A ₀ Concept

Moist Heat Disinfection and Revisiting the A ₀ Concept

Survival of Clostridioides difficile spores in thermal and chemo-thermal laundering processes and influence of the exosporium on their adherence to cotton bed sheets

Development of a silver-based dual-function antimicrobial laundry additive and textile coating for the decontamination of healthcare laundry

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Re-evaluation of current A0 value recommendations for thermal disinfection of reusable human waste containers based on new experimental data

Cited by 17 publications

References 10 publications

Moist Heat Disinfection and Revisiting the A 0 Concept

Moist Heat Disinfection and Revisiting the A 0 Concept

Survival of Clostridioides difficile spores in thermal and chemo-thermal laundering processes and influence of the exosporium on their adherence to cotton bed sheets

Development of a silver-based dual-function antimicrobial laundry additive and textile coating for the decontamination of healthcare laundry

Contact Info

Product

Resources

About

Moist Heat Disinfection and Revisiting the A ₀ Concept

Moist Heat Disinfection and Revisiting the A ₀ Concept