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      Evaluation of the virucidal efficacy of disinfectant wipes with a test method simulating practical conditions

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          Abstract

          Background

          The use of disinfectant wipes in hospitals is increasing over the last years. These wipes should be able to inactivate microorganisms including viruses on environmental surfaces and to prevent their transfer to clean areas.

          The European norm (EN) 16615:2015 describes a wiping process over four fields starting on the contaminated field 1 followed by fields 2–4 and back to the starting point (4-field test). This test method exclusively describes killing and transfer of vegetative bacteria and fungi by disinfectant wipes without measuring virucidal activities. Therefore, it was the aim of this study to use the existing test methodology additionally to evaluate virus inactivation by wipes.

          Methods

          The 4-field test was performed with four commercially available disinfectant wipes including the examination of the active solutions of these wipes with a reference wipe. Murine norovirus (MNV) as surrogate of human noroviruses, adenovirus (AdV) type 5 and polyomavirus SV40 (SV40) were chosen as test viruses.

          Results

          The per acetic acid (PAA)-based wipe (wipe A) was able to inactivate all three test viruses resulting in a four log 10 reduction on test field 1, whereas the quaternary ammonium compound (QAC)-based products (wipes B and C) failed to reach such reduction. Both QAC-based wipes were able to inactivate SV40 and only the active solution of wipe B was effective against MNV. Another wipe with 2-propanol as active ingredient (wipe D) was not able to show a sufficient efficacy against all three test viruses. There was a good agreement between the results of the wipes and the corresponding fluids showing no influence of the material of wipes.

          Tests with the 2-propanol-based wipe D showed a transfer of all test viruses to the non-contaminated test fields 2–4. SV40 was additionally transferred by the QAC-based wipe C with 0.78% active ingredients to these additional fields. In all other cases no virus transfer to test fields 2–4 was observed. Finally, no virus could be detected in the PAA-based wipe A after usage in the 4-field test in contrast to the other wipes examined.

          Conclusions

          The successful performance of a 4-field test with viruses demonstrated that the existing wiping method with bacteria and fungi can be used in addition for measuring virucidal efficacy. The virus-inactivating properties of surface disinfectants could be evaluated therefore with a test simulating practical conditions with mechanical action resulting in more reliable data than the existing quantitative suspension tests and/or a carrier test without any mechanical action.

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          Most cited references16

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          Beitrag zur kollektiven Behandlung pharmakologischer Reihenversuche

          G. Kärber (1931)
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            Role of hospital surfaces in the transmission of emerging health care-associated pathogens: norovirus, Clostridium difficile, and Acinetobacter species.

            Health care-associated infections (HAI) remain a major cause of patient morbidity and mortality. Although the main source of nosocomial pathogens is likely the patient's endogenous flora, an estimated 20% to 40% of HAI have been attributed to cross infection via the hands of health care personnel, who have become contaminated from direct contact with the patient or indirectly by touching contaminated environmental surfaces. Multiple studies strongly suggest that environmental contamination plays an important role in the transmission of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus spp. More recently, evidence suggests that environmental contamination also plays a role in the nosocomial transmission of norovirus, Clostridium difficile, and Acinetobacter spp. All 3 pathogens survive for prolonged periods of time in the environment, and infections have been associated with frequent surface contamination in hospital rooms and health care worker hands. In some cases, the extent of patient-to-patient transmission has been found to be directly proportional to the level of environmental contamination. Improved cleaning/disinfection of environmental surfaces and hand hygiene have been shown to reduce the spread of all of these pathogens. Importantly, norovirus and C difficile are relatively resistant to the most common surface disinfectants and waterless alcohol-based antiseptics. Current hand hygiene guidelines and recommendations for surface cleaning/disinfection should be followed in managing outbreaks because of these emerging pathogens. (c) 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
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              The role played by contaminated surfaces in the transmission of nosocomial pathogens.

              Studies in the 1970s and 1980s suggested that environmental surface contamination played a negligible role in the endemic transmission of healthcare-associated infections. However, recent studies have demonstrated that several major nosocomial pathogens are shed by patients and contaminate hospital surfaces at concentrations sufficient for transmission, survive for extended periods, persist despite attempts to disinfect or remove them, and can be transferred to the hands of healthcare workers. Evidence is accumulating that contaminated surfaces make an important contribution to the epidemic and endemic transmission of Clostridium difficile, vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, Pseudomonas aeruginosa, and norovirus and that improved environmental decontamination contributes to the control of outbreaks. Efforts to improve environmental hygiene should include enhancing the efficacy of cleaning and disinfection and reducing the shedding of pathogens. Further high-quality studies are needed to clarify the role played by surfaces in nosocomial transmission and to determine the effectiveness of different interventions in reducing associated infection rates.
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                Author and article information

                Contributors
                britta.becker@brillhygiene.com
                lars.henningsen@brillhygiene.com
                dajana.paulmann@brillhygiene.com
                birte.bischoff@brillhygiene.com
                daniel.todt@rub.de
                eike.steinmann@rub.de
                joerg.steinmann@klinikum-nuernberg.de
                florian.brill@brillhygiene.com
                +49 421 27819102 , jochen.steinmann@brillhygiene.com
                Journal
                Antimicrob Resist Infect Control
                Antimicrob Resist Infect Control
                Antimicrobial Resistance and Infection Control
                BioMed Central (London )
                2047-2994
                16 July 2019
                16 July 2019
                2019
                : 8
                : 121
                Affiliations
                [1 ]Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Norderoog 2, 28259 Bremen, Germany
                [2 ]ISNI 0000 0004 0490 981X, GRID grid.5570.7, Faculty of Medicine, Department for Molecular and Medical Virology, , Ruhr University Bochum, ; Bochum, Germany
                [3 ]Institute of Hospital Hygiene, Medical Microbiology and Clinical Infectiology, Paracelsus Medical University, Nuremberg, Germany
                Author information
                http://orcid.org/0000-0002-3564-1014
                Article
                569
                10.1186/s13756-019-0569-4
                6636036
                31346462
                56cd35bb-b1bd-469b-9f50-f00ab9514aa0
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 January 2019
                : 4 July 2019
                Funding
                Funded by: Deutsche Gesellschaft für Krankenhaushygiene
                Award ID: Not appplicable
                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                Infectious disease & Microbiology
                virucidal efficacy,wipes,4-field test,virus transfer,surfaces
                Infectious disease & Microbiology
                virucidal efficacy, wipes, 4-field test, virus transfer, surfaces

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