Russell, Hugo & Ayliffe’s Principles and Practice of Disinfection, Preservation & Sterilization Russell, Hugo & Ayliffe’s Principles and Practice of Disinfection, Preservation & Sterilization EDITED BY Adam P Fraise MB BS FRCPath Consultant Medical Microbiologist and Director Hospital Infection Research Laboratory City Hospital Birmingham, UK Peter A Lambert BSc PhD DSc Reader in Microbiology Pharmaceutical and Biological Sciences Aston University Birmingham, UK Jean-Yves Maillard BSc PhD Senior Lecturer in Pharmaceutical Microbiology School of Pharmacy and Biomolecular Sciences University of Brighton Brighton, UK FOURTH EDITION © 1982, 1992, 1999 by Blackwell Science Ltd © 2004 by Blackwell Publishing Ltd Blackwell Publishing, Inc., 350 Main Street, Malden, Massachusetts 02148-5020, USA Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Blackwell Publishing Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053, Australia The right of the Author to be identified as the Author of this Work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. First published 1982 Second edition 1992 Reprinted 1994 (twice) Third edition 1999 Fourth edition 2004 Library of Congress Cataloging-in-Publication Data Russell, Hugo & Ayliffe’s Principles and practice of disinfection, preservation and sterilization / edited by Adam P. Fraise, Peter A. Lambert, Jean-Yves Maillard.—4th ed. p. ; cm. Rev. ed. of: Principles and practice of disinfection, preservation, and sterilization, 1999. Includes bibliographical references and index. ISBN 1-4051-0199-7 1. Disinfection and disinfectants. 2. Sterilization. 3. Preservation of materials. [DNLM: 1. Disinfection—methods. 2. Sterilization—methods. 3. Anti-Infective Agents. 4. Preservatives, Pharmaceutical. WA 240 R963 2004] I. Title: Principles and practice of disinfection, preservation and sterilization. II. Russell, A. D. (Allan Denver), 1936–. III. Hugo, W. B. (William Barry). IV. Ayliffe, G. A. J. V. Fraise, Adam P. VI. Lambert, Peter A. VII. Maillard, J.-Y. VIII. Principles and practice of disinfection, preservation, and sterilization. IX. Title. RA761.P84 2004 614.4¢8—dc22 2003017281 ISBN 1-4051-0199-7 A catalogue record for this title is available from the British Library Set in 9.5/12 Sabon by SNP Best-set Typesetter Ltd, Hong Kong Printed and bound in the United Kingdom by CPI Bath Commissioning Editor: Maria Khan Managing Editor: Rupal Malde Production Editor: Prepress Projects Ltd Production Controller: Kate Charman For further information on Blackwell Publishing, visit our website: http://www.blackwellpublishing.com Contents List of contributors, vii 7.2 Evaluation of the antibacterial and antifungal activity of disinfectants, 220 Preface to the fourth edition, ix Gerald Reybrouck 8 Sensitivity of protozoa to disinfectants, 241 Preface to the first edition, x 8.1 Acanthamoeba, contact lenses and disinfection, 241 Neil A Turner Part 1: Principles 8.2 Intestinal protozoa and biocides, 258 1 Historical introduction, 3 Jean-Yves Maillard Adam P Fraise 9 Viricidal activity of biocides, 272 2 Types of antimicrobial agents, 8 Jean-Yves Maillard Suzanne L Moore and David N Payne 10 Transmissible degenerative encephalopathies: 3 Factors influencing the efficacy of inactivation of the unconventional causal antimicrobial agents, 98 agents, 324 A Denver Russell David M Taylor 4 Biofilms and antimicrobial resistance, 128 Part 2: Practice Peter Gilbert, Alexander H Rickard and Andrew J McBain 11 Evaluation of antimicrobial efficacy, 345 5 Mechanisms of action of biocides, 139 Ronald J W Lambert Peter A Lambert 12 Sterilization, 361 6 Bacterial resistance, 154 12.1 Heat sterilization, 361 6.1 Intrinsic resistance of Gram-negative Grahame W Gould bacteria, 154 12.2 Radiation sterilization, 384 David J Stickler Peter A Lambert 6.2 Acquired resistance, 170 12.3 Gaseous sterilization, 401 Keith Poole Jean-Yves Dusseau, Patrick Duroselle 6.3 Resistance of bacterial spores to chemical and Jean Freney agents, 184 12.4 Filtration sterilization, 436 Peter A Lambert Stephen P Denyer and Norman A 6.4 Mycobactericidal agents, 191 Hodges Peter M Hawkey 13 New and emerging technologies, 473 7 Antifungal activity of disinfectants, 205 Grahame W Gould 7.1 Antifungal activity of biocides, 205 14 Preservation of medicines and cosmetics, 484 Jean-Yves Maillard Sarah J Hiom v Contents 15 Reuse of single-use devices, 514 20 Other health-related issues, 595 Geoffrey W Hanlon 20.1 Special issues in dentistry, 595 16 Sterility assurance: concepts, methods and Jeremy Bagg and Andrew Smith problems, 526 20.2 Veterinary practice, 604 Rosamund M Baird Anders Engvall and Susanna Sternberg 17 Special problems in hospital antisepsis, 540 20.3 Recreational and hydrotherapy pools, Manfred L Rotter 614 18 Decontamination of the environment and John V Dadswell medical equipment in hospitals, 563 21 Good manufacturing practice, 622 Adam P Fraise Elaine Underwood 19 Treatment of laundry and clinical waste in hospitals, 586 Index, 641 Christina R Bradley vi List of contributors Jeremy Bagg PhD FDS RCS (Ed) Anders Engvall DVM Sarah J Hiom PhD MRPharmS FDS RCPS (Glasg) FRCPath Professor and Chief Epizootiologist Senior Pharmacist R&D, NHS Wales Professor of Clinical Microbiology National Veterinary Institute SVA St Mary’s Pharmaceutical Unit University of Glasgow Dental School Uppsala Cardiff, UK Glasgow, UK Sweden Norman A Hodges BPharm Rosamund M Baird BPharm PhD Adam P Fraise MB BS FRCPath MRPharmS PhD MRPharmS Consultant Medical Microbiologist and Principal Lecturer in Pharmaceutical School of Pharmacy Director Microbiology University of Bath Hospital Infection Research Laboratory School of Pharmacy and Biomolecular Bath, UK City Hospital Sciences Birmingham, UK University of Brighton Christina R Bradley AIBMS Brighton, UK Laboratory Manager Jean Freney PhD Hospital Infection Research Laboratory Professor of Microbiology Peter A Lambert BSc PhD DSc City Hospital Department of Bacteriology and Virology Reader in Microbiology Birmingham, UK Faculty of Pharmacy Pharmaceutical and Biological Sciences Lyon Aston University John V Dadswell MB BS France Birmingham, UK FRCPath Former Director Peter Gilbert BSc PhD Ronald J W Lambert BA BSc PhD Reading Public Health Laboratory Professor of Microbial Physiology CChem MRSC Reading, UK School of Pharmacy and Pharmaceutical Director Sciences R2-Scientific Stephen P Denyer BPharm PhD University of Manchester Sharnbrook FRPharmS Manchester, UK Beds, UK Head of School Welsh School of Pharmacy Grahame W Gould BSc MSc PhD Andrew J McBain Cardiff University Visiting Professor of Microbiology Research Fellow Cardiff, UK University of Leeds School of Pharmacy and Pharmaceutical Leeds, UK Sciences Patrick Duroselle PhD University of Manchester Department of Bacteriology and Virology Geoffrey W Hanlon BSc PhD Manchester, UK Faculty of Pharmacy MRPharmS Lyon Reader in Pharmaceutical Microbiology Jean-Yves Maillard BSc PhD France School of Pharmacy and Biomolecular Senior Lecturer in Pharmaceutical Sciences Microbiology Jean-Yves Dusseau MD University of Brighton School of Pharmacy and Biomolecular Spécialiste des Hôpitaux des armees Brighton, UK Sciences Hôpital d’instruction des armées Desgenettes University of Brighton Département de Biologie Médicale Peter M Hawkey BSc DSc MB BS Brighton, UK Lyon MD FRCPath France Professor of Clinical and Public Health Suzanne L Moore BSc PhD Bacteriology and Honorary Consultant External Innovation, Health and Personal The Medical School, University of Care R&D Birmingham Reckitt Benckiser Healthcare (UK) Health Protection Agency, Birmingham Hull, UK Heartlands and Solihull NHS Trust Birmingham, UK vii List of contributors David N Payne MIBiol CBiol Manfred L Rotter MD Dip Bact David J Stickler BSc MA DPhil Microbiology Manager Director and Professor of Hygiene and Senior Lecturer in Medical Microbiology Reckitt Benckiser Healthcare (UK) Medical Microbiology Cardiff School of Biosciences Hull, UK Department of Hygiene and Medical Cardiff University Microbiology of the University of Vienna Cardiff, UK Keith Poole PhD Vienna Professor of Microbiology and Immunology Austria David M Taylor PhD MBE Queen’s University Consultant Kingston, ON A Denver Russell BPharm PhD SEDECON 2000 Canada DSc FRCPath FRPharmS Edinburgh, UK Professor of Pharmaceutical Microbiology Gerald Reybrouck MD AggrHO Welsh School of Pharmacy Neil A Turner BSc PhD Professor Cardiff University Postdoctoral Research Fellow Hospital Hygiene and Infection Control Cardiff, UK Department of Medical and Molecular Department Parasitology Katholiecke Universiteit Leuven Andrew Smith BDS FDS RCS PhD New York University School of Medicine Leuven MRCPath New York Belgium Senior Lecturer and Honorary Consultant in USA Microbiology Alexander H Rickard BSc MSc University of Glasgow Dental School Elaine Underwood BSc PhD PhD Glasgow, UK Wyeth Pharmaceuticals Research Fellow SMA Nutrition Division School of Pharmacy and Pharmaceutical Susanna Sternberg DVM PhD Maidenhead, UK Sciences Laboratory Veterinary Officer University of Manchester National Veterinary Institute SVA Manchester, UK Uppsala Sweden viii Preface to the fourth edition It has been a privilege to take on the editing of this Inevitably much of the content of the previous textbook. The major change that has taken place is editions is still valid and we are grateful for the ef- that the organization of the chapters has been al- forts of the previous editorial team and authors, tered such that Chapters 1–10 deal with the prin- without whom it would have been impossible to ciples of disinfection, preservation and steriliza- achieve this fourth edition within the allotted tion, and Chapters 11–21 deal with the practice. timescale. We are especially grateful to authors of Although the book has always been aimed at micro- chapters in previous editions, who have allowed biologists, physicians and pharmacists, the content their text to be used by new authors in this edition. of this fourth edition has been modified to reflect We also thank all contributors (both old and new) this clinical emphasis more. Consequently, chapters for their hard work in maintaining this text as one on textile, leather, paint and wood preservation of the foremost works on the subject. have been removed, whereas sections on biofilms, prions and specific clinical areas such as dentistry A.P.F. have been updated and expanded. All other chap- P.A.L. ters have been revised, with new material added J.-Y.M. where appropriate. ix Preface to the first edition Sterilization, disinfection and preservation, all de- instrumentation of the patient. Although heat ster- signed to eliminate, prevent or frustrate the growth ilization processes at high temperatures are pre- of microorganisms in a wide variety of products, ferred whenever possible, medical equipment is were incepted empirically from the time of man’s often difficult to clean adequately, and components emergence and remain a problem today. The fact are sometimes heat-labile. Disposable equipment is that this is so is due to the incredible ability of the useful and is widely used if relatively cheap but is first inhabitants of the biosphere to survive and obviously not practicable for the more expensive adapt to almost any challenge. This ability must in items. Ethylene oxide is often used in industry for turn have been laid down in their genomes during sterilizing heat-labile products but has a limited their long and successful sojourn on this planet. use for reprocessing medical equipment. Low- It is true to say that, of these three processes, ster- temperature steam, with or without formaldehyde, ilization is a surer process than disinfection, which has been developed as a possible alternative to in turn is a surer process than preservation. It is in ethylene oxide in the hospital. the last field that we find the greatest interactive Although aseptic methods are still used for play between challenger and challenged. The surgical techniques, skin disinfection is still necess- microbial spoilage of wood, paper, textiles, paints, sary and a wider range of non-toxic antiseptic stonework, stored foodstuffs, to mention only a few agents suitable for application to tissues is required. categories at constant risk, costs the world many Older antibacterial agents have been reintroduced, billions of pounds each year, and if it were not for e.g. silver nitrate for burns, alcohol for hand considerable success in the preservative field, this disinfection in the general wards and less corro- figure would rapidly become astronomical. Disin- sive hypochlorites for disinfection of medical fection processes do not suffer quite the same fail- equipment. ure rate and one is left with the view that failure here Nevertheless, excessive use of disinfectants in the is due more to uninformed use and naïve interpreta- environment is undesirable and may change the tion of biocidal data. Sterilization is an infinitely hospital flora, selecting naturally antibiotic-resis- more secure process and, provided that the proce- tant organisms, such as Pseudomonas aeruginosa, dural protocol is followed, controlled and moni- which are potentially dangerous to highly suscep- tored, it remains the most successful of the three tible patients. Chemical disinfection of the hospital processes. environment is therefore reduced to a minimum In the field of communicable bacterial diseases and is replaced where applicable by good cleaning and some virus infections, there is no doubt that methods or by physical methods of disinfection or these have been considerably reduced, especially in sterilization. the wealthier industrial societies, by improved hy- giene, more extensive immunization and possibly A.D.R. by availability of antibiotics. However, hospital- W.B.H. acquired infection remains an important problem G.A.J.A. and is often associated with surgical operations or x Part 1 Principles