Chapter 11 : Decontamination, Disinfection, and Sterilization

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Decontamination, Disinfection, and Sterilization, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555816728/9781555814632_Chap11-1.gif /docserver/preview/fulltext/10.1128/9781555816728/9781555814632_Chap11-2.gif


Most disinfectants were introduced to the market more than 30 years ago and little is known about their modes of action and the mechanisms of resistance. In addition, a few basic procedures in decontamination, disinfection, and sterilization have been tested in randomized clinical trials. This chapter cites highest level of evidence available. Even the definition of sterilization as the absence of any viable microorganisms must be revised to address the prions responsible for Creutzfeldt-Jakob disease (CJD) and variant CJD (vCJD). Semicritical equipment should be processed with a high-level disinfectant such as glutaraldehyde, stabilized hydrogen peroxide, peracetic acid, or a chlorine compound. The chapter discusses use of peracetic acid for chemical sterilization of instruments and endoscopes. Studies of sheep naturally infected with scrapie demonstrated that the infectious agent first appears in lymphatic tissue of the tonsils and gastrointestinal tract, suggesting the oral route may be the principal mode of transmission. Numerous studies underline the importance of the B cell in transmission of the bovine spongiform encephalopathy (BSE) agent. In May 2005, British officials published an excellent assessment of the risk for contaminating surgical instruments with prions. The key observation in this report is that on average 0.2 mg of protein remains on surgical instruments despite “standard cleaning and disinfection,” which was sufficient to cause an experimental case of CJD. Therefore, more research and new methods of cleaning and disinfection are needed for surgical instruments.

Citation: Widmer A, Frei R. 2011. Decontamination, Disinfection, and Sterilization, p 143-173. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch11

Key Concept Ranking

Herpes simplex virus 1
Severe Acute Respiratory Syndrome
Herpes simplex virus 2
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of FIGURE 1

Microorganisms' resistance to disinfectants. HSV, herpes simplex virus; CMV, cytomegalovirus; RSV, respiratory syncytial virus.

Citation: Widmer A, Frei R. 2011. Decontamination, Disinfection, and Sterilization, p 143-173. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch11
Permissions and Reprints Request Permissions
Download as Powerpoint


1. ADA Council on Scientific Affairs and ADA Council on Dental Practice. 1996. Infection control recommendations for the dental office and the dental laboratory. J. Am. Dent. Assoc. 127:672680.
2. Adams, B. G.,, and T. J. Marrie. 1982. Hand carriage of aerobic gram-negative rods may not be transient. J. Hyg. (London) 89:3346.
3. Agerton, T.,, S. Valway,, B. Gore,, C. Pozsik,, B. Plikaytis,, C. Woodley,, and I. Onorato. 1997. Transmission of a highly drug-resistant strain (strain W1) of Mycobacterium tuberculosis. Community outbreak and nosocomial transmission via a contaminated bronchoscope. JAMA 278:10731077.
4. Aguzzi, A.,, and M. Glatzel. 2004. vCJD tissue distribution and transmission by transfusion—a worst-case scenario coming true? Lancet 363:411412.
5. Aguzzi, A.,, and C. Weissmann. 1998. Spongiform encephalopathies. The prion’s perplexing persistence. Nature 392:763764.
6. Aiello, A. E.,, and E. Larson. 2003. Antibacterial cleaning and hygiene products as an emerging risk factor for antibiotic resistance in the community. Lancet Infect. Dis. 3:501506.
7. Akamatsu, T.,, K. Tabata,, M. Hironaga,, and M. Uyeda. 1997. Evaluation of the efficacy of a 3.2% glutaraldehyde product for disinfection of fibreoptic endoscopes with an automatic machine. J. Hosp. Infect. 35:4757.
8. Akbar-Khanzadeh, F.,, M. U. Vaquerano,, M. Akbar- Khanzadeh,, and M. S. Bisesi. 1994. Formaldehyde exposure, acute pulmonary response, and exposure control options in a gross anatomy laboratory. Am. J. Ind. Med. 26:6175.
9. Alasri, A.,, C. Roques,, G. Michel,, C. Cabassud,, and P. Aptel. 1992. Bactericidal properties of peracetic acid and hydrogen peroxide, alone and in combination, and chlorine and formaldehyde against bacterial water strains. Can. J. Microbiol. 38:635642.
10. Alasri, A.,, M. Valverde,, C. Roques,, G. Michel,, C. Cabassud,, and P. Aptel. 1993. Sporocidal properties of peracetic acid and hydrogen peroxide, alone and in combination, in comparison with chlorine and formaldehyde for ultrafiltration membrane disinfection. Can. J. Microbiol. 39:5260.
11. Alfa, M. J.,, P. DeGagne,, and N. Olson. 1997. Bacterial killing ability of 10% ethylene oxide plus 90% hydrochlorofluorocarbon sterilizing gas. Infect. Control. Hosp. Epidemiol. 18:641645.
12. Alvarado, C. J.,, M. Reichelderfer, et al. 2000. APIC guideline for infection prevention and control in flexible endoscopy. Am. J. Infect. Control 28:138155.
13. Anderson, R. L.,, R. W. Vess,, A. L. Panlilio,, and M. S. Favero. 1990. Prolonged survival of Pseudomonas cepacia in commercially manufactured povidone-iodine. Appl. Environ. Microbiol. 56:35983600.
14.Anonymous. 1994. Tentative final monograph for healthcare antiseptic drug products. Fed. Regist 59:3140131452.
15. Ansari, S. A.,, S. A. Sattar,, V. S. Springthorpe,, G. A. Wells,, and W. Tostowaryk. 1989. In vivo protocol for testing efficacy of hand-washing agents against viruses and bacteria: experiments with rotavirus and Escherichia coli. Appl. Environ. Microbiol. 55:31133118.
16. Arata, T.,, T. Murakami,, and Y. Hirai. 1993. Evaluation of povidone-iodine alcoholic solution for operative site disinfection. Postgrad. Med. J. 69(Suppl. 3):S93S96.
17. Archibald, L. K.,, A. Corl,, B. Shah,, M. Schulte,, M. J. Arduino,, S. Aguero,, D. J. Fisher,, B. W. Stechenberg,, S. N. Banerjee,, and W. R. Jarvis. 1997. Serratia marcescens outbreak associated with extrinsic contamination of 1% chlorxylenol soap. Infect Control. Hosp. Epidemiol. 18:704709.
18. Arnon, S. S.,, R. Schechter,, T. V. Inglesby,, D. A. Henderson,, J. G. Bartlett,, M. S. Ascher,, E. Eitzen,, A. D. Fine,, J. Hauer,, M. Layton,, S. Lillibridge,, M. T. Osterholm,, T. O’Toole,, G. Parker,, T. M. Perl,, P. K. Russell,, D. L. Swerdlow,, and K. Tonat. 2001. Botulinum toxin as a biological weapon: medical and public health management. JAMA 285:10591070.
19. Ascenzi, J. M., 1996. Glutaraldehyde-based disinfectants, p. 111132. In J. P. Ascenzi (ed. ), Handbook of Disinfectants and Antiseptics. Marcel Dekker, Inc. New York, NY.
20. Astagneau, P.,, N. Desplaces,, V. Vincent,, V. Chicheportiche,, A. Botherel,, S. Maugat,, K. Lebascle,, P. Leonard,, J. Desenclos,, J. Grosset,, J. Ziza,, and G. Brucker. 2001. Mycobacterium xenopi spinal infections after discovertebral surgery: investigation and screening of a large outbreak. Lancet 358:747751.
21. Axon, A.,, M. Jung,, A. Kruse,, T. Ponchon,, J. F. Rey,, U. Beilenhoff,, D. Duforest-Rey,, C. Neumann,, M. Pietsch,, K. Roth,, A. Papoz,, D. Wilson,, I. Kircher-Felgenstreff,, M. Stief,, R. Blum,, K. B. Spencer,, J. Mills,, E. P. Mart,, B. Slowey,, H. Biering,, U. Lorenz, et al. 2000. The European Society of Gastrointestinal Endoscopy (ESGE): check list for the purchase of washer-disinfectors for flexible endoscopes. Endoscopy 32:914919.
22. Bagg, J.,, C. P. Sweeney,, K. M. Roy,, T. Sharp,, and A. Smith. 2001. Cross infection control measures and the treatment of patients at risk of Creutzfeldt Jakob disease in UK general dental practice. Br. Dent. J. 191:8790.
23. Beilenhoff, U.,, C. S. Neumann,, J. F. Rey,, H. Biering,, R. Blum,, M. Cimbro,, B. Kampf,, M. Rogers,, and V. Schmidt. 2008. ESGE-ESGENA guideline: cleaning and disinfection in gastrointestinal endoscopy. Endoscopy 40:939957.
24. Beiswanger, B. B.,, M. E. Mallatt,, M. S. Mau,, R. D. Jackson,, and D. K. Hennon. 1990. The clinical effects of a mouthrinse containing 0. 1% octenidine. J. Dent. Res. 69:454457.
25. Belay, E. D.,, and L. B. Schonberger. 2005. The public health impact of prion diseases. Annu. Rev. Public Health 26:191212.
26. Bellamy, K.,, R. Alcock,, J. R. Babb,, J. G. Davies,, and G. A. Ayliffe. 1993. A test for the assessment of ‘hygienic’ hand disinfection using rotavirus. J. Hosp. Infect. 24:201210.
27. Berkelman, R. L.,, B. W. Holland,, and R. L. Anderson. 1982. Increased bactericidal activity of dilute preparations of povidone-iodine solutions. J. Clin. Microbiol. 15:635639.
28. Berkelman, R. L.,, S. Lewin,, J. R. Allen,, R. L. Anderson,, L. D. Budnick,, S. Shapiro,, S. M. Friedman,, P. Nicholas,, R. S. Holzman,, and R. W. Haley. 1981. Pseudobacteremia attributed to contamination of povidone-iodine with Pseudomonas cepacia. Ann. Intern. Med 95:3236.
29. Biron, F.,, B. Verrier,, and D. Peyramond. 1997. Transmission of the human immunodeficiency virus and the hepatitis C virus. N. Engl. J. Med. 337:348349.
30. Blanc, D. S.,, I. Nahimana,, C. Petignat,, A. Wenger,, J. Bille,, and P. Francioli. 2004. Faucets as a reservoir of endemic Pseudomonas aeruginosa colonization/infections in intensive care units. Intensive Care Med. 30:19641968.
31. Blanc, D. S.,, T. Parret,, B. Janin,, P. Raselli,, and P. Francioli. 1997. Nosocomial infections and pseudoinfections from contaminated bronchoscopes: two-year follow up using molecular markers. Infect. Control. Hosp. Epidemiol. 18:134136.
32. Blattler, T.,, S. Brandner,, A. J. Raeber,, M. A. Klein,, T. Voigtlander,, C. Weissmann,, and A. Aguzzi. 1997. PrPexpressing tissue required for transfer of scrapie infectivity from spleen to brain. Nature 389:6973.
33. Block, S. S. 2001. Disinfection, Sterilization, and Preservation. Lippincott Williams & Wilkins, Philadelphia, PA.
34. Bond, W. W.,, M. S. Favero,, N. J. Petersen,, and J. W. Ebert. 1983. Inactivation of hepatitis B virus by intermediate- to-high-level disinfectant chemicals. J. Clin. Microbiol. 18:535538.
35. 35 Borchardt, M. A.,, P. D. Bertz,, S. K. Spencer,, and D. A. Battigelli. 2003. Incidence of enteric viruses in groundwater from household wells in Wisconsin. Appl. Environ. Microbiol. 69:11721180.
36. Bosi, C.,, A. Davin-Regli,, R. Charrel,, B. Rocca,, D. Monnet,, and C. Bollet. 1996. Serratia marcescens nosocomial outbreak due to contamination of hexetidine solution. J. Hosp. Infect. 33:217224.
37. Bou, R.,, A. Aguilar,, J. Perpinan,, P. Ramos,, M. Peris,, L. Lorente,, and A. Zuniga. 2006. Nosocomial outbreak of Pseudomonas aeruginosa infections related to a flexible bronchoscope. J. Hosp. Infect. 64:129135.
38. Bowie, J. H.,, M. H. Kennedy,, and I. Robertson. 1975. Improved Bowie and Dick test. Lancet 1:1135.
39. Boyce, J. M.,, and M. L. Pearson. 2003. Low frequency of fires from alcohol-based hand rub dispensers in healthcare facilities. Infect. Control Hosp. Epidemiol. 24:618619.
40. Boyce, J. M.,, and D. Pittet. 2002. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect. Control Hosp. Epidemiol. 23:S3S40.
41. Boyce, J. M.,, G. Potter-Bynoe,, S. M. Opal,, L. Dziobek,, and A. A. Medeiros. 1990. A common-source outbreak of Staphylococcus epidermidis infections among patients undergoing cardiac surgery. J. Infect. Dis. 161:493499.
42. Bradley, C. R.,, J. R. Babb,, and G. A. Ayliffe. 1995. Evaluation of the Steris System 1 peracetic acid endoscope processor. J. Hosp. Infect. 29:143151.
43. Bradley, C. R.,, and A. P. Fraise. 1996. Heat and chemical resistance of enterococci. J. Hosp. Infect. 34:191196.
44. Brady, M. J.,, C. M. Lisay,, A. V. Yurkovetskiy,, and S. P. Sawan. 2003. Persistent silver disinfectant for the environmental control of pathogenic bacteria. Am. J. Infect. Control 31:208214.
45. Broadley, S. J.,, J. R. Furr,, P. A. Jenkins,, and A. D. Russell. 1993. Antimycobacterial activity of ‘Virkon’. J. Hosp. Infect. 23:189197.
46. Bronowicki, J. P.,, V. Venard,, C. Botte,, N. Monhoven,, I. Gastin,, L. Chone,, H. Hudziak,, B. Rhin,, C. Delanoe,, A. LeFaou,, M. A. Bigard,, and P. Gaucher. 1997. Patient-topatient transmission of hepatitis C virus during colonoscopy. N. Engl. J. Med. 337:237240.
47. Brown, P. 2001. Bovine spongiform encephalopathy and variant Creutzfeldt-Jakob disease. BMJ 322:841844.
48. Brown, P.,, P. P. Liberski,, A. Wolff,, and D. C. Gajdusek. 1990. Resistance of scrapie infectivity to steam autoclaving after formaldehyde fixation and limited survival after ashing at 360 degrees C: practical and theoretical implications. J. Infect. Dis. 161:467472.
49. Bruce, M. E.,, R. G. Will,, J. W. Ironside,, I. McConnell,, D. Drummond,, A. Suttie,, L. McCardle,, A. Chree,, J. Hope,, C. Birkett,, S. Cousens,, H. Fraser,, and C. J. Bostock. 1997. Transmissions to mice indicate that ‘new variant’ CJD is caused by the BSE agent. Nature 389:498501.
50. Bryant, W. P.,, and D. Zimmerman. 1995. Iodine-induced hyperthyroidism in a newborn. Pediatrics 95:434436.
51. Bryce, E. A.,, F. J. Roberts,, B. Clements,, and S. MacLean. 1997. When the biological indicator is positive: investigating autoclave failures. Infect. Control. Hosp. Epidemiol. 18:654656.
52.Centers for Disease Control. 1995. Management of Patients with Suspected Viral Hemorrhagic Fever—United States. MMWR. Morb. Mortal. Wkly. Rep. 44:475479.
53. Centers for Disease Control and Prevention. 1999. Bronchoscopy-related infections and pseudoinfections— New York, 1996 and 1998. MMWR Morb. Mortal. Wkly. Rep. 48:557560.
54. Centers for Disease Control and Prevention. 2001. Protracted outbreaks of cryptosporidiosis associated with swimming pool use—Ohio and Nebraska, 2000. MMWR Morb. Mortal. Wkly. Rep. 50:406410.
55.Centers for Disease Control and Prevention. 1989. Guidelines for prevention of transmission of human immunodeficiency virus and hepatitis B virus to health-care and public-safety workers. MMWR. Morb. Mortal. Wkly. Rep. 38(Suppl. 6):137.
56. Centers for Disease Control and Prevention. 1996. Community- level prevention of human immunodeficiency virus infection among high-risk populations: the AIDS community demonstration projects. MMWR Recommend. Rep. 45(RR-6):131.
57.Centers for Disease Control and Prevention. 1993. Recommended infection-control practices for dentistry. MMWR. Morb. Mortal. Wkly. Rep. 42:112.
58. Cetinkaya, Y.,, P. Falk,, and C. G. Mayhall. 2000. Vancomycin- resistant enterococci. Clin. Microbiol. Rev. 13:686707.
59. Cetre, J. C.,, M. C. Nicolle,, H. Salord,, M. Perol,, S. Tigaud,, G. David,, M. Bourjault,, and P. Vanhems. 2005. Outbreaks of contaminated broncho-alveolar lavage related to intrinsically defective bronchoscopes. J. Hosp. Infect. 61:3945.
60. Chamberland, M. E. 2002. Emerging infectious agents: do they pose a risk to the safety of transfused blood and blood products? Clin. Infect. Dis. 34:797805.
61. Charatan, F. 2001. United States takes precautions against BSE. West. J. Med. 174:235.
62. Chazot, G.,, E. Broussolle,, C. Lapras,, T. Blattler,, A. Aguzzi,, and N. Kopp. 1996. New variant of Creutzfeldt-Jakob disease in a 26-year-old French man. Lancet 347:1181.
63. Cheung, R. J.,, D. Ortiz,, and A. J. DiMarino, Jr. 1999. GI endoscopic reprocessing practices in the United States. Gastrointest. Endosc. 50:362368.
64. Chitnis, V.,, S. Chitnis,, S. Patil,, and D. Chitnis. 2004. Practical limitations of disinfection of body fluid spills with 10,000 ppm sodium hypochlorite (NaOCl). Am. J. Infect. Control 32:306308.
65. Chuanchuen, R.,, K. Beinlich,, T. T. Hoang,, A. Becher,, R. R. Karkhoff-Schweizer,, and H. P. Schweizer. 2001. Cross-resistance between triclosan and antibiotics in Pseudomonas aeruginosa is mediated by multidrug efflux pumps: exposure of a susceptible mutant strain to triclosan selects nfxB mutants overexpressing MexCDOpr J. Antimicrob. Agents Chemother. 45:428432.
66. Clay, S.,, S. Maherchandani,, Y. S. Malik,, and S. M. Goyal. 2006. Survival on uncommon fomites of feline calicivirus, a surrogate of noroviruses. Am. J. Infect. Control. 34:4143.
67. Coates, D. 1996. Sporicidal activity of sodium dichloroisocyanurate, peroxygen and glutaraldehyde disinfectants against Bacillus subtilis. J. Hosp. Infect. 32:283294.
68. Collins, F. M. 1986. Bactericidal activity of alkaline glutaraldehyde solution against a number of atypical mycobacterial species. J. Appl. Bacteriol. 61:247251.
69. Collins, F. M. 1986. Kinetics of the tuberculocidal response by alkaline glutaraldehyde in solution and on an inert surface. J. Appl. Bacteriol. 61:8793.
70. Collins, S. J.,, V. A. Lawson,, and C. L. Masters. 2004. Transmissible spongiform encephalopathies. Lancet 363:5161.
71. Corne, P.,, S. Godreuil,, H. Jean-Pierre,, O. Jonquet,, J. Campos,, E. Jumas-Bilak,, S. Parer,, and H. Marchandin. 2005. Unusual implication of biopsy forceps in outbreaks of Pseudomonas aeruginosa infections and pseudo-infections related to bronchoscopy. J. Hosp. Infect. 61:2026.
72. Craven, D. E.,, B. Moody,, M. G. Connolly,, N. R. Kollisch,, K. D. Stottmeier,, and W. R. McCabe. 1981. Pseudobacteremia caused by povidone-iodine solution contaminated with Pseudomonas cepacia. N. Engl. J. Med. 305:621623.
73. Crow, S. 1993. Steam sterilizers: an evolution in design. Infect. Control. Hosp. Epidemiol. 14:488490.
74. Cruse, P. J., and R. Foord. 1973. A five-year prospective study of 23,649 surgical wounds. Arch. Surg. 107:206210.
75. Dancer, S. J. 2008. Importance of the environment in meticillin-resistant Staphylococcus aureus acquisition: the case for hospital cleaning. Lancet Infect. Dis. 8:101113.
76. Darouiche, R. O.,, M. J. Wall, Jr.,, K. M. Itani,, M. F. Otterson,, A. L. Webb,, M. M. Carrick,, H. J. Miller,, S. S. Awad,, C. T. Crosby,, M. C. Mosier,, A. Alsharif,, and D. H. Berger. 2010. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N. Engl. J. Med. 362:1826.
77. Daschner, F. 1994. STERIS SYSTEM 1 in Germany. Infect. Control Hosp. Epidemiol. 15:294,296. (Letter and comment.)
78. de Lassence, A.,, N. Hidri,, J. F. Timsit,, M. L. Joly-Guillou,, G. Thiery,, A. Boyer,, P. Lable,, A. Blivet,, H. Kalinowski,, Y. Martin,, J. P. Lajonchere,, and D. Dreyfuss. 2006. Control and outcome of a large outbreak of colonization and infection with glycopeptide-intermediate Staphylococcus aureus in an intensive care unit. Clin. Infect. Dis. 42:170178.
79. Dennis, D. T.,, T. V. Inglesby,, D. A. Henderson,, J. G. Bartlett,, M. S. Ascher,, E. Eitzen,, A. D. Fine,, A. M. Friedlander,, J. Hauer,, M. Layton,, S. R. Lillibridge,, J. E. McDade,, M. T. Osterholm,, T. O’Toole,, G. Parker,, T. M. Perl,, P. K. Russell,, and K. Tonat. 2001. Tularemia as a biological weapon: medical and public health management. JAMA 285:27632773.
80. Denton, G. E., 1991. Chlorhexidine, p. 274289. In S. S. Block (ed.), Disinfection, Sterilization and Preservation. Lea & Febiger, Philadelphia, PA.
81. Dettenkofer, M.,, C. Wilson,, A. Gratwohl,, C. Schmoor,, H. Bertz,, R. Frei,, D. Heim,, D. Luft,, S. Schulz,, and A. F. Widmer. 2010. Skin disinfection with octenidine dihydrochloride for central venous catheter site care: a doubleblind, randomized, controlled trial. Clin. Microbiol. Infect. 16:600606.
82. Deva, A. K.,, K. Vickery,, J. Zou,, R. H. West,, J. P. Harris,, and Y. E. Cossart. 1996. Establishment of an in-use testing method for evaluating disinfection of surgical instruments using the duck hepatitis B model. J. Hosp. Infect. 33:119130.
83. Dharan, S.,, P. Mourouga,, P. Copin,, G. Bessmer,, B. Tschanz,, and D. Pittet. 1999. Routine disinfection of patients’ environmental surfaces. Myth or reality? J. Hosp. Infect. 42:113117.
84. DiazGranados, C. A.,, M. Y. Jones,, T. Kongphet-Tran,, N. White,, M. Shapiro,, Y. F. Wang,, S. M. Ray,, and H. M. Blumberg. 2009. Outbreak of Pseudomonas aeruginosa infection associated with contamination of a flexible bronchoscope. Infect. Control Hosp. Epidemiol. 30:550555.
85. Disch, K. 1994. Glucoprotamine—a new antimicrobial substance. Zentralbl. Hyg. Umweltmed. 195:357365.
86. Doebbeling, B. N.,, G. L. Stanley,, C. T. Sheetz,, M. A. Pfaller,, A. K. Houston,, L. Annis,, N. Li,, and R. P. Wenzel. 1992. Comparative efficacy of alternative hand-washing agents in reducing nosocomial infections in intensive care units. N. Engl. J. Med. 327:8893.
87. Dolce, P.,, M. Gourdeau,, N. April,, and P. M. Bernard. 1995. Outbreak of glutaraldehyde-induced proctocolitis. Am. J. Infect. Control 23:3439.
88. Dormont, D. 1996. How to limit the spread of Creutzfeldt- Jakob disease. Infect. Control Hosp. Epidemiol. 17:521528.
89. Druce, J. D.,, D. Jardine,, S. A. Locarnini,, and C. J. Birch. 1995. Susceptibility of HIV to inactivation by disinfectants and ultraviolet light. J. Hosp. Infect. 30:167180.
90. Evans, R. J. 1992. Acute anaphylaxis due to topical chlorhexidine acetate. BMJ 304:686.
91. Farina, A.,, M. H. Fievet,, F. Plassart,, M. C. Menet,, and A. Thuillier. 1999. Residual glutaraldehyde levels in fiberoptic endoscopes: measurement and implications for patient toxicity. J. Hosp. Infect. 43:293297.
92. Favero, M. S. 1991. Strategies for disinfection and sterilization of endoscopes: the gap between basic principles and actual practice. Infect. Control Hosp. Epidemiol. 12:279281.
93. Favero, M. S.,, and F. A. Manian. 1993. Is eliminating flash sterilization practical? Infect. Control Hosp. Epidemiol. 14:479480.
94. Feldman, H. I.,, M. Kinosian,, W. B. Bilker,, C. Simmons,, J. H. Holmes,, M. V. Pauly,, and J. J. Escarce. 1996. Effect of dialyzer reuse on survival of patients treated with hemodialysis. JAMA 276:1724.
95. Fenner, L.,, A. F. Widmer,, A. Stranden,, M. Conzelmann,, A. Goorhuis,, C. Harmanus,, E. J. Kuijper,, and R. Frei. 2008. First cluster of clindamycin-resistant Clostridium difficile PCR ribotype 027 in Switzerland. Clin. Microbiol. Infect. 14:514515.
96. Fichet, G.,, E. Comoy,, C. Duval,, K. Antloga,, C. Dehen,, A. Charbonnier,, G. McDonnell,, P. Brown,, C. I. Lasmezas,, and J. P. Deslys. 2004. Novel methods for disinfection of prioncontaminated medical devices. Lancet 364:521526.
97. Flynn, N.,, S. Jain,, E. M. Keddie,, J. R. Carlson,, M. B. Jennings,, H. W. Haverkos,, N. Nassar,, R. Anderson,, S. Cohen,, and D. Goldberg. 1994. In vitro activity of readily available household materials against HIV-1: is bleach enough? J. Acquir. Immune. Defic. Syndr. 7:747753.
98. Fraise, A. P.,, P. A. Lambert,, and J. Y. Maillard. 2004. Russell, Hugo and Ayliffe’s Principles and Practice of Disinfections, Preservation and Sterilization. Blackwell Publishing, Malden, MA.
99. Frank, M. J.,, and W. Schaffner. 1976. Contaminated aqueous benzalkonium chloride. An unnecessary hospital infection hazard. JAMA 236:24182419.
100. Fraser, T. G.,, S. Reiner,, M. Malczynski,, P. R. Yarnold,, J. Warren,, and G. A. Noskin. 2004. Multidrug-resistant Pseudomonas aeruginosa cholangitis after endoscopic retrograde cholangiopancreatography: failure of routine endoscope cultures to prevent an outbreak. Infect. Control Hosp. Epidemiol. 25:856859.
101. Fraser, V. J.,, G. Zuckerman,, R. E. Clouse,, S. O’Rourke,, M. Jones,, J. Klasner,, and P. Murray. 1993. A prospective randomized trial comparing manual and automated endoscope disinfection methods. Infect. Control Hosp. Epidemiol. 14:383389.
102. Fraud, S.,, J. Y. Maillard,, and A. D. Russell. 2001. Comparison of the mycobactericidal activity of ortho-phthalaldehyde, glutaraldehyde and other dialdehydes by a quantitative suspension test. J. Hosp. Infect. 48:214221.
103. Furuhashi, M.,, and T. Miyamae. 1979. Effect of pre-operative hand scrubbing and influence of pinholes appearing in surgical rubber gloves during operation. Bull. Tokyo. Med. Dent. Univ. 26:7380.
104. Fuselier, H. A. J.,, and C. Mason. 1997. Liquid sterilization versus high level disinfection in the urologic office. Urology. 50:337340.
105. Fuursted, K.,, A. Hjort,, and L. Knudsen. 1997. Evaluation of bactericidal activity and lag of regrowth (postantibiotic effect) of five antiseptics on nine bacterial pathogens. J. Antimicrob. Chemother. 40:221226.
106. Gamage, B.,, D. Moore,, R. Copes,, A. Yassi,, and E. Bryce. 2005. Protecting HCWs from SARS and other respiratory pathogens: a review of the infection control literature. Am. J. Infect. Control 33:114121.
107. Garibaldi, R. A.,, D. Skolnick,, T. Lerer,, A. Poirot,, J. Graham,, E. Krisuinas,, and R. Lyons. 1988. The impact of preoperative skin disinfection on preventing intraoperative wound contamination. Infect. Control Hosp. Epidemiol. 9:109113.
108. Gelinas, P.,, J. Goulet,, G. M. Tastayre,, and G. A. Picard. 1991. Effect of temperature and contact time on the activity of eight disinfectants—a classification. J. Food Prot. 47:841847.
109. Georgiade, G.,, R. Riefkohl,, N. Georgiade,, R. Georgiade,, and M. F. Wildman. 1985. Efficacy of povidone-iodine in preoperative skin preparation. J Hosp. Infect 6(Suppl. A):6771.
110. Ghannoum, M. A.,, K. A. Elteen,, M. Ellabib,, and P. A. Whittaker. 1990. Antimycotic effects of octenidine and pirtenidine. J. Antimicrob. Chemother. 25:237245.
111. Gillespie, T. G.,, L. Hogg,, E. Budge,, A. Duncan,, and J. E. Coia. 2000. Mycobacterium chelonae isolated from rinse water within an endoscope washer-disinfector. J. Hosp. Infect. 45:332334.
112. Glatzel, M.,, K. Stoeck,, H. Seeger,, T. Luhrs,, and A. Aguzzi. 2005. Human prion diseases: molecular and clinical aspects. Arch. Neurol. 62:545552.
113. Gorse, G. J.,, and R. L. Messner. 1991. Infection control practices in gastrointestinal endoscopy in the United States: a national survey. Infect. Control Hosp. Epidemiol. 12:289296.
114. Gottardi, W., 1991. Iodine and iodine compounds, p. 152166. In S. S. Block (ed.), Disinfection, Sterilization and Preservation. Lea & Febiger, Philadelphia.
115. Graham, G. S., 1997. Decontamination: scientific principles, p. 19. In M. Reichert, and J. H. Young (ed.), Sterilization Technology. Aspen Publishers, Gaithersburg, MD.
116. Griffiths, P. A.,, J. R. Babb,, C. R. Bradley,, and A. P. Fraise. 1997. Glutaraldehyde-resistant Mycobacterium chelonae from endoscope washer disinfectors. J. Appl. Microbiol. 82:519526.
117. Gubler, J. G.,, M. Salfinger,, and A. von Graevenitz. 1992. Pseudoepidemic of nontuberculous mycobacteria due to a contaminated bronchoscope cleaning machine. Report of an outbreak and review of the literature. Chest 101:12451249.
118. Gurevich, I.,, R. Dubin,, and B. A. Cunha. 1996. Dental instrument and device sterilization and disinfection practices. J. Hosp. Infect. 32:295304.
119. Gurevich, I.,, S. M. Qadri,, and B. A. Cunha. 1993. False- positive results of spore tests from improper clip use with the STERIS chemical sterilant system. Am. J. Infect. Control. 21:4243.
120. Gurevich, I.,, P. Tafuro,, P. Ristuccia,, J. Herrmann,, A. R. Young,, and B. A. Cunha. 1983. Disinfection of respirator tubing: a comparison of chemical versus hot water machineassisted processing. J. Hosp. Infect. 4:199208.
121. Hall, C. B.,, and R. G. Douglas, Jr. 1981. Modes of transmission of respiratory syncytial virus. J. Pediatr. 99:100103.
122. Hamilton, E.,, D. V. Seal,, and J. Hay. 1996. Comparison of chlorine and chlorine dioxide disinfection for control of Legionella in a hospital potable water supply. J Hosp. Infect 32:156160.
123. Hanson, P. J.,, D. Gor,, J. R. Clarke,, M. V. Chadwick,, B. Gazzard,, D. J. Jeffries,, H. Gaya,, and J. V. Collins. 1991. Recovery of the human immunodeficiency virus from fibreoptic bronchoscopes. Thorax 46:410412.
124. Hanson, P. J.,, D. J. Jeffries,, and J. V. Collins. 1991. Viral transmission and fibreoptic endoscopy. J. Hosp. Infect. 18 (Suppl. A):136140.
125. Heikenwalder, M.,, N. Zeller,, H. Seeger,, M. Prinz,, P. C. Klohn,, P. Schwarz,, N. H. Ruddle,, C. Weissmann,, and A. Aguzzi. 2005. Chronic lymphocytic inflammation specifies the organ tropism of prions. Science 307:11071110.
126. Held, P. J.,, R. A. Wolfe,, D. S. Gaylin,, F. K. Port,, N. W. Levin,, and M. N. Turenne. 1994. Analysis of the association of dialyzer reuse practices and patient outcomes. Am. J. Kidney Dis. 23:692708.
127. Helms, C. M.,, R. M. Massanari,, R. P. Wenzel,, M. A. Pfaller,, N. P. Moyer,, and N. Hall. 1988. Legionnaires’ disease associated with a hospital water system. A five-year progress report on continuous hyperchlorination. JAMA 259:24232427.
128. Henderson, D. A.,, T. V. Inglesby,, J. G. Bartlett,, M. S. Ascher,, E. Eitzen,, P. B. Jahrling,, J. Hauer,, M. Layton,, J. McDade,, M. T. Osterholm,, T. O’Toole,, G. Parker,, T. Perl,, P. K. Russell,, K. Tonat, et al. 1999. Smallpox as a biological weapon: medical and public health management. JAMA 281:21272137.
129. Herzog, C.,, N. Sales,, N. Etchegaray,, A. Charbonnier,, S. Freire,, D. Dormont,, J. P. Deslys,, and C. I. Lasmezas. 2004. Tissue distribution of bovine spongiform encephalopathy agent in primates after intravenous or oral infection. Lancet 363:422428.
130. Hill, A. F.,, M. Desbruslais,, S. Joiner,, K. C. Sidle,, I. Gowland,, J. Collinge,, L. J. Doey,, and P. Lantos. 1997. The same prion strain causes vCJD and BSE. Nature 389:448450.
131. Holmes, K. V. 2003. SARS-associated coronavirus. N. Engl. J. Med. 348:19481951.
132. Holton, J.,, and N. Shetty. 1997. In-use stability of N u-Cidex. J. Hosp. Infect 35:245248.
133. Houston, F.,, J. D. Foster,, A. Chong,, N. Hunter,, and C. J. Bostock. 2000. Transmission of BSE by blood transfusion in sheep. Lancet 356:9991000.
134. Hughes, R.,, and S. Kilvington. 2001. Comparison of hydrogen peroxide contact lens disinfection systems and solutions against Acanthamoeba polyphaga. Antimicrob. Agents Chemother. 45:20382043.
135. Hussaini, S. N.,, and K. R. Ruby. 1976. Sporicidal activity of peracetic acid against B. anthracis spores. Vet. Rec. 98:257259.
136. Im, S. W.,, J. P. Fung,, S. Y. So,, and D. Y. Yu. 1982. Unusual dissemination of pseudomonads by ventilators. Anaesthesia 37:10741077.
137. Inglesby, T. V.,, D. T. Dennis,, D. A. Henderson,, J. G. Bartlett,, M. S. Ascher,, E. Eitzen,, A. D. Fine,, A. M. Friedlander,, J. Hauer,, J. F. Koerner,, M. Layton,, J. McDade,, M. T. Osterholm,, T. O’Toole,, G. Parker,, T. M. Perl,, P. K. Russell,, M. Schoch-Spana,, K. Tonat, et al. 2000. Plague as a biological weapon: medical and public health management. JAMA 283:22812290.
138. Inglesby, T. V.,, D. A. Henderson,, J. G. Bartlett,, M. S. Ascher,, E. Eitzen,, A. M. Friedlander,, J. Hauer,, J. Mc- Dade,, M. T. Osterholm,, T. O’Toole,, G. Parker,, T. M. Perl,, P. K. Russell,, K. Tonat, et al. 1999. Anthrax as a biological weapon: medical and public health management. JAMA 281:17351745.
139. Isenberg, S. J.,, L. Apt,, and M. Wood. 1995. A controlled trial of povidone-iodine as prophylaxis against ophthalmia neonatorum. N. Engl. J. Med. 332:562566.
140. Jackson, J.,, J. E. Leggett,, D. A. Wilson,, and D. N. Gilbert. 1996. Mycobacterium gordonae in fiberoptic bronchoscopes. Am. J. Infect. Control. 24:1923.
141. Jones, R. D.,, H. B. Jampani,, J. L. Newman,, and A. S. Lee. 2000. Triclosan: a review of effectiveness and safety in health care settings. Am. J. Infect Control 28:184196.
142. Joslyn, L. J., 1991. Sterilization by heat, p. 495526. In S. S. Block (ed. ), Disinfection, Sterilization and Preservation. Lea & Febiger, Philadelphia, PA.
143. Kaatz, G. W.,, S. D. Gitlin,, D. R. Schaberg,, K. H. Wilson,, C. A. Kauffman,, S. M. Seo,, and R. Fekety. 1988. Acquisition of Clostridium difficile from the hospital environment. Am. J. Epidemiol. 127:12891293.
144. Kaczmarek, R. G.,, R. M. J. Moore,, J. McCrohan,, D. A. Goldmann,, C. Reynolds,, C. Caquelin,, and E. Israel. 1992. Multi-state investigation of the actual disinfection/sterilization of endoscopes in health care facilities. Am. J. Med. 92:257261.
145. Kampf, G.,, R. Bloss,, and H. Martiny. 2004. Surface fixation of dried blood by glutaraldehyde and peracetic acid. J. Hosp. Infect. 57:139143.
146. Kampf, G.,, and A. Kramer. 2004. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin. Microbiol. Rev. 17:863893.
147. Kampf, G.,, C. Ostermeyer,, and P. Heeg. 2005. Surgical hand disinfection with a propanol-based hand rub: equivalence of shorter application times. J. Hosp. Infect. 59:304310.
148. Karol, M. H. 1995. Toxicologic principles do not support the banning of chlorine. A Society of Toxicology position paper. Fundam. Appl. Toxicol. 24:12.
149. Kawashima, T.,, H. Furukawa,, K. Doh-ura,, and T. Iwaki. 1997. Diagnosis of new variant Creutzfeldt-Jakob disease by tonsil biopsy. Lancet 350:6869.
150. Khanna, N.,, D. Goldenberger,, P. Graber,, M. Battegay,, and A. F. Widmer. 2003. Gastroenteritis outbreak with norovirus in a Swiss university hospital with a newly identified virus strain. J. Hosp. Infect. 55:131136.
151. Klein, M.,, and A. DeForest. 1963. The inactivation of viruses by germicides. Chem. Specialists Manuf. Assoc. Proc. 49:116118.
152. Klein, M. A.,, R. Frigg,, E. Flechsig,, A. J. Raeber,, U. Kalinke,, H. Bluethman,, F. Bootz,, J. Suter,, R. M. Zinkernagel,, and A. Aguzzi. 1997. A crucial role for B cells in neuroinvasive scrapie. Nature 390:687.
153. Kobayashi, H.,, M. Tsuzuki,, K. Koshimizu,, H. Toyama,, N. Yoshihara,, T. Shikata,, K. Abe,, K. Mizuno,, N. Otomo,, and T. Oda. 1984. Susceptibility of hepatitis B virus to disinfectants or heat. J. Clin. Microbiol. 20:214216.
154. Kool, J. L.,, J. C. Carpenter,, and B. S. Fields. 1999. Effect of monochloramine disinfection of municipal drinking water on risk of nosocomial Legionnaires’ disease. Lancet 353:272277.
155. Kralovic, R. C. 1993. Use of biological indicators designed for steam or ethylene oxide to monitor a liquid chemical sterilization process. Infect. Control Hosp. Epidemiol. 14:313319.
156. Kramer, A.,, P. Rudolph,, G. Kampf,, and D. Pittet. 2002. Limited efficacy of alcohol-based hand gels. Lancet 359:14891490.
157. Kurtz, J. B.,, T. W. Lee,, and A. J. Parsons. 1980. The action of alcohols on rotavirus, astrovirus and enterovirus. J. Hosp. Infect. 1:321325.
158. Lai, M. Y.,, P. K. Cheng,, and W. W. Lim. 2005. Survival of severe acute respiratory syndrome coronavirus. Clin. Infect. Dis. 41:e67e71.
159. Larson, E. 1988. Guideline for use of topical antimicrobial agents. Am. J. Infect. Control. 16:253266.
160. Larson, E. L., 1991. Alcohols, p. 191203. In S. S. Block (ed.), Disinfection, Sterilization and Preservation. Lea & Febiger, Philadelphia, PA.
161. Larson, E. L.,, A. M. Butz,, D. L. Gullette,, and B. A. Laughon. 1990. Alcohol for surgical scrubbing? Infect. Control. Hosp. Epidemiol. 11:139143.
162. Leaper, S. 1984. Influence of temperature on the synergistic sporicidal effect of peracetic acid plus hydrogen peroxide in Bacillus subtilis SA22 (NCA 72-52). Food Microbiol 1:199203.
163. Levenson, J. E. 1989. Corneal damage from improperly cleaned tonometer tips. Arch. Ophthalmol. 107:1117.
164. Lever, A. M.,, and S. V. W. Sutton,. 1996. Antimicrobial effects of hydrogen peroxide as an antiseptic and disinfectant, p. 159176. In J. P. Ascenzi (ed. ), Handbook of Disinfectants and Antiseptics. Marcel Dekker, Inc., New York, NY.
165. Lowbury, E. J.,, and H. A. Lilly. 1974. The effect of blood on disinfection of surgeons’ hands. Br. J. Surg. 61:1921.
166. Lowbury, E. J.,, H. A. Lilly,, and J. P. Bull. 1964. Methods for disinfection of operation sites. Br. Med. J. 2:531533.
167. Maillard, J. Y. 2002. Bacterial target sites for biocide action. J. Appl. Microbiol. 92 (Suppl.):16S27S.
168. Maki, D. G.,, and C. A. Hassemer. 1987. Flash sterilization: carefully measured haste. Infect. Control 8:307310.
169. Maki, D. G.,, S. M. Stolz,, S. Wheeler,, and L. A. Mermel. 1997. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. A randomized, controlled trial. Ann. Intern. Med. 127:257266.
170. Mangram, A. J.,, T. C. Horan,, M. L. Pearson,, L. C. Silver,, W. R. Jarvis, et al. 1999. Guideline for prevention of surgical site infection, 1999. Infect. Control Hosp. Epidemiol. 20:250278.
171. Mannion, P. T. 1995. The use of peracetic acid for the reprocessing of flexible endoscopes and rigid cystoscopes and laparoscopes. J. Hosp. Infect. 29:313315.
172. Martin, L. S.,, J. S. McDougal,, and S. L. Loskoski. 1985. Disinfection and inactivation of the human T lymphotropic virus type II/lymphadenopathy-associated virus. J. Infect. Dis. 152:400403.
173. Martin, M. A.,, M. Reichelderfer, et al. 1994. APIC guidelines for infection prevention and control in flexible endoscopy. Am. J. Infect. Control. 22:1938.
174. Mathers, W. D.,, J. E. Sutphin,, R. Folberg,, P. A. Meier,, R. P. Wenzel,, and R. G. Elgin. 1996. Outbreak of keratitis presumed to be caused by Acanthamoeba. Am. J. Ophthalmol. 121:129142.
175. Mayer, S.,, M. Boos,, A. Beyer,, A. C. Fluit,, and F. J. Schmitz. 2001. Distribution of the antiseptic resistance genes qacA, qacB and qacC in 497 methicillin-resistant and -susceptible European isolates of Staphylococcus aureus. J. Antimicrob. Chemother. 47:896897.
176. Mbithi, J. N.,, V. S. Springthorpe,, and S. A. Sattar. 1990. Chemical disinfection of hepatitis A virus on environmental surfaces. Appl. Environ. Microbiol. 56:36013604.
177. Mbithi, J. N.,, V. S. Springthorpe,, S. A. Sattar,, and M. Pacquette. 1993. Bactericidal, virucidal, and mycobactericidal activities of reused alkaline glutaraldehyde in an endoscopy unit. J. Clin. Microbiol. 31:29882995.
178. McDonald, L. C.,, G. E. Killgore,, A. Thompson,, R. C. Owens, Jr.,, S. V. Kazakova,, S. P. Sambol,, S. Johnson,, and D. N. Gerding. 2005. An epidemic, toxin gene-variant strain of Clostridium difficile. N. Engl. J. Med. 353:24332441.
179. McDonnell, G.,, and A. D. Russell. 1999. Antiseptics and disinfectants: activity, action, and resistance. Clin. Microbiol. Rev. 12:147179.
180. Mentel, R.,, and J. Schmidt. 1973. Investigations on rhinovirus inactivation by hydrogen peroxide. Acta Virol. 17:351354.
181. Merianos, J. J., 1991. Quaternary ammonium antimicrobial compounds, p. 225255. In S. S. Block (ed. ), Disinfection, Sterilization and Preservation. Lea & Febiger, Philadelphia, PA.
182. Mermel, L. A.,, S. L. Josephson,, J. Dempsey,, S. Parenteau,, C. Perry,, and N. Magill. 1997. Outbreak of Shigella sonnei in a clinical microbiology laboratory. J. Clin. Microbiol. 35:31633165.
183. Meyer, B.,, and C. Kluin. 1999. Efficacy of Glucoprotamin containing disinfectants against different species of atypical mycobacteria. J. Hosp. Infect. 42:151154.
184. Michele, T. M.,, W. A. Cronin,, N. M. Graham,, D. M. Dwyer,, D. S. Pope,, S. Harrington,, R. E. Chaisson,, and W. R. Bishai. 1997. Transmission of Mycobacterium tuberculosis by a fiberoptic bronchoscope. Identification by DNA fingerprinting. JAMA 278:10931095.
185. Middleton, A. M.,, M. V. Chadwick,, J. L. Sanderson,, and H. Gaya. 2000. Comparison of a solution of super-oxidized water (Sterilox) with glutaraldehyde for the disinfection of bronchoscopes, contaminated. J. Hosp. Infect. 45:278282.
186. Milstone, A. M.,, C. L. Passaretti,, and T. M. Perl. 2008. Chlorhexidine: expanding the armamentarium for infection control and prevention. Clin. Infect. Dis. 46:274281.
187. Misteli, H.,, W. P. Weber,, S. Reck,, R. Rosenthal,, M. Zwahlen,, P. Fueglistaler,, M. K. Bolli,, D. Oertli,, A. F. Widmer,, and W. R. Marti. 2009. Surgical glove perforation and the risk of surgical site infection. Arch. Surg. 144:553558.
188. Mitchell, B. A.,, M. H. Brown,, and R. A. Skurray. 1998. QacA multidrug efflux pump from Staphylococcus aureus: comparative analysis of resistance to diamidines, biguanidines, and guanylhydrazones. Antimicrob. Agents Chemother. 42:475477.
189. Nakashima, A. K.,, A. K. Highsmith,, and W. J. Martone. 1987. Survival of Serratia marcescens in benzalkonium chloride and in multiple-dose medication vials: relationship to epidemic septic arthritis. J. Clin. Microbiol. 25:10191021.
190. Narang, H. K.,, and A. A. Codd. 1983. Action of commonly used disinfectants against enteroviruses. J Hosp. Infect 4:209212.
191. Nelson, D. B.,, W. R. Jarvis,, W. A. Rutala,, A. E. Foxx- Orenstein,, G. Isenberg,, G. R. Dash,, C. J. Alvarado,, M. Ball,, J. Griffin-Sobel,, C. Petersen,, K. A. Ball,, J. Henderson,, R. L. Stricof, et al. 2003. Multi-society guideline for reprocessing flexible gastrointestinal endoscopes. Infect. Control Hosp. Epidemiol. 24:532537.
192. Neumann, G.,, T. Noda,, and Y. Kawaoka. 2009. Emergence and pandemic potential of swine-origin H1N1 influenza virus. Nature. 459:931939.
193. O’Connor, D. O.,, and J. R. Rubino,. 1991. Phenolic compounds, p. 204224. In S. S. Block (ed. ), Disinfection, Sterilization and Preservation. Lea & Febiger, Philadelphia, PA.
194. Oie, S.,, and A. Kamiya 1996. Microbial contamination of antiseptics and disinfectants. Am. J. Infect. Control. 24:389395.
195. Parker, F.,, and S. Foran. 1995. Chlorhexidine catheter lubricant anaphylaxis. Anaesth. Intensive Care 23:126.
196. Patterson, P. 2009. CDC sterilization, disinfection guideline. OR Manager 25:1416.
197. Perencevich, E. N.,, M. T. Wong,, and A. D. Harris. 2001. National and regional assessment of the antibacterial soap market: a step toward determining the impact of prevalent antibacterial soaps. Am. J. Infect. Control 29:281283.
198. Piazza, M.,, G. Borgia,, L. Picciotto,, S. Nappa,, S. Cicciarello,, and R. Orlando. 1995. Detection of hepatitis C virus-RNA by polymerase chain reaction in dental surgeries. J. Med. Virol. 45:4042.
199. Pittet, D.,, S. Hugonnet,, S. Harbarth,, P. Mourouga,, V. Sauvan,, S. Touveneau,, and T. V. Perneger. 2000. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 356:13071312.
200. Price, P. B. 1938. The bacteriology of normal skin; a new quantitative test applied to a study of the bacterial biota and the disinfectant action of mechanical cleansing. J. Infect. Dis. 63:301318.
201. Pronovost, P.,, D. Needham,, S. Berenholtz,, D. Sinopoli,, H. Chu,, S. Cosgrove,, B. Sexton,, R. Hyzy,, R. Welsh,, G. Roth,, J. Bander,, J. Kepros,, and C. Goeschel. 2006. An intervention to decrease catheter-related bloodstream infections in the ICU. N. Engl. J. Med. 355:27252732.
202. Prusiner, S. B. 1982. Novel proteinaceous infectious particles cause scrapie. Science 216:136144.
203. Prusiner, S. B. 1997. Prion diseases and the BSE crisis. Science 278:245251.
204. Ranganathan, N. S., 1996. Chlorhexidine, p. 235264. In J. P. Ascenzi (ed.), Handbook of Disinfectants and Antiseptics. Marcel Dekker, Inc., New York, NY.
205. Reiss, I.,, A. Borkhardt,, R. Fussle,, A. Sziegoleit,, and L. Gortner. 2000. Disinfectant contaminated with Klebsiella oxytoca as a source of sepsis in babies. Lancet 356:310.
206. Robertson, L. J.,, A. T. Campbell,, and H. V. Smith. 1992. Survival of Cryptosporidium parvum oocysts under various environmental pressures. Appl. Environ. Microbiol. 58:34943500.
207. Rossmoore, H. W.,, and M. Sondossi. 1988. Applications and mode of action of formaldehyde condensate biocides. Adv. Appl. Microbiol. 33:223277.
208. Rotter, M. A., 1996. Alcohols for antisepsis of hands and skin, p. 177234. In J. P. Ascenzi (ed. ), Handbook of Disinfectants and Antiseptics. Marcel Dekker, Inc., New York, NY.
209. Rotter, M. L.,, W. Koller,, G. Wewalka,, H. P. Werner,, G. A. Ayliffe,, and J. R. Babb. 1986. Evaluation of procedures for hygienic hand-disinfection: controlled parallel experiments on the Vienna test model. J. Hyg. (London) 96:2737.
210. Rotter, M. L.,, S. O. Larsen,, E. M. Cooke,, J. Dankert,, F. Daschner,, D. Greco,, P. Gronross,, O. B. Jepsen,, A. Lystad,, B. Nystrom, et al. 1988. A comparison of the effects of preoperative whole-body bathing with detergent alone and with detergent containing chlorhexidine gluconate on the frequency of wound infections after clean surgery. J. Hosp. Infect. 11:310320.
211. Rotter, M. L.,, R. A. Simpson,, and W. Koller. 1998. Surgical hand disinfection with alcohols at various concentrations: parallel experiments using the new proposed European standards method. Infect. Control Hosp. Epidemiol. 19:778781.
212. Rubbo, S. D.,, J. F. Gardner,, and R. L. Webb. 1967. Biocidal activities of glutaraldehyde and related compounds. J. Appl. Bacteriol. 30:7887.
213. Russell, A. D. 1994. Glutaraldehyde: current status and uses. Infect. Control Hosp. Epidemiol. 15:724733.
214. Russell, A. D. 2004. Whither triclosan? J. Antimicrob. Chemother. 53:693695.
215. Russell, A. D.,, W. B. Hugo,, and G. A. J. Ayliffe. 1992. Principles and Practice of Disinfection, Preservation and Sterilization. Blackwell Scientific Publications, London, United Kingdom.
216. Rutala, W. A., et al. 1996. APIC guideline for selection and use of disinfectants. Am. J. Infect. Control. 24:313342.
217. Rutala, W. A. 1996. Disinfection and sterilization of patientcare items. Infect. Control Hosp. Epidemiol. 17:377384.
218. Rutala, W. A.,, and E. C. Cole. 1987. Ineffectiveness of hospital disinfectants against bacteria: a collaborative study. Infect. Control 8:501506.
219. Rutala, W. A.,, E. C. Cole,, N. S. Wannamaker,, and D. J. Weber. 1991. Inactivation of Mycobacterium tuberculosis and Mycobacterium bovis by 14 hospital disinfectants. Am. J Med. 91:267S271S.
220. Rutala, W. A.,, M. F. Gergen,, and D. J. Weber. 1993. Evaluation of a rapid readout biological indicator for flash sterilization with three biological indicators and three chemical indicators. Infect. Control. Hosp. Epidemiol. 14:390394.
221. Rutala, W. A.,, M. F. Gergen,, and D. J. Weber. 1993. Inactivation of Clostridium difficile spores by disinfectants. Infect Control Hosp. Epidemiol. 14:3639.
222. Rutala, W. A.,, M. F. Gergen,, and D. J. Weber. 1999. Sporicidal activity of a new low-temperature sterilization technology: the Sterrad 50 sterilizer. Infect. Control Hosp. Epidemiol. 20:514516.
223. Rutala, W. A.,, S. M. Jones,, and D. J. Weber. 1996. Comparison of a rapid readout biological indicator for steam sterilization with four conventional biological indicators and five chemical indicators. Infect. Control Hosp. Epidemiol. 17:423428.
224. Rutala, W. A.,, and D. J. Weber. 1995. FDA labeling requirements for disinfection of endoscopes: a counterpoint. Infect. Control Hosp. Epidemiol. 16:231235.
225. Rutala, W. A.,, and D. J. Weber. 1997. Uses of inorganic hypochlorite (bleach) in health-care facilities. Clin. Microbiol. Rev. 10:597610.
226. Rutala, W. A.,, and D. J. Weber. 1999. Disinfection of endoscopes: review of new chemical sterilants used for high-level disinfection. Infect. Control Hosp. Epidemiol. 20:6976.
227. Rutala, W. A.,, and D. J. Weber. 2001. New disinfection and sterilization methods. Emerg. Infect. Dis. 7:348353.
228. Rutala, W. A.,, and D. J. Weber. 2004. Disinfection and sterilization in health care facilities: what clinicians need to know. Clin. Infect. Dis. 39:702709.
229. Rutala, W. A.,, and D. J. Weber. 2010. Guideline for disinfection and sterilization of prion-contaminated medical instruments. Infect. Control Hosp. Epidemiol. 31:107117.
230. Rutala, W. A.,, D. J. Weber,, and K. J. Chappell. 1999. Patient injury from flash-sterilized instruments. Infect. Control Hosp. Epidemiol. 20:458.
231. Rutala, W. A.,, D. J. Weber,, C. A. Thomann,, J. F. John,, S. M. Saviteer,, and F. A. Sarubbi. 1988. An outbreak of Pseudomonas cepacia bacteremia associated with a contaminated intra-aortic balloon pump. J. Thorac. Cardiovasc. Surg. 96:157161.
232. Ryan, C. K.,, and G. D. Potter. 1995. Disinfectant colitis. Rinse as well as you wash. J. Clin. Gastroenterol. 21:69.
233. Sagripanti, J. L. 1992. Metal-based formulations with high microbicidal activity. Appl. Environ. Microbiol. 58:31573162.
234. Sagripanti, J. L.,, and A. Bonifacino. 1996. Comparative sporicidal effect of liquid chemical germicides on three medical devices contaminated with spores of Bacillus subtilis. Am. J. Infect. Control 24:364371.
235. Sagripanti, J. L.,, C. A. Eklund,, P. A. Trost,, K. C. Jinneman,, C. J. Abeyta,, C. A. Kaysner,, and W. E. Hill. 1997. Comparative sensitivity of 13 species of pathogenic bacteria to seven chemical germicides. Am. J. Infect. Control 25:335339.
236. Sailer, A.,, H. Bueler,, M. Fischer,, A. Aguzzi,, and C. Weissmann. 1994. No propagation of prions in mice devoid of PrP. Cell 77:967968.
237. Samore, M. H.,, L. Venkataraman,, P. C. DeGirolami,, R. D. Arbeit,, and A. W. Karchmer. 1996. Clinical and molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea. Am. J. Med. 100:3240.
238. Sattar, S. A.,, H. Jacobsen,, H. Rahman,, T. M. Cusack,, and J. R. Rubino. 1994. Interruption of rotavirus spread through chemical disinfection. Infect. Control. Hosp. Epidemiol. 15:751756.
239. Saurina, G.,, D. Landman,, and J. M. Quale. 1997. Activity of disinfectants against vancomycin-resistant Enterococcus faecium. Infect. Control Hosp. Epidemiol. 18:345347.
240. Schelenz, S.,, and G. French. 2000. An outbreak of multidrug- resistant Pseudomonas aeruginosa infection associated with contamination of bronchoscopes and an endoscope washer-disinfector. J. Hosp. Infect. 46:2330.
241. Scherrer, M.,, and K. Kümmerer. 1997. Manual and automated processing of medical instruments. Environmental and economic aspects. Central Service 5:183194.
242. Sedlock, D. M.,, and D. M. Bailey. 1985. Microbicidal activity of octenidine hydrochloride, a new alkanediylbis[pyridine] germicidal agent. Antimicrob. Agents Chemother. 28:786790.
243. Sehulster, L.,, and R. Y. Chinn. 2003. Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recommend. Rep. 52:142.
244. Sheldon, A. T., Jr. 2005. Antiseptic “resistance”: real or perceived threat? Clin. Infect. Dis. 40:16501656.