KoreanJournal of

NosocomialInfection Conhol
V o l . 3N o . 1

Bactericidal Effect of Disinfectant a Super-oxidued

water, Medilox@

Tae Youn Choi, M.D., Won Bae Kim, M.D.

Muy, 1998.

Department of Clinical Pathology, College of medicine,

Soonchunhyang Universitgr
657, Hannam-dong,Yongsan-gu,Seoul,Korea
TEL i 82-2-701)-942t FAX : 82-2-709-9934
 Bactericidal effect of Disinfectant a Super-oxidized
water, Medilox@

Tae Youn Choi, M.D., Won Bae Kim, M.D.

Department of Cliniul Pathology, College of Medicine,

Soonchunhyang Uniuersity, Seoul, Korea

Background : Disinfection is essential for the prevention of hospital infection. Medilox

(Soo San ENC Co., Yongin, Korea), a Super-oxidized water was recently developed as a

disinfectant. This is not costly and does not cause any clinical problems and environmental
pollution. We evaluated the disinfective activity of Medilox against several clinical isolates of

bacteria and yeasts.

Methods : 25 strains of bacteria and two strains of fungi were exposed to Medilox (ll0 &

50 ppm HOCI) disinfectant for the various periods (0.5, 1, 2, 4, 8, 10, 15 and 20 minutes).
After the exposure to Medilox disinfectant, 0.01 mL of mixture of microorganisms and

Medilox was inoculated into brain-hezrt infusion broth or onto Sabouraud dextrose agar and
incubated at 35t for 48 hours.

Results : All strains of bacteria and fungi were killed within 30 seconds after an exposure

to 30 ppm of Medilox. All of three strains of spore forming Bacillus subtilis were killed
within 4 minutes after an exposure to 30 ppm of Medilox, but all of three strains were killed

within 30 seconds in 50 ppm of Medilox.

Conclusions : This study showed that Medilox disinfectant was effective for the

disinfection of commonly isolated bacteria and yeast from hospital, but less effcctive against
spore-forming bacteria. It may be recommendedthat Medilox should be used for the effective
disinfection of skin, instruments and hospital floors.

Key Words : Disinfectant, Medilox, Hospital infection, Super oxidized water

Introduction

'foday,
nosocomial infections by human and environmental microorganisms are a very

important problem in hospitals. Disinfection is essential for the prevention of hospital infection.
'I'here
are many physical or chemical methods of sterilization, but the most common sterilizer

is chlorine compound. Medilox (Soo San ENC Co., Yongin, Korea), one of the Super-oxidized
'fhis
water was recently developed as a disinfectant. is not costly and does not cause any

clinical problems and environmental pollution.

This study has examined the disinfective activity of Medilox against several clinical isolates

of bacteria and fungi.

Materials and methods

1. Super-oxidized water (Medilox solution)

Medilox solution was prepared by electrolysis of sodium chloride solution using the Medilox
system (Soo San ENC Co., Yongin, Korea). Iilectrolysis yields Super-oxidizedwater with pH
of 5.0-6.5 ancl an oxidation-reduction potential of )950 mV containing about 30-50 ppm of
hypochlorgus acid (HOCI). Freshly prepared Medilox solutions with 30 ppm and 50 ppm of
FIOCI conccntration were used as disinfectants.

2. Microorganisms

J'est strains were methicillin-sensitive Staphylococcus aureus, methicillin-resistant

Staphylococcus antreus, Staplrylococcus epidermidis, Enterococctts faemlis, Streptocttccus

pneumoniae, Salmonella typhi, Salmonella paratyphi A, Salmonella enteritidis, Shigella

flexneri, Pseudomonas aeruginosa, Acinetobacter baumannii, E. coli, Serratia mnrcescens,

Klebsielta pneumoniae, Enterobacter cloacae, Citrobacter freundii, Stenotrophomonas

mattophitia, Proteus mirabitis, Chryseobacterium meningosepticum, Candida albimns and

spore-forming Bacillus subtilis isolated from patients admitted in Soonchunhyang University

Hospital in Korea.
3. Determination of bactericidal activity

Test bacteria and fungi were cultured into brain-heart infusion broth fot 24 or 48 hours at
35"g. Each cultured microorganism was washed three times with phosphate buffered solution
(p117.D by centrifugation to remove contaminating organic material derived from the culture

medium and the final suspensionin PBS used for inactivation studies. Disinfection testing was
carried out by adding 0.1 mL of each microorganism suspensionto 5 mL of freshly prepared
Medilox with 30 ppm and 50 ppm of HOCI concentraion and mixing thoroughly (l0t-107
CFU/mL). Each organism was exposed to disinfectant for various periods (0.5, l, 2, 4, 8, IO,
15 and 20 minutes). After the exposure of Medilox disinfectant, 0.01 mL of the mixture of
microorganism and Medilox was inoculated into brain-heart infusion broth or onto Sabouraud
'I'he growth
dextrose agar. of microorganism was examined after incubation at 35C for 48

hours. All tests were run in duplicate.

Results

1. Bactericidal effect against gram-positive bacteria

Gram-positive bacteria such as methicillin-susceptible StaplryLococcus QureLts,

methicillin-resistant Stapltylococcus aureus, Staplrylococcus epidermidis, Enterococcus faecalis

ppm
and Streptococcys pneumoniae were killed within 30 seconds after the exposure to 30
and 50 ppm of Medilox.

2. Bactericidal effect against gram-negative bacteria

Gram-negative bacteria such as Salmonella typhi, Salmonella paratyphi A, Salmonella
enteritidis, Shigetla flexneri, Pseudomorns aeruginosa, Acinetobacter baumannii, E. coli,

Serratta fftarcescens, Klebsietkt pneumoniae, Dnterobacter cloacae, Citrobacter .freundii,

Stenotroplutmorws maltophilia, Proteus mirabilis and Chryseobacterium meningosepticum

were killed within 30 seconds after the exposure to 30 ppm and 50 ppm of Medilox.

- 3
3. Bactericidal effect against C,andidaalbiuns

Two strains of Candida albicans were killed within 30 seconds after the exposure to 30
ppm and 50 ppm of Medilox.

4. Bactericidal effect against spore*forming Bacillus subtilis

All of three strains of spore*forming Bacillus subtilis were killed within 4 minutes after the

exposure to 30 ppm of Medilox, but all of three strains were killed within 30 seconds after
the exposure to 50 ppm of Medilox.

Table 1. Bactericidal activity of Medilox (HOCI 30 ppm & 50 ppm) disinfectant

according to the exposure time

Exposure time(min)

ethicillin resistant S. aureus

Methicillin-sensitive S. aureus

>treptococcus pneumonlae I
Enterococcusfaeulis

Escherichia coli
Klebsiella pneumoniae
Enterobacter cloame
!'4yolqcrel frnul4ll_
P seudomonasoeruginosa
Acinetobacter baumanrut
ierratia rnrcescens
r191qusmirabitii -
i t eno tr op homonas malt ophi lia
Chryseobacterium meningosepticum
;eJ!!e4glt"_Up!!_

ilmonella enLeritidis

'llus
subtilis.ATCC 6051
Bacillus subtilis, ATCC 6633
Bacillus subrilis, SUH
Discussion

The most effective method of preventing nosocomial infection includes proper disinfection of
h<tspital surroundings, assured sterilization of various medical instruments, mdntenance of
clean hands of doctors and nurses that are in contact with patients, thorough disinfection of
the area of surgery or treatment and others. Many sterilization methods are being introduced
in order to prevent nosocomial infections. Disinfectants play an important role in the
prevention of nosocomial infection.
Super-oxidized water prepared by the electrolysis of sodium chloride solution was develolrd

as a disinfectant. It is an electrochemical solution containing a mixture of radicals with strong

oxidizing properties. Strongly acidic super oxidizcd water, developed as Super-oxidized water

at the outset, has a problem of low preservative capacity and low sterilizing effect in the

presence of organic substances. Medilox, an weakly acidic Super-oxidized water recent['

developed by Soo San ENC Company in Korea was improved such inadequacies and enhanced

the sterilizing effect. It is not costly and does not cause any clinical problems and

environmental pollution.

The experimental result of the disinfective activity of Medilox solution showed that gcncral

bacteria and fungi isolated in hospital had all been sterilized within 30 seconds to the I{OCI

ccrncentration of 30 ppm. All of three strains of spore-forming BacilLus subtilis were killed

within 4 minutes to Medilox with HOCI concentration of 30 ppm, but all of three strains were

killed within 30 seconds to the HOCI concentration of 50 ppm. Thus, HOCI concentration

should be increased to enhance sterilization for spore forming bacteria.

1'he potent biocidal activity of Medilox in the absence of organic matter, after a 30 seconds

exposure time, was demonstrated across a range of microorganisms including general bactcria,

fungi and spore forming bacteria. Medilox, as a strong disinfectant, is uscful for hand

washing, sterilizing of skin and cleaning of the hospital environment. In clinical arcas where it

is recommended that instruments be thoroughly to remove blood and body fluids bcforc

disinfection, Medilox acts as a highly effective disinfecting agent.

It may be recommended that Medilox should be used for the effective disinfcction of skin.

various medical instruments and hospital surroundings.

References

1. Korean Society for Nosocomial Infection Control, Infection control directive,

1996:66-97

2. Rutala WA. Disinfection, sterilization and waste disposal. In:Wenzel IlP, ed. Prevention
and control of nosocomialinfections. 3rd ed. Baltimore:Williams & Wilkins,
1997:539-93

3. Marsik FJ, Denys GA. Sterilization and disinfection procedures for the microbiology
laboratory. In:Murry PR, RH, eds. Manual of clinical microbiology. 6th ed.
Washington DC:American society for Microbiology,
1995:86-98

4. Euichong Kim, Chongsung Seok, Bactericidal effect of disinfectant Super-oxidized

water, The newest medical science,
1995;38:21-7

6 -