Assessing the stability and sporicidal efficacy of oxidizing disinfectants

BACKGROUND

The role of the healthcare environment in the transmission of clinical pathogens is well established. EN 17126:2018 was developed to address the need for regulated sporicidal product testing and includes a realistic medical soil to enable validation of products that claim combined cleaning and disinfection efficacy.

AIM

To investigate the chemical stability and sporicidal efficacy of oxidizing disinfectant products in the presence of simulated clean and medical dirty conditions.

METHODS

Disinfectant stability and sporicidal efficacy were evaluated in like-for-like ratios of soil:product. Disinfectants were exposed to simulated test soils and free chlorine, chlorine dioxide or peracetic acid concentrations were measured using standard colorimetric methods. Efficacy of disinfectants against C. difficile R027 endospores was assessed as per EN 17126:2018. Comparisons of performance between clean and medical dirty conditions were performed using one-way analysis of variance. Correlation analysis was performed using Pearson product-moment correlation.

FINDINGS

Performance of chlorine-releasing agents (sodium dichloroisocyanurate, chlorine dioxide and hypochlorous acid) was concentration dependent, with 1000 ppm chlorine showing reduced stability and efficacy in dirty conditions. By contrast, peracetic acid product demonstrated stability and consistently achieved efficacy in dirty conditions.

CONCLUSION

These results have implications for clinical practice, as ineffective environmental decontamination may increase the risk of transmission of pathogens that can cause healthcare-associated infections.

Performance improvement in a hospital transfusion service

Blood bankers have always embraced the concepts of quality exemplified by the American Association of Blood Banks' Standards for Blood Banks and Transfusion Services and its accreditation program. The emergence of a quality management system based on a set of quality system essentials represents a natural evolution of these quality initiatives. When fully implemented, a quality system provides a powerful tool with which to improve the quality of both intralaboratory and, importantly, extralaboratory processes related to transfusion medicine. In addition, a functional quality system enhances a transfusion service's ability to meet current and proposed requirements of the American Association of Blood Banks, the Food and Drug Administration, the Joint Commission on Accreditation of Healthcare Organizations, and the National Committee for Clinical Laboratory Standards.

What do the accreditation organizations expect? American Association of Blood Banks

In 1958, the American Association of Blood Banks introduced the first edition of Standards for Blood Banks and Transfusion Services. That same year, the association implemented the Inspection and Accreditation Program. This program served the association well for 40 years; however, factors such as the application of Current Good Manufacturing Practices by the Food and Drug Administration, the implementation of the Clinical Laboratory Improvement Amendments of 1988 by the Health Care Financing Administration, managed care, competition, and increased cost pressures have changed the way the blood banking community conducts its business. In the early 1990s the board of directors recognized the need to reevaluate the Inspection and Accreditation Program and developed a strategic plan for implementation of a new accreditation program, with an emphasis on prevention rather than detection of errors. The first step in the process was the development of the Accreditation Program Committee. The committee was charged to develop and coordinate a program that would bring the accreditation process in tune with the current climate of blood banking and move it into the 21st century. The board charged the committee with the development of a program that recognizes the differences and similarities within the diverse groups of American Association of Blood Banks institutional members and to take into consideration how they do business and respond to regulations, standards, and other requirements.

Regulatory and legislative issues in transfusion medicine

The nation's blood supply is safer than ever following the implementation of more restrictive donor screening and additional tests for infectious agents. As a result of the AIDS crisis, however, there is a heightened awareness that blood transfusion is not an entirely benign therapy. As blood banking practices continue to undergo close scrutiny by members of Congress, regulators, and the American public, blood banks and transfusion services are striving to communicate effectively their efforts to ensure the provision of quality blood components and services.