Efficacy of various disinfectants against SARS coronavirus
Identifieur interne : 001152 ( Pmc/Corpus ); précédent : 001151; suivant : 001153Efficacy of various disinfectants against SARS coronavirus
Auteurs : H. F. Rabenau ; G. Kampf ; J. Cinatl ; H. W. DoerrSource :
- The Journal of Hospital Infection [ 0195-6701 ] ; 2005.
Abstract
The recent severe acute respiratory syndrome (SARS) epidemic in Asia and Northern America led to broad use of various types of disinfectant in order to control the public spread of the highly contagious virus. However, only limited data were available to demonstrate their efficacy against SARS coronavirus (SARS-CoV). We therefore investigated eight disinfectants for their activity against SARS-CoV according to prEN 14476. Four hand rubs were tested at 30 s (Sterillium, based on 45% iso-propanol, 30% n-propanol and 0.2% mecetronium etilsulphate; Sterillium Rub, based on 80% ethanol; Sterillium Gel, based on 85% ethanol; Sterillium Virugard, based on 95% ethanol). Three surface disinfectants were investigated at 0.5% for 30 min and 60 min (Mikrobac forte, based on benzalkonium chloride and laurylamine; Kohrsolin FF, based on benzalkonium chloride, glutaraldehyde and didecyldimonium chloride; Dismozon pur, based on magnesium monoperphthalate), and one instrument disinfectant was investigated at 4% for 15 min, 3% for 30 min and 2% for 60 min [Korsolex basic, based on glutaraldehyde and (ethylenedioxy)dimethanol]. Three types of organic load were used: 0.3% albumin, 10% fetal calf serum, and 0.3% albumin with 0.3% sheep erythrocytes. Virus titres were determined by a quantitative test (endpoint titration) in 96-well microtitre plates. With all tested preparations, SARS-CoV was inactivated to below the limit of detection (reduction factor mostly ≥4), regardless of the type of organic load. In summary, SARS-CoV can be inactivated quite easily with many commonly used disinfectants.
Url:
DOI: 10.1016/j.jhin.2004.12.023
PubMed: 15923059
PubMed Central: 7132504
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PMC:7132504Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Efficacy of various disinfectants against SARS coronavirus</title><author><name sortKey="Rabenau, H F" sort="Rabenau, H F" uniqKey="Rabenau H" first="H. F." last="Rabenau">H. F. Rabenau</name><affiliation><nlm:aff id="aff1">Institut für Medizinische Virologie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Paul-Ehrlich-Str. 40, 60596 Frankfurt, Germany</nlm:aff></affiliation></author><author><name sortKey="Kampf, G" sort="Kampf, G" uniqKey="Kampf G" first="G." last="Kampf">G. Kampf</name><affiliation><nlm:aff id="aff2">Bode Chemie GmbH & Co., Scientific Affairs, Melanchthonstr. 27, 22525 Hamburg, Germany</nlm:aff></affiliation><affiliation><nlm:aff id="aff3">Institut für Hygiene und Umweltmedizin, Ernst-Moritz-Arndt Universität Greifswald, Walther-Rathenau-Str. 49a, 17489 Greifswald, Germany</nlm:aff></affiliation></author><author><name sortKey="Cinatl, J" sort="Cinatl, J" uniqKey="Cinatl J" first="J." last="Cinatl">J. Cinatl</name><affiliation><nlm:aff id="aff1">Institut für Medizinische Virologie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Paul-Ehrlich-Str. 40, 60596 Frankfurt, Germany</nlm:aff></affiliation></author><author><name sortKey="Doerr, H W" sort="Doerr, H W" uniqKey="Doerr H" first="H. W." last="Doerr">H. W. Doerr</name><affiliation><nlm:aff id="aff1">Institut für Medizinische Virologie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Paul-Ehrlich-Str. 40, 60596 Frankfurt, Germany</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">15923059</idno><idno type="pmc">7132504</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132504</idno><idno type="RBID">PMC:7132504</idno><idno type="doi">10.1016/j.jhin.2004.12.023</idno><date when="2005">2005</date><idno type="wicri:Area/Pmc/Corpus">001152</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001152</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Efficacy of various disinfectants against SARS coronavirus</title><author><name sortKey="Rabenau, H F" sort="Rabenau, H F" uniqKey="Rabenau H" first="H. F." last="Rabenau">H. F. Rabenau</name><affiliation><nlm:aff id="aff1">Institut für Medizinische Virologie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Paul-Ehrlich-Str. 40, 60596 Frankfurt, Germany</nlm:aff></affiliation></author><author><name sortKey="Kampf, G" sort="Kampf, G" uniqKey="Kampf G" first="G." last="Kampf">G. Kampf</name><affiliation><nlm:aff id="aff2">Bode Chemie GmbH & Co., Scientific Affairs, Melanchthonstr. 27, 22525 Hamburg, Germany</nlm:aff></affiliation><affiliation><nlm:aff id="aff3">Institut für Hygiene und Umweltmedizin, Ernst-Moritz-Arndt Universität Greifswald, Walther-Rathenau-Str. 49a, 17489 Greifswald, Germany</nlm:aff></affiliation></author><author><name sortKey="Cinatl, J" sort="Cinatl, J" uniqKey="Cinatl J" first="J." last="Cinatl">J. Cinatl</name><affiliation><nlm:aff id="aff1">Institut für Medizinische Virologie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Paul-Ehrlich-Str. 40, 60596 Frankfurt, Germany</nlm:aff></affiliation></author><author><name sortKey="Doerr, H W" sort="Doerr, H W" uniqKey="Doerr H" first="H. W." last="Doerr">H. W. Doerr</name><affiliation><nlm:aff id="aff1">Institut für Medizinische Virologie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Paul-Ehrlich-Str. 40, 60596 Frankfurt, Germany</nlm:aff></affiliation></author></analytic><series><title level="j">The Journal of Hospital Infection</title><idno type="ISSN">0195-6701</idno><idno type="eISSN">1532-2939</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><p>The recent severe acute respiratory syndrome (SARS) epidemic in Asia and Northern America led to broad use of various types of disinfectant in order to control the public spread of the highly contagious virus. However, only limited data were available to demonstrate their efficacy against SARS coronavirus (SARS-CoV). We therefore investigated eight disinfectants for their activity against SARS-CoV according to prEN 14476. Four hand rubs were tested at 30 s (Sterillium, based on 45% iso-propanol, 30% n-propanol and 0.2% mecetronium etilsulphate; Sterillium Rub, based on 80% ethanol; Sterillium Gel, based on 85% ethanol; Sterillium Virugard, based on 95% ethanol). Three surface disinfectants were investigated at 0.5% for 30 min and 60 min (Mikrobac forte, based on benzalkonium chloride and laurylamine; Kohrsolin FF, based on benzalkonium chloride, glutaraldehyde and didecyldimonium chloride; Dismozon pur, based on magnesium monoperphthalate), and one instrument disinfectant was investigated at 4% for 15 min, 3% for 30 min and 2% for 60 min [Korsolex basic, based on glutaraldehyde and (ethylenedioxy)dimethanol]. Three types of organic load were used: 0.3% albumin, 10% fetal calf serum, and 0.3% albumin with 0.3% sheep erythrocytes. Virus titres were determined by a quantitative test (endpoint titration) in 96-well microtitre plates. With all tested preparations, SARS-CoV was inactivated to below the limit of detection (reduction factor mostly ≥4), regardless of the type of organic load. In summary, SARS-CoV can be inactivated quite easily with many commonly used disinfectants.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Guan, Y" uniqKey="Guan Y">Y. Guan</name></author><author><name sortKey="Peiris, J S" uniqKey="Peiris J">J.S. Peiris</name></author><author><name sortKey="Zheng, B" uniqKey="Zheng B">B. Zheng</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Berger, A" uniqKey="Berger A">A. Berger</name></author><author><name sortKey="Drosten, C" uniqKey="Drosten C">C. Drosten</name></author><author><name sortKey="Doerr, H W" uniqKey="Doerr H">H.W. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Hosp Infect</journal-id><journal-id journal-id-type="iso-abbrev">J. Hosp. Infect</journal-id><journal-title-group><journal-title>The Journal of Hospital Infection</journal-title></journal-title-group><issn pub-type="ppub">0195-6701</issn><issn pub-type="epub">1532-2939</issn><publisher><publisher-name>The Hospital Infection Society. Published by Elsevier Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">15923059</article-id><article-id pub-id-type="pmc">7132504</article-id><article-id pub-id-type="publisher-id">S0195-6701(05)00044-7</article-id><article-id pub-id-type="doi">10.1016/j.jhin.2004.12.023</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Efficacy of various disinfectants against SARS coronavirus</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Rabenau</surname><given-names>H.F.</given-names></name><email>rabenau@em.uni-frankfurt.de</email><xref rid="aff1" ref-type="aff">a</xref><xref rid="cor1" ref-type="corresp">*</xref></contrib><contrib contrib-type="author"><name><surname>Kampf</surname><given-names>G.</given-names></name><xref rid="aff2" ref-type="aff">b</xref><xref rid="aff3" ref-type="aff">c</xref></contrib><contrib contrib-type="author"><name><surname>Cinatl</surname><given-names>J.</given-names></name><xref rid="aff1" ref-type="aff">a</xref></contrib><contrib contrib-type="author"><name><surname>Doerr</surname><given-names>H.W.</given-names></name><xref rid="aff1" ref-type="aff">a</xref></contrib></contrib-group><aff id="aff1"><label>a</label>Institut für Medizinische Virologie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Paul-Ehrlich-Str. 40, 60596 Frankfurt, Germany</aff><aff id="aff2"><label>b</label>Bode Chemie GmbH & Co., Scientific Affairs, Melanchthonstr. 27, 22525 Hamburg, Germany</aff><aff id="aff3"><label>c</label>Institut für Hygiene und Umweltmedizin, Ernst-Moritz-Arndt Universität Greifswald, Walther-Rathenau-Str. 49a, 17489 Greifswald, Germany</aff><author-notes><corresp id="cor1"><label>*</label>Corresponding author. Tel.: +49 69 6301 5312; fax: +49 69 6301 83061. <email>rabenau@em.uni-frankfurt.de</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>31</day><month>5</month><year>2005</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>10</month><year>2005</year></pub-date><pub-date pub-type="epub"><day>31</day><month>5</month><year>2005</year></pub-date><volume>61</volume><issue>2</issue><fpage>107</fpage><lpage>111</lpage><history><date date-type="received"><day>5</day><month>7</month><year>2004</year></date><date date-type="accepted"><day>23</day><month>12</month><year>2004</year></date></history><permissions><copyright-statement>Copyright © 2005 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.</copyright-statement><copyright-year>2005</copyright-year><copyright-holder>The Hospital Infection Society</copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract><title>Summary</title><p>The recent severe acute respiratory syndrome (SARS) epidemic in Asia and Northern America led to broad use of various types of disinfectant in order to control the public spread of the highly contagious virus. However, only limited data were available to demonstrate their efficacy against SARS coronavirus (SARS-CoV). We therefore investigated eight disinfectants for their activity against SARS-CoV according to prEN 14476. Four hand rubs were tested at 30 s (Sterillium, based on 45% iso-propanol, 30% n-propanol and 0.2% mecetronium etilsulphate; Sterillium Rub, based on 80% ethanol; Sterillium Gel, based on 85% ethanol; Sterillium Virugard, based on 95% ethanol). Three surface disinfectants were investigated at 0.5% for 30 min and 60 min (Mikrobac forte, based on benzalkonium chloride and laurylamine; Kohrsolin FF, based on benzalkonium chloride, glutaraldehyde and didecyldimonium chloride; Dismozon pur, based on magnesium monoperphthalate), and one instrument disinfectant was investigated at 4% for 15 min, 3% for 30 min and 2% for 60 min [Korsolex basic, based on glutaraldehyde and (ethylenedioxy)dimethanol]. Three types of organic load were used: 0.3% albumin, 10% fetal calf serum, and 0.3% albumin with 0.3% sheep erythrocytes. Virus titres were determined by a quantitative test (endpoint titration) in 96-well microtitre plates. With all tested preparations, SARS-CoV was inactivated to below the limit of detection (reduction factor mostly ≥4), regardless of the type of organic load. In summary, SARS-CoV can be inactivated quite easily with many commonly used disinfectants.</p></abstract><kwd-group><title>Keywords</title><kwd>SARS-CoV</kwd><kwd>Disinfectants</kwd><kwd>Virucidal activity</kwd><kwd>prEN 14476</kwd></kwd-group></article-meta></front><body><sec id="section0005"><title>Introduction</title><p id="para0005">The recent severe acute respiratory syndrome (SARS) epidemic affected over 30 countries,<xref rid="bib1" ref-type="bibr"><sup>1</sup></xref> mainly in Asia and Northern America, and involved more than 8000 probable cases and more than 700 deaths worldwide.<xref rid="bib2" ref-type="bibr"><sup>2</sup></xref> New cases were reported in 2004.<xref rid="bib3" ref-type="bibr"><sup>3</sup></xref> Several hospital outbreaks occurred, affecting both patients and healthcare workers.<xref rid="bib4" ref-type="bibr">4</xref>, <xref rid="bib5" ref-type="bibr">5</xref> It has been suggested that healthcare workers who are exposed to SARS patients can be infected with SARS coronavirus (SARS-CoV), regardless of the intensity of exposure.<xref rid="bib6" ref-type="bibr"><sup>6</sup></xref> This has alerted the global infection control community. Management of infected patients consisted of isolation and strict respiratory and contact precautions.<xref rid="bib7" ref-type="bibr"><sup>7</sup></xref> A case-control study among 241 non-infected and 13 infected staff members with documented exposure to 11 index SARS patients suggested that wearing a face mask is the most important infection control tool, followed by appropriate hand hygiene,<xref rid="bib8" ref-type="bibr"><sup>8</sup></xref> suggesting that droplets and hands play a major role in transmission of SARS-CoV. Hands may be contaminated by patient excretions or contact with contaminated surfaces. From the inanimate environment, nosocomial pathogens can be transmitted to hands quite easily.<xref rid="bib9" ref-type="bibr"><sup>9</sup></xref> SARS-CoV has been described to persist on surfaces for up to 96 h.<xref rid="bib10" ref-type="bibr"><sup>10</sup></xref> In another study, dried SARS-CoV retained its infectivity for as long as six days, indicating a relatively strong survival ability. Only after nine days in a dried state did SARS-CoV completely lose its infectivity.<xref rid="bib11" ref-type="bibr"><sup>11</sup></xref> Results of a cohort study among visitors of a hotel suggested that environmental contamination should be considered as a possible source of infection.<xref rid="bib12" ref-type="bibr"><sup>12</sup></xref> The Robert Koch Institute, Berlin, Germany has recommended the use of disinfectants that have complete virucidal activity including the spectrum of non-enveloped viruses.<xref rid="bib13" ref-type="bibr"><sup>13</sup></xref> The World Health Organization (WHO) has suggested that standard disinfectants should be effective against SARS-CoV,<xref rid="bib14" ref-type="bibr"><sup>14</sup></xref> but experimental evidence is not available to date. This is why we have investigated the activity of various disinfectants against SARS-CoV.</p></sec><sec id="section0015"><title>Materials and methods</title><sec id="section0025"><title>Products</title><p id="para0015">Eight commercial products were tested, all manufactured by and obtained from Bode Chemie GmbH & Co., Hamburg, Germany. Four were alcohol-based hand disinfectants: Sterillium, based on 45% iso-propanol, 30% n-propanol and 0.2% mecetronium etilsulphate; Sterillium Rub, based on 80% ethanol; Sterillium Gel, based on 85% ethanol; and Sterillium Virugard, based on 95% ethanol. All alcohol-based hand rubs were tested without dilution. Three products were surface disinfectants: Mikrobac forte, based on benzalkonium chloride and laurylamine; Korsolin FF, based on benzalkonium chloride, glutaraldehyde and didecyldimonium chloride; and Dismozon pur, based on magnesium monoperphthalate. The surface disinfectants were tested at the recommended concentration for the recommended application time at which they have been shown to have bactericidal and yeasticidal activity, as well as sufficient efficacy in tests under practical conditions.<xref rid="bib15" ref-type="bibr"><sup>15</sup></xref> The instrument disinfectant Korsolex basic, based on glutaraldehyde and (ethylenedioxy)dimethanol, was included due to the possible transmission of SARS-CoV by flexible bronchoscopes. The product was tested at the recommended concentration and application time that has been shown to have bactericidal and yeasticidal activity, as well as sufficient efficacy in tests under practical conditions.<xref rid="bib15" ref-type="bibr"><sup>15</sup></xref></p></sec><sec id="section0035"><title>Test procedure</title><sec id="section0045"><title>Viruses and cells</title><p id="para0025">SARS-CoV isolate FFM-1<xref rid="bib16" ref-type="bibr"><sup>16</sup></xref> was obtained from the sputum of a patient hospitalized with a diagnosis of probable SARS in the Isolation Unit of Frankfurt University Hospital, Germany. SARS-CoV were grown in Vero cell cultures (African green monkey kidney, ATCC no. CCL-81). The maintenance medium consisted of minimum essential medium (MEM) without fetal calf serum (FCS) and containing 100 IU/mL of penicillin and 100 μg/mL of streptomycin. Virus stock was stored at −80 °C. Infectious virus titres were calculated as described by Kärber<xref rid="bib17" ref-type="bibr"><sup>17</sup></xref> and Spearman,<xref rid="bib18" ref-type="bibr"><sup>18</sup></xref> and determined as 50% tissue culture infective doses. Different virus stocks were used for the experiments. The initial log<sub>10</sub> virus titres were between 8.93±0.25 and 9.30±0.38. In accordance with WHO recommendations, all work involving infectious SARS-CoV was performed under biosafety level (BSL)-3 conditions in a BSL-3 facility.</p></sec><sec id="section0055"><title>Susceptibility of SARS-CoV to different chemical disinfectants</title><p id="para0035">The experiments were performed according to prEN 14476.<xref rid="bib19" ref-type="bibr"><sup>19</sup></xref> For each of the experiments, eight parts of the compound were adapted to room temperature (RT) and mixed with one part of virus suspension and one part of organic load or MEM. The organic loads used were 0.3% albumin, 10% FCS, and 0.3% albumin with 0.3% sheep erythrocytes. Immediately after incubation for defined periods of time at RT, the mixture was diluted 1:10 with ice-cold MEM and put into an ice bath to avoid an extension of the effective incubation period. Serial 10-fold dilutions with ice-cold MEM were performed to assess virus titres as described above. For each dilution step, eight wells containing suspended cells were inoculated. After three to four days of incubation at 37 °C in an CO<sub>2</sub> incubator, cells were microscopically examined for virus-specific cytopathogenic effects. All tests were performed in triplicate, and for each experiment, a virus control containing MEM instead of disinfectant was included (‘control titration’). Further control experiments included formaldehyde (0.7%) as standard disinfectant, and a ‘termination control’, which is a 1:10 dilution of the disinfectant. This control demonstrates the first 1:10 dilution step in the above mentioned procedure and should verify if a postincubation effect of the disinfectant exists. Furthermore, cytotoxic effects caused by the compounds at various dilutions were assessed in suspended Vero cells in 96-well plates using the MTT Cell Proliferative Kit I (Roche, Mannheim, Germany) as published previously.<xref rid="bib20" ref-type="bibr">20</xref>, <xref rid="bib21" ref-type="bibr">21</xref> Tests for cytotoxicity were performed as single assays using 10% FCS and disinfectant but without addition of virus.</p></sec></sec><sec id="section0065"><title>Calculation of the reduction factor</title><p id="para0045">The reduction factor (RF) was calculated as the difference in the quotient of the infection titre before (‘control titration’) and after incubation of the virus with the disinfectant (‘remaining virus’). Therefore, the log<sub>10</sub> titre and its (double) standard deviation (SD) were calculated as well as the variance of the RF.</p></sec></sec><sec id="section0075"><title>Results</title><p id="para0055">The results are shown in <xref rid="tbl1" ref-type="table">Table I</xref>. All four alcohol-based hand rubs led to inactivation of SARS-CoV to below the limit of detection (RF≥4.3, SD 0.5 to ≥5.5, SD 0.5), irrespective of the presence and type of organic load, within 30 s (<xref rid="tbl1" ref-type="table">Table I</xref>). The three surface disinfectants also inactivated SARS-CoV to below the limit of detection (RF≥3.8, SD 0.7 to ≥6.1, SD 0.4) within 30 min. The same efficacy was seen with the instrument disinfectant at concentrations of 2% (60 min), 3% (30 min) and 4% (15 min), regardless of the type of organic load (<xref rid="tbl1" ref-type="table">Table I</xref>). The mean RF with the instrument disinfectant was ≥3.3, SD 0.5, which is nearly tenfold below the results of the other disinfectants, due to initial virus titre which was tenfold lower. The results of the controls (data not presented) showed that the termination controls had nearly the same titre as the ‘control titration’. This means that no postexposure disinfection effect could be seen. The incubation of SARS-CoV with 0.7% formaldehyde showed an RF≥3, and the cytotoxicity controls indicated that the compounds are cytotoxic up to a dilution between 1:10 to 1:100, while 0.7% formaldehyde was cytotoxic up to a 1:10 000 dilution.<table-wrap position="float" id="tbl1"><label>Table I</label><caption><p>Efficacy of different types of disinfectant at various exposure times against SARS coronavirus, expressed as minimum reduction factors (RFs) of three parallel experiments: 0.3% serum albumin (BSA), 10% fetal calf serum (FCS), and 0.3% BSA with 0.3% sheep erythrocytes</p></caption><table frame="hsides" rules="groups"><thead><tr><th>Product</th><th align="center">Type of area of application</th><th align="center">Concentration</th><th align="center">Exposure time</th><th colspan="3" align="center">RF (and SD)<hr></hr></th></tr><tr><th></th><th></th><th></th><th></th><th align="center">0.3% BSA</th><th align="center">10% FCS</th><th align="center">0.3% BSA and 0.3% sheep erythrocytes</th></tr></thead><tbody><tr><td>Sterillium</td><td>Hand rub</td><td>Undiluted</td><td>30 s</td><td align="char">≥4.25 (0.47)</td><td align="char">≥4.25 (0.47)</td><td align="char">≥4.25 (0.47)</td></tr><tr><td>Sterillium Rub</td><td>Hand rub</td><td>Undiluted</td><td>30 s</td><td align="char">≥4.25 (0.47)</td><td align="char">≥4.25 (0.47)</td><td align="char">≥4.25 (0.47)</td></tr><tr><td>Sterillium Gel</td><td>Hand rub</td><td>Undiluted</td><td>30 s</td><td align="char">≥5.5 (0.54)</td><td align="char">≥5.5 (0.54)</td><td align="char">≥5.5 (0.54)</td></tr><tr><td>Sterillium Virugard</td><td>Hand rub</td><td>Undiluted</td><td>30 s</td><td align="char">≥5.5 (0.54)</td><td align="char">≥5.5 (0.54)</td><td align="char">≥5.5 (0.54)</td></tr><tr><td>
Mikrobac forte</td><td>Surface disinfectant</td><td>0.5%</td><td>30 min</td><td align="char">≥6.13 (0.35)</td><td align="char">≥6.13 (0.35)</td><td align="char">≥6.13 (0.35)</td></tr><tr><td></td><td></td><td></td><td>60 min</td><td align="char">≥6.13 (0.35)</td><td align="char">≥6.13 (0.35)</td><td align="char">≥6.13 (0.35)</td></tr><tr><td>
Kohrsolin FF</td><td>Surface disinfectant</td><td>0.5%</td><td>30 min</td><td align="char">≥3.75 (0.71)</td><td align="char">≥3.75 (0.71)</td><td align="char">≥3.75 (0.71)</td></tr><tr><td></td><td></td><td></td><td>60 min</td><td align="char">≥3.75 (0.71)</td><td align="char">≥3.75 (0.71)</td><td align="char">≥3.75 (0.71)</td></tr><tr><td>
Dismozon pur</td><td>Surface disinfectant</td><td>0.5%</td><td>30 min</td><td align="char">≥4.5 (0.54)</td><td align="char">≥4.5 (0.54)</td><td align="char">≥4.5 (0.54)</td></tr><tr><td></td><td></td><td></td><td>60 min</td><td align="char">≥4.5 (0.54)</td><td align="char">≥4.5 (0.54)</td><td align="char">≥4.5 (0.54)</td></tr><tr><td>
Korsolex basic</td><td>Instrument disinfectant</td><td>4%</td><td>15 min</td><td align="char">≥3.25 (0.47)</td><td align="char">≥3.25 (0.47)</td><td align="char">≥3.25 (0.47)</td></tr><tr><td></td><td></td><td>3%</td><td>30 min</td><td align="char">≥3.25 (0.47)</td><td align="char">≥3.25 (0.47)</td><td align="char">≥3.25 (0.47)</td></tr><tr><td></td><td></td><td>2%</td><td>60 min</td><td align="char">≥3.25 (0.47)</td><td align="char">≥3.25 (0.47)</td><td align="char">≥3.25 (0.47)</td></tr></tbody></table></table-wrap></p></sec><sec id="section0085"><title>Discussion</title><p id="para0065">Data on the efficacy of various types of disinfectants against SARS-CoV are very limited. We were able to show a reproducible activity with all disinfectants at the commonly used concentrations and exposure times, even with different types of organic load. Alcohols have been described to have immediate, very good activity<xref rid="bib22" ref-type="bibr"><sup>22</sup></xref> against many different enveloped viruses such as orthopoxvirus,<xref rid="bib23" ref-type="bibr">23</xref>, <xref rid="bib24" ref-type="bibr">24</xref> influenza A virus,<xref rid="bib23" ref-type="bibr">23</xref>, <xref rid="bib24" ref-type="bibr">24</xref> herpes simplex virus type 1 and 2,<xref rid="bib24" ref-type="bibr"><sup>24</sup></xref> Newcastle disease virus,<xref rid="bib25" ref-type="bibr"><sup>25</sup></xref> togavirus,<xref rid="bib26" ref-type="bibr"><sup>26</sup></xref> hepatitis B virus<xref rid="bib27" ref-type="bibr">27</xref>, <xref rid="bib28" ref-type="bibr">28</xref>, <xref rid="bib29" ref-type="bibr">29</xref> and human immunodeficiency virus.<xref rid="bib24" ref-type="bibr">24</xref>, <xref rid="bib30" ref-type="bibr">30</xref>, <xref rid="bib31" ref-type="bibr">31</xref> Our finding with SARS-CoV is therefore in line with previously reported data against many other enveloped viruses. The use of alcohol-based hand rubs after contamination of the hands with SARS-CoV, e.g. by respiratory secretions during patient contact, should be effective to prevent further transmission of SARS-CoV by healthcare workers' hands.</p><p id="para0075">Patients with SARS may well spread the virus to the inanimate environment, which has been described as a source for SARS infections.<xref rid="bib12" ref-type="bibr"><sup>12</sup></xref> SARS-CoV may persist on inanimate surfaces for up to six days,<xref rid="bib11" ref-type="bibr"><sup>11</sup></xref> and serve as a source of infection during that time. That is why the disinfection of surfaces provides additional safety to control the spread of SARS-CoV from inanimate surfaces in an outbreak situation. The three tested surface disinfectants were all effective against SARS-CoV at the concentration and exposure time recommended for routine disinfection of surfaces.<xref rid="bib15" ref-type="bibr"><sup>15</sup></xref> The recommendation is derived from experimental evidence which includes bactericidal and yeasticidal activity in suspension tests, and which provides sufficient efficacy under practical conditions.<xref rid="bib15" ref-type="bibr"><sup>15</sup></xref> This spectrum of activity appears to include SARS-CoV. prEN 14476 allows surface disinfectants to be tested at exposure times of 5 and 15 min, as well as 30 and 60 min. Shorter times are more relevant to the exposure times used in practice for surface disinfection (i.e. before drying), and are usually achieved with higher concentrations of the surface disinfectant. Especially in critical areas such as paediatric intensive care, a higher concentration of surface disinfectants provides more safety and is preferable.<xref rid="bib32" ref-type="bibr"><sup>32</sup></xref></p><p id="para0085">One instrument disinfectant was tested against SARS-CoV. Patients with SARS may require a bronchoscopy. The flexible endoscope will be processed after use and must not spread the virus to any other patient. Different approaches to achieve optimum results during reprocessing flexible endoscopes are currently debated worldwide,<xref rid="bib33" ref-type="bibr">33</xref>, <xref rid="bib34" ref-type="bibr">34</xref>, <xref rid="bib35" ref-type="bibr">35</xref>, <xref rid="bib36" ref-type="bibr">36</xref> but the minimum spectrum of activity for an instrument disinfectant has not yet been defined. We were able to show that a standard instrument disinfectant achieved sufficient activity against SARS-CoV using the recommended concentration and exposure time,<xref rid="bib15" ref-type="bibr"><sup>15</sup></xref> indicating that SARS-CoV is quite easily inactivated.</p><p id="para0095">All experiments were carried out with three different types of organic load: 10% FCS, 0.3% albumin, and a combination of 0.3% albumin with 0.3% washed sheep erythrocytes (‘dirty conditions’). All disinfectants were found to be active against SARS-CoV regardless of the type of organic load. Against other enveloped viruses, an ethanol-based hand rub was also described to be effective under different types of organic load.<xref rid="bib24" ref-type="bibr"><sup>24</sup></xref> Against the feline calicivirus (FCV), however, there was a significant influence of the type of organic load on the efficacy of 70% ethanol and 70% iso-propanol; FCS did not impair the efficacy against FCV but the presence of albumin or sheep erythrocytes significantly reduced the efficacy of the alcohols.<xref rid="bib37" ref-type="bibr"><sup>37</sup></xref> Our data indicate that sufficient activity against SARS-CoV can be expected with the tested disinfectants, regardless of the type of organic load.</p></sec></body><back><ref-list id="bibliography0005"><title>References</title><ref id="bib1"><label>1</label><element-citation publication-type="journal"><person-group 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The study was sponsored by a grant from Bode Chemie GmbH & Co., Hamburg, Germany.</p></ack></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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