Chapter 11 : Decontamination, Disinfection, and Sterilization

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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
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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
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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: 33 46.
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: 1073 1077.
4. Aguzzi, A.,, and M. Glatzel. 2004. vCJD tissue distribution and transmission by transfusion—a worst-case scenario coming true? Lancet 363: 411 412.
5. Aguzzi, A.,, and C. Weissmann. 1998. Spongiform encephalopathies. The prion’s perplexing persistence. Nature 392: 763 764.
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: 501 506.
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: 47 57.
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: 61 75.
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: 635 642.
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: 52 60.
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: 641 645.
12. Alvarado, C. J.,, M. Reichelderfer, et al. 2000. APIC guideline for infection prevention and control in flexible endoscopy. Am. J. Infect. Control 28: 138 155.
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: 3598 3600.
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: 3113 3118.
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): S93 S96.
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: 704 709.
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: 1059 1070.
19. Ascenzi, J. M., 1996. Glutaraldehyde-based disinfectants, p. 111 132. 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: 747 751.
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: 914 919.
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: 87 90.
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: 939 957.
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: 454 457.
25. Belay, E. D.,, and L. B. Schonberger. 2005. The public health impact of prion diseases. Annu. Rev. Public Health 26: 191 212.
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: 201 210.
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: 635 639.
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: 32 36.
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: 348 349.
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: 1964 1968.
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: 134 136.
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: 69 73.
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: 535 538.
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: 1172 1180.
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: 217 224.
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: 129 135.
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: 618 619.
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: S3 S40.
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: 493 499.
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: 143 151.
43. Bradley, C. R.,, and A. P. Fraise. 1996. Heat and chemical resistance of enterococci. J. Hosp. Infect. 34: 191 196.
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: 208 214.
45. Broadley, S. J.,, J. R. Furr,, P. A. Jenkins,, and A. D. Russell. 1993. Antimycobacterial activity of ‘Virkon’. J. Hosp. Infect. 23: 189 197.
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: 237 240.
47. Brown, P. 2001. Bovine spongiform encephalopathy and variant Creutzfeldt-Jakob disease. BMJ 322: 841 844.
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: 467 472.
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: 498 501.
50. Bryant, W. P.,, and D. Zimmerman. 1995. Iodine-induced hyperthyroidism in a newborn. Pediatrics 95: 434 436.
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: 654 656.
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: 686 707.
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: 39 45.
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: 797 805.
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: 362 368.
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: 306 308.
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: 428 432.
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: 41 43.
67. Coates, D. 1996. Sporicidal activity of sodium dichloroisocyanurate, peroxygen and glutaraldehyde disinfectants against Bacillus subtilis. J. Hosp. Infect. 32: 283 294.
68. Collins, F. M. 1986. Bactericidal activity of alkaline glutaraldehyde solution against a number of atypical mycobacterial species . J. Appl. Bacteriol. 61: 247 251.
69. Collins, F. M. 1986. Kinetics of the tuberculocidal response by alkaline glutaraldehyde in solution and on an inert surface. J. Appl. Bacteriol. 61: 87 93.
70. Collins, S. J.,, V. A. Lawson,, and C. L. Masters. 2004. Transmissible spongiform encephalopathies. Lancet 363: 51 61.
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: 20 26.
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: 621 623.
73. Crow, S. 1993. Steam sterilizers: an evolution in design. Infect. Control. Hosp. Epidemiol. 14: 488 490.
74. Cruse, P. J., and R. Foord. 1973. A five-year prospective study of 23,649 surgical wounds. Arch. Surg. 107: 206 210.
75. Dancer, S. J. 2008. Importance of the environment in meticillin-resistant Staphylococcus aureus acquisition: the case for hospital cleaning. Lancet Infect. Dis. 8: 101 113.
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: 18 26.
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: 170 178.
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: 2763 2773.
80. Denton, G. E., 1991. Chlorhexidine, p. 274 289. 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: 600 606.
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: 119 130.
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: 113 117.
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: 550 555.
85. Disch, K. 1994. Glucoprotamine—a new antimicrobial substance. Zentralbl. Hyg. Umweltmed. 195: 357 365.
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: 88 93.
87. Dolce, P.,, M. Gourdeau,, N. April,, and P. M. Bernard. 1995. Outbreak of glutaraldehyde-induced proctocolitis. Am. J. Infect. Control 23: 34 39.
88. Dormont, D. 1996. How to limit the spread of Creutzfeldt- Jakob disease. Infect. Control Hosp. Epidemiol. 17: 521 528.
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: 167 180.
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: 293 297.
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: 279 281.
93. Favero, M. S.,, and F. A. Manian. 1993. Is eliminating flash sterilization practical? Infect. Control Hosp. Epidemiol. 14: 479 480.
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: 514 515.
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: 521 526.
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: 747 753.
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: 2418 2419.
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: 856 859.
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: 383 389.
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: 214 221.
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: 73 80.
104. Fuselier, H. A. J.,, and C. Mason. 1997. Liquid sterilization versus high level disinfection in the urologic office. Urology. 50: 337 340.
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: 221 226.
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: 114 121.
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: 109 113.
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: 841 847.
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): 67 71.
110. Ghannoum, M. A.,, K. A. Elteen,, M. Ellabib,, and P. A. Whittaker. 1990. Antimycotic effects of octenidine and pirtenidine. J. Antimicrob. Chemother. 25: 237 245.
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: 332 334.
112. Glatzel, M.,, K. Stoeck,, H. Seeger,, T. Luhrs,, and A. Aguzzi. 2005. Human prion diseases: molecular and clinical aspects. Arch. Neurol. 62: 545 552.
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: 289 296.
114. Gottardi, W., 1991. Iodine and iodine compounds, p. 152 166. In S. S. Block (ed.), Disinfection, Sterilization and Preservation. Lea & Febiger, Philadelphia.
115. Graham, G. S., 1997. Decontamination: scientific principles, p. 1 9. 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: 519 526.
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: 1245 1249.
118. Gurevich, I.,, R. Dubin,, and B. A. Cunha. 1996. Dental instrument and device sterilization and disinfection practices. J. Hosp. Infect. 32: 295 304.
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: 42 43.
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: 199 208.
121. Hall, C. B.,, and R. G. Douglas, Jr. 1981. Modes of transmission of respiratory syncytial virus. J. Pediatr. 99: 100 103.
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: 156 160.
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: 410 412.
124. Hanson, P. J.,, D. J. Jeffries,, and J. V. Collins. 1991. Viral transmission and fibreoptic endoscopy. J. Hosp. Infect. 18 ( Suppl. A): 136 140.
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: 1107 1110.
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: 692 708.
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: 2423 2427.
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: 2127 2137.
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: 422 428.
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: 448 450.
131. Holmes, K. V. 2003. SARS-associated coronavirus. N. Engl. J. Med. 348: 1948 1951.
132. Holton, J.,, and N. Shetty. 1997. In-use stability of N u-Cidex. J. Hosp. Infect 35: 245 248.
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: 999 1000.
134. Hughes, R.,, and S. Kilvington. 2001. Comparison of hydrogen peroxide contact lens disinfection systems and solutions against Acanthamoeba polyphaga. Antimicrob. Agents Chemother. 45: 2038 2043.
135. Hussaini, S. N.,, and K. R. Ruby. 1976. Sporicidal activity of peracetic acid against B. anthracis spores. Vet. Rec. 98: 257 259.
136. Im, S. W.,, J. P. Fung,, S. Y. So,, and D. Y. Yu. 1982. Unusual dissemination of pseudomonads by ventilators. Anaesthesia 37: 1074 1077.
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: 2281 2290.
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: 1735 1745.
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: 562 566.
140. Jackson, J.,, J. E. Leggett,, D. A. Wilson,, and D. N. Gilbert. 1996. Mycobacterium gordonae in fiberoptic bronchoscopes. Am. J. Infect. Control. 24: 19 23.
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: 184 196.
142. Joslyn, L. J., 1991. Sterilization by heat, p. 495 526. 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: 1289 1293.
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: 257 261.
145. Kampf, G.,, R. Bloss,, and H. Martiny. 2004. Surface fixation of dried blood by glutaraldehyde and peracetic acid. J. Hosp. Infect. 57: 139 143.
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: 863 893.
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: 304 310.
148. Karol, M. H. 1995. Toxicologic principles do not support the banning of chlorine. A Society of Toxicology position paper. Fundam. Appl. Toxicol. 24: 1 2.
149. Kawashima, T.,, H. Furukawa,, K. Doh-ura,, and T. Iwaki. 1997. Diagnosis of new variant Creutzfeldt-Jakob disease by tonsil biopsy. Lancet 350: 68 69.
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: 131 136.
151. Klein, M.,, and A. DeForest. 1963. The inactivation of viruses by germicides. Chem. Specialists Manuf. Assoc. Proc. 49: 116 118.
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: 214 216.
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: 272 277.
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: 313 319.
156. Kramer, A.,, P. Rudolph,, G. Kampf,, and D. Pittet. 2002. Limited efficacy of alcohol-based hand gels. Lancet 359: 1489 1490.
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: 321 325.
158. Lai, M. Y.,, P. K. Cheng,, and W. W. Lim. 2005. Survival of severe acute respiratory syndrome coronavirus. Clin. Infect. Dis. 41: e67 e71.
159. Larson, E. 1988. Guideline for use of topical antimicrobial agents. Am. J. Infect. Control. 16: 253 266.
160. Larson, E. L., 1991. Alcohols, p. 191 203. 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: 139 143.
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: 199 203.
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. 159 176. 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: 19 21.
166. Lowbury, E. J.,, H. A. Lilly,, and J. P. Bull. 1964. Methods for disinfection of operation sites. Br. Med. J. 2: 531 533.
167. Maillard, J. Y. 2002. Bacterial target sites for biocide action. J. Appl. Microbiol. 92 ( Suppl.): 16S 27S.
168. Maki, D. G.,, and C. A. Hassemer. 1987. Flash sterilization: carefully measured haste. Infect. Control 8: 307 310.
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: 257 266.
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: 250 278.
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: 313 315.
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: 400 403.
173. Martin, M. A.,, M. Reichelderfer, et al. 1994. APIC guidelines for infection prevention and control in flexible endoscopy. Am. J. Infect. Control. 22: 19 38.
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: 129 142.
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: 896 897.
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: 3601 3604.
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: 2988 2995.
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: 2433 2441.
179. McDonnell, G.,, and A. D. Russell. 1999. Antiseptics and disinfectants: activity, action, and resistance. Clin. Microbiol. Rev. 12: 147 179.
180. Mentel, R.,, and J. Schmidt. 1973. Investigations on rhinovirus inactivation by hydrogen peroxide. Acta Virol. 17: 351 354.
181. Merianos, J. J., 1991. Quaternary ammonium antimicrobial compounds, p. 225 255. 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: 3163 3165.
183. Meyer, B.,, and C. Kluin. 1999. Efficacy of Glucoprotamin containing disinfectants against different species of atypical mycobacteria. J. Hosp. Infect. 42: 151 154.
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: 1093 1095.
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: 278 282.
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: 274 281.
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: 553 558.
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: 475 477.
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: 1019 1021.
190. Narang, H. K.,, and A. A. Codd. 1983. Action of commonly used disinfectants against enteroviruses. J Hosp. Infect 4: 209 212.
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: 532 537.
192. Neumann, G.,, T. Noda,, and Y. Kawaoka. 2009. Emergence and pandemic potential of swine-origin H1N1 influenza virus. Nature. 459: 931 939.
193. O’Connor, D. O.,, and J. R. Rubino,. 1991. Phenolic compounds, p. 204 224. 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: 389 395.
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: 14 16.
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: 281 283.
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: 40 42.
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: 1307 1312.
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: 301 318.
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: 2725 2732.
202. Prusiner, S. B. 1982. Novel proteinaceous infectious particles cause scrapie. Science 216: 136 144.
203. Prusiner, S. B. 1997. Prion diseases and the BSE crisis. Science 278: 245 251.
204. Ranganathan, N. S., 1996. Chlorhexidine, p. 235 264. 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: 3494 3500.
207. Rossmoore, H. W.,, and M. Sondossi. 1988. Applications and mode of action of formaldehyde condensate biocides. Adv. Appl. Microbiol. 33: 223 277.
208. Rotter, M. A., 1996. Alcohols for antisepsis of hands and skin, p. 177 234. 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: 27 37.
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: 310 320.
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: 778 781.
212. Rubbo, S. D.,, J. F. Gardner,, and R. L. Webb. 1967. Biocidal activities of glutaraldehyde and related compounds. J. Appl. Bacteriol. 30: 78 87.
213. Russell, A. D. 1994. Glutaraldehyde: current status and uses. Infect. Control Hosp. Epidemiol. 15: 724 733.
214. Russell, A. D. 2004. Whither triclosan? J. Antimicrob. Chemother. 53: 693 695.
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: 313 342.
217. Rutala, W. A. 1996. Disinfection and sterilization of patientcare items. Infect. Control Hosp. Epidemiol. 17: 377 384.
218. Rutala, W. A.,, and E. C. Cole. 1987. Ineffectiveness of hospital disinfectants against bacteria: a collaborative study. Infect. Control 8: 501 506.
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: 267S 271S.
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: 390 394.
221. Rutala, W. A.,, M. F. Gergen,, and D. J. Weber. 1993. Inactivation of Clostridium difficile spores by disinfectants. Infect Control Hosp. Epidemiol. 14: 36 39.
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: 514 516.
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: 423 428.
224. Rutala, W. A.,, and D. J. Weber. 1995. FDA labeling requirements for disinfection of endoscopes: a counterpoint. Infect. Control Hosp. Epidemiol. 16: 231 235.
225. Rutala, W. A.,, and D. J. Weber. 1997. Uses of inorganic hypochlorite (bleach) in health-care facilities. Clin. Microbiol. Rev. 10: 597 610.
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: 69 76.
227. Rutala, W. A.,, and D. J. Weber. 2001. New disinfection and sterilization methods. Emerg. Infect. Dis. 7: 348 353.
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: 702 709.
229. Rutala, W. A.,, and D. J. Weber. 2010. Guideline for disinfection and sterilization of prion-contaminated medical instruments. Infect. Control Hosp. Epidemiol. 31: 107 117.
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: 157 161.
232. Ryan, C. K.,, and G. D. Potter. 1995. Disinfectant colitis. Rinse as well as you wash. J. Clin. Gastroenterol. 21: 6 9.
233. Sagripanti, J. L. 1992. Metal-based formulations with high microbicidal activity. Appl. Environ. Microbiol. 58: 3157 3162.
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: 364 371.
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: 335 339.
236. Sailer, A.,, H. Bueler,, M. Fischer,, A. Aguzzi,, and C. Weissmann. 1994. No propagation of prions in mice devoid of PrP. Cell 77: 967 968.
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: 32 40.
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: 751 756.
239. Saurina, G.,, D. Landman,, and J. M. Quale. 1997. Activity of disinfectants against vancomycin-resistant Enterococcus faecium. Infect. Control Hosp. Epidemiol. 18: 345 347.
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: 23 30.
241. Scherrer, M.,, and K. Kümmerer. 1997. Manual and automated processing of medical instruments. Environmental and economic aspects. Central Service 5: 183 194.
242. Sedlock, D. M.,, and D. M. Bailey. 1985. Microbicidal activity of octenidine hydrochloride, a new alkanediylbis[pyridine] germicidal agent. Antimicrob. Agents Chemother. 28: 786 790.
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: 1 42.
244. Sheldon, A. T., Jr. 2005. Antiseptic “resistance”: real or perceived threat? Clin. Infect. Dis. 40: 1650 1656.
245. Shetty, N.,, S. Srinivasan,, J. Holton,, and G. L. Ridgway. 1999. Evaluation of microbicidal activity of a new disinfectant: Sterilox 2500 against Clostridium difficile spores, Helicobacter pylori, vancomycin resistant Enterococcus species, Candida albicans and several Mycobacterium species. J. Hosp. Infect. 41: 101 105.
246. Shimono, N.,, T. Takuma,, N. Tsuchimochi,, A. Shiose,, M. Murata,, Y. Kanamoto,, Y. Uchida,, S. Morita,, H. Matsumoto,, and J. Hayashi. 2008. An outbreak of Pseudomonas aeruginosa infections following thoracic surgeries occurring via the contamination of bronchoscopes and an automatic endoscope reprocessor. J. Infect. Chemother. 14: 418 423.
247. Sorin, M.,, S. Segal-Maurer,, N. Mariano,, C. Urban,, A. Combest,, and J. J. Rahal. 2001. Nosocomial transmission of imipenem-resistant Pseudomonas aeruginosa following bronchoscopy associated with improper connection to the Steris System 1 processor. Infect. Control Hosp. Epidemiol. 22: 409 413.
248. Spach, D. H.,, F. E. Silverstein,, and W. E. Stamm. 1993. Transmission of infection by gastrointestinal endoscopy and bronchoscopy. Ann. Intern. Med. 118: 117 128.
249. Spaulding, E. H., 1968. Chemical disinfection of medical and surgical materials, p. 517 531. In S. Block (ed.), Disinfection, Sterilization and Preservation. Lean & Febiger, Philadelphia, PA.
250. Spotts Whitney, E. A.,, M. E. Beatty,, T. H. Taylor, Jr., R. Weyant, J. Sobel, M. J. Arduino, and D. A. Ashford. 2003. Inactivation of Bacillus anthracis spores. Emerg. Infect. Dis. 9: 623 627.
251. Srinivasan, A.,, L. L. Wolfenden,, X. Song,, K. Mackie,, T. L. Hartsell,, H. D. Jones,, G. B. Diette,, J. B. Orens,, R. C. Yung,, T. L. Ross,, W. Merz,, P. J. Scheel,, E. F. Haponik,, and T. M. Perl. 2003. An outbreak of Pseudomonas aeruginosa infections associated with flexible bronchoscopes. N. Engl. J. Med. 348: 221 227.
252. Stickler, D. J. 1974. Chlorhexidine resistance in Proteus mirabilis. J. Clin. Pathol. 27: 284 287.
253. Stickler, D. J.,, and B. Thomas. 1980. Antiseptic and antibiotic resistance in Gram-negative bacteria causing urinary tract infection. J. Clin. Pathol. 33: 288 296.
254. Stout, J. E.,, Y. S. Lin,, A. M. Goetz,, and R. R. Muder. 1998. Controlling Legionella in hospital water systems: experience with the superheat-and-flush method and copper-silver ionization. Infect. Control Hosp. Epidemiol. 19: 911 914.
255. Suller, M. T.,, and A. D. Russell. 2000. Triclosan and antibiotic resistance in Staphylococcus aureus. J. Antimicrob. Chemother. 46: 11 18.
256. Swenson, B. R.,, T. L. Hedrick,, R. Metzger,, H. Bonatti,, T. L. Pruett,, and R. G. Sawyer. 2009. Effects of preoperative skin preparation on postoperative wound infection rates: a prospective study of 3 skin preparation protocols. Infect. Control Hosp. Epidemiol. 30: 964 971.
257. Tabor, E.,, D. C. Bostwick,, and C. C. Evans. 1989. Corneal damage due to eye contact with chlorhexidine gluconate. JAMA 261: 557 558.
258. Taylor, D. M. 1999. Inactivation of prions by physical and chemical means. J. Hosp. Infect. 43 ( Suppl.): S69 S76.
259. Taylor, D. M.,, S. L. Woodgate,, A. J. Fleetwood,, and R. J. Cawthorne. 1997. Effect of rendering procedures on the scrapie agent. Vet. Rec. 141: 643 649.
260. Terleckyj, B.,, and D. A. Axler. 1987. Quantitative neutralization assay of fungicidal activity of disinfectants. Antimicrob. Agents Chemother. 31: 794 798.
261. Tietz, A.,, R. Frei,, M. Dangel,, D. Bolliger,, J. R. Passweg,, A. Gratwohl,, and A. E. Widmer. 2005. Octenidine hydrochloride for the care of central venous catheter insertion sites in severely immunocompromised patients. Infect. Control Hosp. Epidemiol. 26: 703 707.
262. Tiwari, T. S.,, B. Ray,, K. C. Jost, Jr.,, M. K. Rathod,, Y. Zhang,, B. A. Brown-Elliott,, K. Hendricks,, and R. J. Wallace, Jr. 2003. Forty years of disinfectant failure: outbreak of postinjection Mycobacterium abscessus infection caused by contamination of benzalkonium chloride. Clin. Infect. Dis. 36: 954 962.
263. Trampuz, A.,, and A. F. Widmer. 2004. Hand hygiene: a frequently missed lifesaving opportunity during patient care. Mayo Clin. Proc. 79: 109 116.
264. Turner, P.,, B. Saeed,, and M. C. Kelsey. 2004. Dermal absorption of isopropyl alcohol from a commercial hand rub: implications for its use in hand decontamination. J. Hosp. Infect. 56: 287 290.