Professional Documents
Culture Documents
4,1992 635
DISINFECTANTS
Collaborators: A. Bittle; R. Christensen; T. Czerkowicz; R.S. Dahiya; G. Dennis; A. Diallo; K. landoli; S. Kim; D. Mauriello;
D. O'Connor; P. Olsen; B. Paolella; P. Ploeger; D. Suchmann; V. Vlasaty; E. Wiese; J. Young
A collaborative study was undertaken to evaluate a gested a performance standard of <2 positive carri-
new disinfectant efficacy method called the hard ers out of 60 tested for S. aureus and
surface carrier test. This new method is a qualita- S. choleraesuis, and <3 positive carriers out of 60
tive carrier test that uses disposable glass carriers tested for P. aeruginosa. This standard was derived
and standardized bacterial cultures. Ten labora- from an analysis of the data by calculating an ex-
tories tested 6 disinfectant-type formulations, pected count of positive carriers and a 95% upper
which included positive and negative controls, confidence limit for a set of 60 carriers. The
against 3 microorganisms. No significant differ- method has been adopted first action by AOAC In-
ences were found among the 10 laboratories for ternational.
tests with Pseudomonas aeruginosa and Salmo-
nella choleraesuis, but a small but statistically sig-
nificant difference was present among laboratories n 1953, AOAC adopted the use-dilution method (UDM) to
for Staphylococcus aureus. The majority of data for
this organism showed very good agreement; how-
ever, several tests exhibited slightly higher positive
I confirm germicidal activity of disinfectant dilutions ob-
tained with the phenol coefficient test (1,2). This test has
since been expanded from the original 10 carriers to 60 carriers,
responses, which resulted in this overall differ- and Pseudomonas aeruginosa has joined Staphyloccocus au-
ence. This difference was not considered signifi- reus and Salmonella choleraesuis as a test organism for hospi-
cant within the scope and precision of this method tal disinfectants (2). Today, the U.S. Environmental Protection
or when compared with results for the other 2 or- Agency (EPA) requires that the UDM be used to generate effi-
ganisms. The initial estimates of pure intralabora- cacy data to support disinfectant registration (3).
tory variance, determined from mean squares from The UDM has been criticized for inconsistent results and
analysis of variance results, were 1.009,0.295, and lack of reproducibility. One report stated that the disinfectant
1.553 for P. aeruginosa, S. aureus, and claims for 22% of the hospital disinfectants registered with
S. choleraesuis, respectively. The experimental EPA could not be reproduced (4). In 1985, an 18 laboratory
error for S. aureus was 3-5 times smaller than for collaborative study was conducted under the direction of the
the other 2 organisms, which helps explain the sta- University of North Carolina (UNC) using 6 EPA registered
tistical significance of the results observed with disinfectants. "Extreme variability of the test results among
this organism. Final estimates of intralaboratory laboratories testing identical products" was detected (5). In
variance obtained after dropping nonsignificant 1986, UNC ran another collaborative study incorporating 32
terms from the models were 0.90,0.30, and 0.58 for
P. aeruginosa, S. aureus, and S. choleraesuis, re- Submitted for publication July 10, 1991.
spectively. Small but statistically significant differ- The recommendation was approved by the General Referee, Committee
ences were noted in the formulation means for Statistician, and Committee on Pesticide Formulation and Disinfectants and
was adopted by the Official Methods Board of the Association. See
P. aeruginosa and S. aureus but not for "Changes in Official Method of Analysis" (1992) J. AOAC Int. 75,
S. choleraesuis. The results of this study sug- 223 (1992).
636 RUBINO ET AL.: JOURNAL OF AOAC INTERNATIONAL VOL. 75, No. 4,1992
changes into the method. Again, variability was seen, espe- This analyst was instructed to maintain a separate notebook for
cially with P. aeruginosa and 5. aureus. These studies were run this study in which to keep detailed notes about the test and to
with stainless steel cylinders and without control of the inocu- recordresults.The following 6 disinfectant-type formulations,
lum level. It was decided that the development of a new repro- which included a positive and a negative control, a marginal
ducible method was necessary (6). formulation, and a blind duplicate, were used in the study:
The UDM has several identified deficiencies that may ac- Disinfectant 7.—n-Alkyl (60% C14, 30% C16, 5% C12, 5%
count for test variability (7-9): (7) the inconsistent surfaces of Qg) dimethylbenzylammonium chlorides, 4.50%; /z-alkyl
the stainless steel penicylinders that carry the bacteria into the (68% C12, 32% C14) dimethylethylbenzylammonium chlor-
disinfectant; (2) an inconsistent inoculum level; and (3) a diffi- ides, 4.50%; and inert ingredients, 91.00%. The use-dilution
cult-to-follow, vague, and ambiguous written method. was 1:128.
The surfaces of 4 types of carriers were examined by scan- Disinfectant 2.—Disinfectant cleaner formula without ac-
As with any analysis of a carefully developed and well- Hard Surface Carrier Test Methods
designed research project, the final and best interpretation
can only be made in conjunction with expert(s) in the subject (Applicable to testing disinfectants miscible with H 2 0 to
* matter. The microbiologists and the statisticians carefully determine effectiveness of given bactericidal concentration
worked together to interpret and understand the results. using standard test strains under controlled conditions. Test re-
It seems appropriate to begin with a brief discussion of sults may not necessarily reflect a product's efficacy on a vari-
the nature of the data to clarify the analysis to be reported. ety of inanimate surfaces or within specified environments.
In their simplest form, the data are binomial with an un- These microbiological methods are very sensitive and tech-
known p (fraction of positive carriers), because a single car- nique-oriented. Exact adherence to the method with identified
rier was inoculated and examined for microbial growth. If critical control points, good microbiological techniques, good
growth was observed, the carrier was counted as positive; if laboratory practices, and quality control are required for profi-
no growth was noted, it was counted as negative. Thus, the ciency and for validity of results. It is essential that the glass
Table 991.47. Method performance for 991.47, testing flasks or 20 x 150 mm test tubes. Sterilize 15 min at 121°. Place
disinfectants against Salmonella choleraesuis, in 45° H 2 0 bath until agar is 45°. pH must be 7.3 ± 0.2. Pour in
Staphylococcus aureus, and Pseudomonas aeruginosa, 20 mL portions into 15 x 100 mm sterile Petri dishes (TSA
hard surface carrier test method plates) for spread plate method.
Disinfectant3 (5) Nutrient agar.—To nutrient broth, A(a)(7), before auto-
claving, add 1.5% Bacto agar (Difco, or equivalent), and boil
Organism A B C
until dissolved. Cool; pH must be 7.2 ± 0.2. Place 10 mL por-
S. choleraesuis tions into 20 x 150 mm test tubes, autoclave 15 min at 121°,
and slant.
pb 0.0258 0.0066 0 (6) MacConkey's agar.—Contains 17.0 g pancreatic digest
60 x p 1.55 0.4 0 of gelatin, 1.5 g pancreatic digest of casein, 1.5 g peptic digest
UCL 4 2 0
Pasteur pipets; 150, 200, and 400 or 500 mL beakers. Clean (n) pH meter.—Calibrate daily or as necessary, using 2-
glassware with detergent in hot water, rinse with hot water, and point calibration with commercial buffer solutions (Baxter Sci-
then deionized water. Sterilize clean glassware with dry heat at entific Products, or equivalent). If pH of sample is expected to
170° 1 h for loose glassware, 2 h for glassware in metal con- be in alkaline range, calibrate pH meter with pH 7 and pH 10
tainers, or steam at 121° for 20 min (with dry cycle for loose buffer solutions. If pH of sample is expected to be in acid range,
glassware). Before using this method and when cleaning agents calibrate pH meter with pH 4 and pH 7 buffer solutions.
change, perform APHA test for inhibitory residues on glass- (o) Sterility validation.—Check sterility of pre-sterilized
ware using the test organisms after 3 broth transfers (APHA, articles or apparatus using appropriate media that supports both
Standard Methods for the Examination of Water and Waste bacterial and fungal growth.
Water (1985) 16th Ed., 834-835).
C. Operating Technique
(b) Petri dishes.—15 or 20 x 100 mm glass (Pyrex) or plas-
ers several times against side of tube to remove excess droplets sured. Randomly select one negative tube for each 10 tubes
of culture medium. Remove no more than 5 carriers/wire hook tested, and to each tube add appropriate amount of 18-24 h test
each time from suspension. Repeat 1-5 carrier transfer proce- strain broth culture in diluted PBDW to deliver 5-100
dures until <12 carriers are placed into sterile Petri dish with cells/tube. Confirm number of cells added by pour plate
filter paper. Use this suspension only once to inoculate 24 car- method (inoculate 15 x 100 mm sterile Petri dishes and over-
riers; then discard. Use fresh suspension for next 24 carriers. lay with 15-20 mL trypticase soy agar or use spread plate
With sterile wire hook, tip each carrier to 60°, and rotate carrier technique with glass rod). Prepare in duplicate. Incubate 4 8 -
360° to blot off excess medium at ring base. Move each carrier 54 h at 37°, count colonies on plates to determine inoculum
to dry section of paper and stand upright, avoiding contact be- size (5-100 colonies/plate for valid results), and examine
tween carriers. Gently probe inside of each carrier with sterile tubes for growth. Growth in all tubes indicates effective ger-
dacron swab to remove excess liquid on inside of ring. Use 1 micide neutralization. Absence of growth in >1 tubes indi-
dacron swab/12 carriers; then discard swab. Cover dishes and
carriers with fewer counts invalidates test. If carrier counts are above this range and disinfectant gives >3 positives/60 tested,
above this range and disinfectant gives >2 positives/60 tested, retest to confirm results. Use carriers with counts falling within
retest to confirm results. Use carriers with counts falling within specified range in the retest.
specified range in the retest. Ref.: JAOAC 75, July/August issue (1992)
Ref.: JAOAC 75, July/August issue (1992)
Results and Discussion
991.49 Testing Disinfectants Against
Pseudomonas aeruginosa—Hard Surface Carrier The results from each of the 10 participating laboratories for
Test Method testing 6 formulations against P. aeruginosa, S. aureus, and
S. choleraesuis are shown in Table 1. Laboratory B showed 1
First Action 1991 positive carrier out of 60 tested (+1/60) for Disinfectant 1 and
+18/60 for Disinfectant 6 for P. aeruginosa. This led to a rather
Table 1. Number of positive carriers out of 60 Table 2. Weighted analysis of variance of data
replicates for 10 laboratories testing 6 formulations from Table 1
against 3 microorganisms
Source DF MS p-value
Formulation
P. aeruginosa
Laboratory 1a 6a 2 3 4
Formulation 3 6.319 8.26 0.014
P. aeruginosa
Laboratory 9 1.060 1.05 0.472
Formulation x laboratory 27 0.981 0.97 0.557
3 27
Error 9 1.009 — —
18* 60
0 56 S. aureus
3 44
S. aureus
Formulation 3 3.054 1.97 0.1830
Laboratory 9 0.566 0.36 0.9279
A 1 2 60 3 1 0 Formulation x laboratory 27 0.341 0.22 0.9992
B 1 1 60 0 0 2 — —
Error 10 1.553
C 2 2 60 1 3 0
D 2 3 60 5 3 2
E 3 2 55 1 6 0
F 0 0 60 0 2 0
G 0 2 60 11 1 0 This was not surprising. S. choleraesuis has been shown to be
H 0 1 60 0 0 0 the most sensitive of the 3 organisms to disinfectants (6). The
1 2 0 60 2 2 1 formulations were designed to show different levels of activity.
J 1 0 60 0 2 0 Therefore, one would expect to see these differences among the
more resistant organisms. The differences will be somewhat
S. choleraesuis
obscured with the more sensitive S. choleraesuis.
A 3 1 14 1 0 0 To obtain a better estimate of the relative contribution to the
B 1 1 13 1 2 0 total variance due to formulation, laboratories, and intralabora-
C 4 0 60 0 2 0 tory sources, we reanalyzed the P. aeruginosa and
D 1 0 60 0 1 0 S. choleraesuis data because the laboratory x formulation in-
E 1 7 48 2 2 0 teraction was found to be nonsignificant. The weighted analy-
F 0 1 56 0 1 0 ses of variance summarized in Table 5 show that only negligi-
G 1 0 45 0 3 0 ble differences in terms of significance are evident when
H 2 0 15 0 5 0 compared with results in Table 2 for the same microorganisms.
I 6 0 28 0 0 0 Because the laboratory mean squares are smaller than the cor-
J 1 1 46 0 2 0 responding intralaboratory mean squares in Table 5, variance
a
components cannot be estimated from these analyses, unless
Blind duplicate samples. one assumes the variance due to laboratories is zero for these 2
* A repeat at this laboratory with a new sample of disinfectant 6
produced +0/60. Original value, 18, omitted from statistical organisms. Table 6 contains estimates of variance components
analysis. for P. aeruginosa and S. choleraesuis based on this assumption
and for 5. aureus based on the results in Table 2. These were
computed by hand because we are not aware of any program
within the S. aureus data is not significant when compared with that calculates variance components from a weighted analysis
data for the other 2 organisms, however. This statistical differ- of variance. These computations assume that laboratory is a
ence, therefore, appears not to be biologically significant random factor, which is the same assumption made by Cole
within the scope and precision of this method. Table 3 shows et al. (6). By its very nature, the weighted analysis of variance
that the laboratory means are not all that different for the 3 leads to nonorthogonal sums of squares and, hence, the equiv-
organisms. alent of an unbalanced design. The variance components for
There were differences among formulations for P. aer- S. aureus are estimated following the method outlined by
uginosa and S. aureus but not S. choleraesuis. All formulations Bowen (W.M. Bowen, unpublished M.S. thesis, Brigham
appeared to be uniformly effective against S. choleraesuis. Young University, Department of Statistics, Provo, UT).
RUBINO ET AL.: JOURNAL OF AOAC INTERNATIONAL VOL. 75, No. 4,1992 643
Table 3. Least square means and standard errors Table 5. Weighted analysis of variance for
for 3 organisms and 10 laboratories8 P. aeruginosa and S. choleraesuis, assuming the
laooratory x T< >rmuia tion interaction is zero
Laboratory P. aeruainosa S. aureus S. choleraesuis
Source DF MS F p-value
A 1.88 (0.64) 1.46 (0.30) 0.88 (0.51)
P. aeruginosa
B 2 13 (0.71) 1 00 (0.25) 1 13 (0.62)
C 1.12 (0.49) 1.63 (0.31) 0.98 (0.57)
Formulation 3 2.53 2.56 0.070
D 2.34 (0.71) 3.10 (0.44) 0.67 (0.47)
Laboratory 9 0.56 0.57 0.816
E 1.98 (0.61) 2.47 (0.38) 1.58 (0.71) Error 36 0.99 ^
F 1.42 (0.57) 0.88 (0.24) 0.67 (0.47)
G 2.85 (0.77) 3.33 (0.45) 1.17 (0.64) S. choleraesuis
Table 6. Variance components estimates based on the statistically significant effects in each model for 3 organisms
Source P. aeruginosa % S. aureus % S. choleraesuis %
The authors thank Bill Campbell and Jean Jenkins of the Means are counts per 60 carriers. Standard errors are in
U.S. Environmental Protection Agency (EPA), Office of Pesti- parentheses.
P. aeruginosa
A 1.60 (0.53) 1.46 (0.30) 0.78 (0.32)
B 1.37 (0.54) 1.00 (0.25) 0.99 (0.35)
1 &6 0.0425 2.55 5 95.4
C 0.71 (0.42) 1.63 (0.31) 0.84 (0.32)
3 0.015 0.9 3 98.7
D 1.17 (0.44) 3.10 (0.44) 0.66 (0.29)
5 0.0133 0.8 2 95.3
E 1.59 (0.53) 2.47 (0.38) 1.34 (0.40)
F 1.07 (0.44) 0.88 (0.24) 0.66 (0.29) S. aureus
G 1.97 (0.58) 3.33 (0.45) 0.77 (0.31)
H 0.96 (0.39) 0.54 (0.18) 0.86 (0.32) 1 &6 0.0208 1.25 3 96.1
I 1.01 (0.44) 1.45 (0.31) 0.62 (0.29) 3 0.0383 2.3 5 97.0
J 1.06 (0.41) 0.92 (0.25) 0.87 (0.32) 5 0.0083 0.5 2 98.6