German
scientists develop fast-acting germ killer
by Kate Kelland
Fast-acting formula tackles even
toughest germs -- Scientists say disinfectant could have huge
impact
LONDON, Jan 20 (Reuters) - A new fast-acting disinfectant that
is effective against bacteria, viruses and other germs could
help stop the spread of deadly infections in hospitals, German
scientists said on Wednesday.
Researchers from the Robert Koch Institute in Berlin said they
had developed a fast-acting, practical formula which would kill
germs on surgical instruments without damaging them through
corrosion.
Disinfectants are the first line of defence against the spread
of hospital-acquired infections and effective cleaning of
surgical instruments is vital to beating them.
The German formula works against a wide range of germs,
including some that survive ordinary disinfectants, such as
Mycobacterium avium bacteria which can cause a tuberculosis-type
illness and enteroviruses that may cause polio.
Drug-resistant bacteria, the so-called "superbugs", are a
growing problem in hospitals worldwide and poor hygiene among
staff is often blamed for the spread of such infections. They
kill about 25,000 people a year in Europe and about 19,000 in
the United States.
In previous studies, the German team found a simple alkaline
detergent that could eradicate prions -- disease-causing
proteins that are particularly hard to get rid of because they
can become fixed onto surfaces through the use of some
conventional disinfectants.
In their new study, Michael Beekes and Martin Mielke from the
Institute's hygiene department mixed the alkaline with varying
amounts of alcohol and tested its ability to rid surgical
instruments of bacteria, viruses and fungi and prions. They
found that a mixture with 20 percent alcohol was best.
Beekes said he thought the new disinfectant could have a huge
impact on hospital safety protocols.
"Standard formulations that eliminate prions are very
corrosive," he said in the study published in the Journal of
General Virology.
"The solution we've come up with is not only safer and more
material-friendly, but easy to prepare, cheap and highly
effective against a wide variety of infectious agents."
A Dutch study published last week found that the
methicillin-resistant staphylococcus aureus (MRSA) superbug,
which can cause blood poisoning, spreads not freely but in
clusters, suggesting it is spread through healthcare systems by
patients being repeatedly admitted to different hospitals.
WO2009074330
A FORMULATION FOR BROAD-RANGE
DISINFECTION INCLUDING PRION DECONTAMINATION
Inventor: MIELKE MARTIN [DE] ; LEMMER KARIN
Applicant: BUNDESREP DEUTSCHLAND / MIELKE MARTIN
2009-06-18
Also published as: EP2070552
Abstract -- The present
invention relates to a formulation for broad-range disinfection
including prion decontamination and inactivation of
non-enveloped viruses and mycobacteria, uses thereof, to a kit
and to a method for prion decontamination and disinfection of
objects.
Description
A formulation for broad-range disinfection including prion
decontamination
The present invention relates to a formulation for broad-range
disinfection including prion decontamination and inactivation of
non-enveloped viruses and mycobacteria, uses thereof, to a kit
and to a method for prion decontamination and disinfection of
objects.
Transmissible spongiform encephalopathies (TSEs) such as
Creutzfeldt- Jakob disease (CJD) and its variant form (vCJD) in
humans, bovine spongiform encephalopathy (BSE) in cattle and
scrapie in sheep are invariably fatal neurodegenerative diseases
of the central nervous system. The agents that cause TSEs are
widely believed to represent a unique biological principle of
infection. According to the prion hypothesis (Prusiner, S. B.
(1982). Science 216, 136-144; Prusiner, S. B. (1998). Proc Natl
Acad Sci USA 95, 13363-13383), TSE agents (so- called
proteinaceous infectious particles or prions) consist
essentially - if not entirely - of a misfolded form of the prion
protein (PrP), which is known as PrP<Sc> and derived from
a host- encoded cellular precursor (PrP<c>). Although the
exact molecular nature of TSE agents remains to be determined,
there is substantial evidence that PrP<Sc> (or its
protease-resistant core, PrP27-30) provides a practical
biochemical marker for these pathogens (Wadsworth, J. D. F.,
Joiner, S., Hill, A. F., Campbell, T. A., Desbruslais, M.,
Luthert, P. J. & Collinge, J. (2001). Lancet 358, 171-180;
Beekes, M. B. & McBride, P.A. (2007). FEBS Journal 274,
588-605). Following the emergence of BSE and vCJD, substantial
evidence has accumulated that the latter can most likely be
attributed to transmission, presumably via contaminated food, of
BSE from cattle to man. The countermeasures implemented in
response to the BSE epidemic are expected to prevent effectively
further spread of this disease to humans, thereby minimizing the
risk of new primary vCJD infections. However, additional
challenges for public health in the context of TSEs arises from
the hypothetical as well as the established risks of
human-to-human transmission of vCJD and classical CJD,
respectively (Beekes, M., Mielke, M., Pauli, G., Baier, M. &
Kurth, R. (2004) In Prions. A Challenge for Science, Medicine
and the Public Health System. Contributions to Microbiology,
vol. 11, pp. 117-135. Edited by H. F. Rabenau, J. Ciantl &
H. W. Doerr. Basel: Karger; Llewelyn, C. A., Hewitt, P. E.,
Knight, R. S., Amar, K., Cousens, S., Mackenzie, J. & Will,
R. G. (2004). Lancet 363, 411-412). The experience with
iatrogenic CJD, of which 267 cases were reported until July 2000
(Brown, P., Preece, M., Brandel, J. P. & 12 other authors
2000. Iatrogenic Creutzfeldt- Jakob disease at the millennium.
Neurology 55, 1075-1081), and the detection of infectivity or
PrP<Sc> in a variety of tissues from vCJD patients in
addition to the brain and spinal cord (e.g. lymphatic system and
peripheral nervous system) have led to the formulation of
national and international recommendations and guidelines aiming
at the prevention of iatrogenic transmission of these diseases
(Simon, D. & Pauli, G. (1998). Bundesgesundheitsblatt 7,
297- 285; World Health Organization, (1999) WHO Infection
Control Guidelines for Transmissible Spongiform
Encephalopathies. Report of a WHO consultation, Geneva,
Switzerland, 23-26 March. WHO/CDS/CSR/APH/2000.3;
Abschlussbericht der Task Force vCJK, (2002). Die Variante der
Creutzfeldt-Jakob-Krankheit (vCJK). Bundesgesundheitsblatt
Gesundheitsforschung Gesundheitsschutz 45, 376-394).
In order to prevent human-to-human transmission, it is of utmost
importance to avoid the spread of TSE infectivity via surgical
instruments by effective and safe decontamination (e.g.
cleaning, chemical disinfection, sterilization; Beekes, M.,
Mielke, M., Pauli, G., Baier, M. & Kurth, R. (2004) In
Prions. A Challenge for Science, Medicine and the Public Health
System. Contributions to Microbiology, vol. 11, pp. 117-135.
Edited by H. F. Rabenau, J. Ciantl & H. W. Doerr. Basel:
Karger; Sehulster, L. M. (2004). Infect Control Hosp Epidemiol
25, 276- 297). This is highlighted by the fact that
PrP<Sc> has also been detected in various tissues
including skeletal muscles of CJD patients (Glatzel, M., Abela,
E. Maissen, M. & Aguzzi, A. (2003) N Engl J Med 349,
1812-1820.) and is present in lymphatic tissues, and possibly
blood, during preclinical phases of vCJD incubation (Hilton, D.
A., Fathers, E, Edwards, P., Ironside, J. W. & Zajicek, J
(1998). Lancet 352, 703-704. Hilton, D. A., Ghani, A. C,
Conyers, L, Edwards, P., McCardle, L., Penney, M., Ritchie, D.
& Ironside, J. W. (2002). BMJ 325, 633-634); Llewelyn, C.
A., Hewitt, P. E., Knight, R. S., Amar, K., Cousens, S.,
Mackenzie, J. & Will, R. G. (2004). Lancet 363, 411-412).
The high resistance of TSE agents to conventional methods of
chemical or thermal inactivation and to UV- or ionizing
radiation, as well as their high binding affinity to and
tenacity on steel surfaces, warrant specific decontamination
procedures in the reprocessing of surgical instruments.
Treatments that are considered appropriate for decontamination
include use of 1-2 M NaOH solution (for 24 h), 2.5-5% NaOCl
solution (for 24 h) as well as 3, 4 or 6 M Guanidine thiocyanate
(GdnSCN) solution (for 24 h, 1 h or 15 min, respectively)
followed by steam sterilization at 134[deg.]C for 18 min to 1 h
(Simon, D. & Pauli, G. (1998). Bundesgesundheitsblatt 7,
297-285; World Health Organization, (1999) WHO Infection Control
Guidelines for Transmissible Spongiform Encephalopathies. Report
of a WHO consultation, Geneva, Switzerland, 23-26 March.
WHO/CDS/CSR/APH/2000.3; H[omicron]rnlimann, B., Pauli, G.,
Harbarth, S., Widmer, H.-R. & Simon, D. (2001) In Prionen
und Prionenkrankheiten, pp. 415-442. Edited by B.
H[omicron]rnlimann, D. Riesner & H. Kretzschmar. Berlin, New
York: de Gruyter). Such stringent conditions, which are
mandatory for the reprocessing of non-disposable instruments
used in patients with known CJD/vCJD (or those with a
recognizable risk of it), are hazardous to both equipment and
operators, therefore they do not offer an option for the routine
maintenance of surgical instruments (used on patients without a
recognizable risk of human TSE). Here, generally applicable
decontamination strategies that take into account the
theoretical risk of CJD and vCJD transmission from asymptomatic
carriers on the one hand, without compromising the conventional
processes for cleaning, disinfection and sterilization on the
other, are required.
In a recent publication (Lemmer et al., 2004, Journal of General
Virology, 85, 3805-3816), the authors have reported on a number
of formulations which exert potent decontaminating activities on
PrP<Sc>/PrP27-30 attached to steel surfaces. These
formulations included a commercially available alkaline cleaner,
a disinfectant containing 0.2% peracetic acid and low
concentrations of NaOH (pH 8.9) or 5% SDS (pH 7.1,) and a
formulation containing 0.2% SDS/0.3% (0.075 M) NaOH (pH 12.8).
The authors used an in-vitro-assay to assess the detailed
decontamination activities exerted by the different reagents on
the pathological prion protein PrP<Sc>. In this assay,
steel wires were contaminated with 263K scrapie brain homogenate
from hamsters and reprocessed for decontamination by exposure to
several different test reagents. Residual contamination with
PrP<Sc> or its protease-resistant core PrP27- 30, still
present after reprocessing on the wire surface or in the
cleaning solution, was monitored by sensitive Western-Blot
detection without or after proteinase K digestion. The amount of
PrP<Sc> bound to the surface of steel wires after
incubation in scrapie brain homogenate can be assessed by
comparing the intensity of PrP-immuno-staining displayed by
eluates from contaminated wires with Western-Blot signals from
internal PrP27-30 standards. In this assay, the efficacy of the
decontamination of steel wires by various test reagents can be
assessed by comparing the initial load of contamination with the
amount of total PrP and PrP27-30 residually attached to the
carriers or released into the cleaning solution after
processing.
This analytical approach also sheds light on the active
principles potentially underlying the effects of the different
reagents (degradation, detachment or destabilization of
PrP<Sc>). (i) If PrP could be detected only in
substantially reduced amounts, or not at all, on the steel wires
and in the cleaning solution without proteinase K (PK)
treatment, this indicated degradation of the normal as well as
the pathological prion protein; (ii) if PrP was found in the
cleaning solution without or after PK treatment, the protein was
at least in part detached from the wire surface; (iii) if prion
protein visible in the Western-Blot prior to PK treatment was
markedly reduced in its amount or completely disappeared upon
digestion with PK, this showed that the respective test reagent
destabilized the protease-resistant core of PrP <c>
molecules in that it made this core more susceptible to
enzymatic degradation. The results of this study showed that the
aforementioned test formulations show good decontaminating
activities on PrP<s>7PrP27-30 attached to steel surfaces.
The secondary, tertiary and aggregation structures of
PrP<Sc> appear to be very important for the resistance
against the inactivation of prions. Certain chaotropic salts
such as guanidine hydrochloride or guanidine thiocyanate lead to
the destruction of hydrogen bonds within polypeptide secondary
structures. Hence, chaotropic salts that exert destabilizing
effects on the overall structure of PrP<Sc> can contribute
to the inactivation of prions.
Alkaline conditions interfere with hydrogen bonds in proteins
and can thereby destabilize the secondary structure of proteins.
Furthermore, alkaline hydrolysis, possibly facilitated by
previous alkaline disintegration of secondary structure elements
such as beta-sheets, may degrade proteins.
Acids with pH values below 3 lead to the neutralization of
glutamate and aspartate which, in turn, leads to the removal of
salt bridges between different segments of the peptide chain and
thus to the destabilization of the tertiary and/or aggreagation
structure. However, an acid inactivation of prions appears to be
effective only at high concentrations of acid or high
temperature. On the contrary, alcohols are commonly thought to
add to the stability of the structure in many proteins. In the
case of PrP<Sc>, alcohols generally seem to add to the
stabilization and fixation of PrP<s>7PrP27-30 molecules.
Detergents affect the tertiary structure of proteins, in that
they interact with hydrophilic and hydrophobic areas of the
protein molecule and loosen the hydrophobic core of the protein
molecule.
Taken together, an ideal disinfectant should have i) no protein
fixating effects and ii) a fast, highly-efficient
decontaminating/inactivating activity on a broad range of
bacteria and viruses, vegetative forms of fungi, as well as on
prions. Furthermore it should be harmless to the user as well as
to the object which is to be decontaminated. Consequently, it
was an aim of the present invention to provide for a formulation
that would be effective both as a decontaminating formulation
against prions and as a disinfectant against bacteria (including
mycobacteria) and enveloped as well as non-enveloped viruses.
Moreover, it was an aim of the present invention to provide for
a material- and device-friendly formulation that can be
routinely used in an easy manner.
Before the present invention is described in more detail below,
it is to be understood that this invention is not limited to the
particular methodology, protocols and reagents described herein
as these may vary. It is also to be understood that the
terminology used herein is for the purpose of describing
particular embodiments only, and is not intended to limit the
scope of the present invention which will be limited only by the
appended claims. Unless defined otherwise, all technical and
scientific terms used herein have the same meanings as commonly
understood by one of ordinary skill in the art. For the purpose
of the present invention, all references cited herein are
incorporated by reference in their entireties.
Aqueous formulations
All these objects are solved by an aqueous formulation
comprising: a) a detergent , b) an alkali hydroxide, c) an
alcohol, preferably having 1 to 4 C-atoms, and d) water as a
solvent.
In one embodiment said detergent is an anionic detergent,
wherein preferably said anionic detergent is selected from the
group comprising alkali-^ -C is)alkyl sulphates, in particular
sodium dodecyl sulphate (SDS), (Ci-Cis)alkyl benzenesulfonates,
(Ci-Cis)alkyl sulphonates, (Ci-Cis)alkyl phosphates and mixtures
thereof.
In one embodiment said detergent, preferably said anionic
detergent, is present in said formulation in an amount in the
range of from 0.1% (w/v) to 1.0% (w/v) with reference to the
formulation, wherein, preferably, said detergent, preferably
said anionic detergent, is present in said formulation in an
amount in the range of from 0.1% (w/v) to 0.3% (w/v) with
reference to the formulation, and wherein, more preferably, said
detergent, preferably said anionic detergent, is present in said
formulation in an amount in the range of from 0.15% (w/v) to
0.25% (w/v) with reference to the formulation.
In one embodiment said alkali hydroxide is selected from the
group comprising NaOH or KOH or mixtures thereof.
In one embodiment said alkali hydroxide is present in said
formulation in an amount in the range of from 0.1% w/v to 1.0%
(w/v) with reference to the formulation, wherein, preferably,
said alkali hydroxide is present in said formulation in an
amount in the range of from 0.2% (w/v) to 0.4% (w/v) with
reference to the formulation., and wherein, more preferably,
said alkali hydroxide is present in said formulation in an
amount in the range of from 0.25% (w/v) to 0.35% (w/v) with
reference to the formulation.
Thereby, an alkali hydroxide amount in the range of from 0.1%
w/v to 1.0% (w/v) with reference to the formulation corresponds
to approximately 0.025 to 0.25 M alkali hydroxide. For example,
0.1% w/v to 1.0% (w/v) NaOH correspond to 0.025 to 0.25 M NaOH.
In one embodiment said alcohol, preferably having 1 to 4
C-atoms, is selected from the group comprising ethanol,
n-propanol, isopropanol, 1-butanol, 2-butanol,
2-methyl-l-propanol (isobutanol), and 2-methyl-2-propanol
(tert-butanol), wherein, preferably said alcohol is n- propanol.
In one embodiment said alcohol, preferably having 1 to 4
C-atoms, preferably said n- propanol, is present in said
formulation in an amount in the range of from 5% (v/v) to 50%
(v/v) with reference to the formulation, more preferably in an
amount in the range of from 10% (v/v) to 50% (v/v) with
reference to the formulation, even more preferably in an amount
in the range of from 15% (v/v) to 50% (v/v) with reference to
the formulation, even more preferably in an amount in the range
of from 10% (v/v) to 45% (v/v) with reference to the
formulation, even more preferably in an amount in the range of
from 15% (v/v) to 40% (v/v) with reference to the formulation,
even more preferably in an amount in the range of from 10% (v/v)
to 40% (v/v) with reference to the formulation, even more
preferably in an amount in the range of from 10% (v/v) to 35%
(v/v) with reference to the formulation. even more preferably in
an amount in the range of from 15% (v/v) to 35% (v/v) with
reference to the formulation.
In one embodiment said alcohol, preferably having 1 to 4
C-atoms, preferably said n- propanol, is present in said
formulation in an amount in the range of from 10% (v/v) to 30%
(v/v), preferably 15% (v/v) to 25% (v/v), more preferably
approximately 20% (v/v) with reference to the formulation.
In one embodiment said alcohol, preferably having 1 to 4
C-atoms, preferably said n- propanol, is present in said
formulation in an amount in the range of from 20% (v/v) to 40%
(v/v), preferably 25% (v/v) to 35% (v/v), more preferably
approximately 30% (v/v) with reference to the formulation.
Preferably, the formulation according to the present invention
has a pH value greater than about 10, preferably a pH value of
from about 12 to about 14, and more preferably approximately pH
13. In preferred embodiments of the invention, the pH value is
about 13, preferably 13.0 +- 0.5.
In a preferred embodiment of the invention, the formulation
comprises: a) an anionic detergent in an amount in the range of
from 0.1% (w/v) to 1.0% (w/v) with reference to the formulation,
b) an alkali hydroxide in an amount in the range of from 0.1%
w/v to 1.0% (w/v) with reference to the formulation, c) an
alcohol in an amount in the range of from 10% (v/v) to 35% (v/v)
with reference to the formulation, preferably 15% (v/v) to 35%
(v/v), and d) water as a solvent.
In one embodiment formulation according to the present
invention, comprises a) sodium dodecyl sulphate (SDS), b) sodium
hydroxide (NaOH), c) n-propanol, and d) water,
wherein, preferably, the formulation comprises a) sodium dodecyl
sulphate in an amount in the range of from 0.1% (w/v) to 0.3%
(w/v), preferably 0.15% (w/v) to 0.25% (w/v), more preferably
approximately 0.2% (w/v), b) sodium hydroxide in an amount in
the range of from 0.2% (w/v) to 0.4% (w/v), preferably 0.25%
(w/v) to 0.35% (w/v), and more preferably approximately 0.3%
(w/v) with reference to the formulation, c) n-propanol in an
amount in the range of from 10% (v/v) to 30% (v/v), preferably
15% (v/v) to 25% (v/v), more preferably approximately 20% (v/v)
with reference to the formulation, and d) water ad 100% (v/v).
In another embodiment the formulation according to the present
invention comprises a) sodium dodecyl sulphate in an amount in
the range of from 0.1% (w/v) to 0.3% (w/v), preferably 0.15%
(w/v) to 0.25% (w/v), more preferably approximately 0.2% (w/v),
b) sodium hydroxide in an amount in the range of from 0.2% (w/v)
to 0.4% (w/v), preferably 0.25% (w/v) to 0.35% (w/v), and more
preferably approximately 0.3% (w/v) with reference to the
formulation, c) n-propanol in an amount in the range of from 20%
(v/v) to 40% (v/v), preferably 25% (v/v) to 35% (v/v), more
preferably approximately 30% (v/v) with reference to the
formulation, and d) water ad 100% (v/v). In preferred
embodiments of the invention, the formulations are as follows
The preferred pH value of formulation A is pH 13.0 - 13.05. The
preferred pH value of formulation B is pH 12.95 - 13.0.
As described herein, the formulations of the invention are
suitable as versatile, efficient, fast broad-range
disinfectants, which preferably do not require further
components, since their active components are the mixture of the
components a), b), c) (and d)) as described herein Therefore,
the formulations of the invention do, preferably, not comprise
further components, that are effective in disinfection /
inactivation / decontamination of infectious agents, other than
components a), b), c) and d) as described herein.
In particular, the formulations of the invention do, preferably,
not comprise corrosion inhibitor agents, and/or anti-corrosive
agents.
In a preferred embodiment, the formulations of the invention do
also not comprise further additives, agents and/or excipients
known to the skilled artisan.
However, in some embodiments further components/additives can be
comprised in the formulations of the invention, such as
- complexing agents (e.g. EDTA),
- excipients,
- fragrances,
- flavouring agents,
- colouring agents and the like,
- polymers, corrosion inhibitor agents, and/or anti-corrosive
agents,
- etc. The skilled artisan will be able to choose respective
components/additives depending on the desired application.
Kits
The objects of the present invention are also solved by a kit
comprising a) a detergent, b) an alkali hydroxide, c) an
alcohol, preferably having 1 to 4 C-atoms and optionally d)
water.
Preferably in said kit, a) - c), and d), if present, are
provided in separate containers.
In another embodiment in said kit, a) - c) and d), if present
are provided in a ready-to-use- mixture.
Preferably, said detergent is as defined above, said alkali
hydroxide is as defined above, and said alcohol, preferably
having 1 to 4 C-atoms is as defined above.
The objects of the present invention are also solved by the use
of a kit according to the present invention for preparing a
formulation according to the present invention.
Decontamination and inactivation
and disinfection methods
The objects of the present invention are also solved by methods
utilizing the formulations of the invention for the disinfection
and/or decontamination of objects or surfaces, wherein the
formulations of the invention are active against a broad range
of pathogens and/or infectious agents.
In the methods of the invention, all pathogens and/or infectious
agents that are present on the respective object or surface are
simultaneously (at the same time) inactivated; the
disinfection/decontamination occurs simultaneously (at the same
time).
The pathogens and/or infectious agents are, but not limited to:
- viruses, including non-enveloped and enveloped viruses,
- prions, bacteria, including mycobacteria, - vegetative forms
of fungi.
These pathogens and/or infectious agents can be comprised in
bodily fluids, such as blood, and/or tissues.
In a step a) of a method according to the invention, said object
or surface is contacted by submerging or rinsing it in or with a
formulation according to the present invention.
In a subsequent step b), said formulation is allowed to remain
in contact with said object or said surface thereof by
submerging or rinsing for a period and under conditions
sufficient to inactivate said pathogens and/or infectious agents
/ decontaminate the object or surface from said pathogens and/or
infectious agents.
In an optional subsequent step c) said object is autoclaved or
sterilised.
The present invention provides a method for rapid broad-range
disinfection, including the inactivation/decontamination of the
infectious agents: non-enveloped viruses, mycobacteria and
prions, preferably for the decontamination/disinfection of a
respectively contaminated object or surface.
The method of the invention comprises the following steps: a)
contacting said object or surface by submerging or rinsing it in
or with a formulation according to the present invention, b)
allowing said formulation to remain in contact with said object
or said surface thereof by submerging or rinsing for a period
and under conditions sufficient to inactivate said infectious
agents (in particular non-enveloped viruses, mycobacteria and
prions) on said object or said surface and at the same time to
disinfect said object or said surface thereof of bacteria, other
viruses (including non-enveloped viruses), and/or vegetative
forms of fungi, and c) optionally followed by autoclaving or
sterilising said object. In a preferred embodiment, the present
invention provides a method for inactivating non- enveloped
viruses, preferably for the decontamination/disinfection of an
object or a surface that is (potentially) contaminated with at
least a non-enveloped virus.
Such an inactivation method comprises the following steps: a)
contacting said object or surface, which is potentially
contaminated with at least a non- enveloped virus, by submerging
or rinsing it in or with a formulation according to the present
invention, b) allowing said formulation to remain in contact
with said object or said surface thereof by submerging or
rinsing for a period and under conditions sufficient to
inactivate the non- enveloped virus on said object or said
surface and at the same time to disinfect said object or said
surface thereof of bacteria (including mycobacteria), other
viruses (including enveloped viruses), vegetative forms of
fungi, and/or prions, and c) optionally followed by autoclaving
or sterilising said object.
In a preferred embodiment, the present invention provides a
method for prion decontaminating and/or disinfecting an object
or a surface thereof.
Such a prion decontaminating and/or disinfecting method
comprises the following steps: a) contacting said object or said
surface thereof by submerging or rinsing it in or with a
formulation according to the present invention, b) allowing said
formulation to remain in contact with said object or said
surface thereof by submerging or rinsing for a period and under
conditions sufficient to decontaminate said object or said
surface thereof of prions and to disinfect said object or said
surface thereof of bacteria (including mycobacteria), or viruses
(including non-enveloped and enveloped viruses), or vegetative
forms of fungi, and c) optionally followed by autoclaving or
sterilising said object.
In the methods of the invention, the pathogens and/or infectious
agents (such as non- enveloped virus, prions, bacteria
(including mycobacteria), other viruses (including enveloped
viruses) and/or vegetative forms of fungi) to be inactivated or
the pathogens and/or infectious agents the objects/surfaces are
to be decontaminated/disinfected of are comprised in a bodily
fluid, preferably blood, or a tissue. Preferably, said period in
the methods of the invention is from 1 min to 60 min, preferably
from about 10 to 20 min.
The term "rapid" as used herein refers to said periods from 1
min to 60 min, preferably from about 10 to 20 min. More
preferably, the term "rapid" as used herein refers to periods of
approximately 20 min or less than 20 min, such as 10-20 min or
5-20 min.
Preferably, said conditions in the methods of the invention are
a temperature in the range of from 5[deg.]C to 80<0>C5
preferably 5<0>C to 50[deg.]C, more preferably 15[deg.]C
to 30[deg.]C.
In preferred embodiments of the methods of the invention:
- said inactivation of non-enveloped virus is a reduction of
viral infectivity by at least a factor of 4 logs of the original
infectivity, and
- said decontamination of prions is a reduction of prion
infectivity by at least a factor of 4 logs of the original
infectivity, and
- said disinfection of bacteria (including mycobacteria) or
viruses (including enveloped and non-enveloped viruses) is a
reduction of bacterial or viral infectivity by at least a factor
of 4 logs of the original infectivity.
In one embodiment said object originates from/belongs to the
field of medicine, dental medicine, veterinary medicine, food
production or -processing, agriculture or laboratory work and is
preferably specified as a surgical instrument, diagnostic
instrument, dental instrument, catheter, other medical device,
operating room, cell culture, laboratory instrument, laboratory
surface or a piece of these
Uses of the formulations
The objects of the present invention are also solved by the use
of a formulation according to the present invention for prion
decontaminating and/or disinfecting an object or a surface
thereof.
The objects of the present invention are also solved by the use
of a formulation according to the present invention for
inactivating bacteria, non-enveloped viruses, other viruses
(including enveloped viruses), mycobacteria and prions,
preferably for decontaminating and/or disinfecting objects or
surfaces thereof.
The formulations of the present invention are in particular
suitable for inactivating/decontaminating/disinfecting over a
broad range of pathogens and infectious agents, i.e. they are
suitable for inactivating/decontaminating/disinfecting these
pathogens at the same time, i.e. simultaneously.
Preferably, the pathogens and/or infectious agents (such as
non-enveloped virus, prions, bacteria (including mycobavteria),
other viruses and/or vegetative forms of fungi) to be
inactivated or the pathogens and/or infectious agents the
objects/surfaces are to be decontaminated/disinfected of are
comprised in a bodily fluid, preferably blood, or a tissue. See
above.
All other disinfectants in use have a narrower spectrum of
activity, a protein fixating effect, or a strongly
oxidative/corrosive activity with adverse effects on steel.
The inventors have found that a formulation comprising a
detergent and an alkali hydroxide and an alcohol, preferably a
C1-C4 alcohol, has a potent disinfecting capability against
viruses and bacteria whilst also maintaining a potent prion
decontaminating activity. This is all the more surprising given
that alcohols are expected to have a stabilizing and fixating
effect on prions, such that one would have expected the presence
of an alcohol e. g. a C1-C4- alcohol to cause an effect that
would compromise the prion decontaminating activity. Yet,
despite such an expected adverse effect of the tested alcohols,
the prion decontaminating activity of the formulation is not
compromised, and an efficient prion decontamination is achieved.
The formulations of the invention are also in particular
suitable for inactivating non- enveloped viruses, such as
poliovirus, norovirus (such as murine norovirus, MNV), or even
HAV.
As used herein, the term "alcohol having 1 to 4 C-atoms" is
meant to refer to any of the following: methanol, ethanol,
n-propanol, isopropanol, 1-butanol, 2-butanol, 2-methyl-l-
propanol (isobutanol), 2-methyl-2-propanol (tert-butanol), and
mixtures thereof. A "kit", as used herein, is meant to refer to
an assembly of agents, wherein each of the agents is provided in
a separate container, such as a vial, and wherein the
formulation in accordance with the present invention may be
provided by appropriate mixing of the various agents, such that
the formulation is made up freshly before use. In a preferred
embodiment, the formulation in accordance with the present
invention is made fresh, prior to its use. However, it has to be
mentioned that a ready-to-use mixture can also be prepared which
does not need to be made-up freshly before use. Thus, a kit
which provides a ready-to-use mixture is also within the scope
of the present invention.
Preferably, the kit in accordance with the present invention
also includes instructions on how and in what quantities to mix
the various components in order to make up the formulation
according to the present invention.
The terms "disinfection", "inactivation" and "decontamination"
are known to the skilled person in the art.
In particular, the term "prion decontaminating", as used herein,
is meant to refer to a process whereby a major proportion of
prion acitivity, i.e. at least 4 logarithmic units (logs) of
prion infectivity (which is quantified in LD50 [50% lethal
doses]), and preferably > 5 logs (i.e. > 99,999% of the
original activity) is removed.
The term "log", as used herein, when referring to an activity,
usually means a factor of 10, e.g. by which such activity is
reduced with respect to the original activity value.
The term "disinfection" according to Deutsches Arzneibuch (DAB,
German Pharmacopeia) refers to: "to bring dead or living
material into a state, where it is no longer infectious". The
term "disinfecting" or "disinfection" as used herein, is meant
to refer to a process whereby pathogens and/or infectious agents
(such as bacteria, viruses or vegetative forms of fungi) are put
into a state where they are no longer infectious, which is
accomplished by a reduction of the infectious load involving
killing, inhibiting the growth or inactivating of the
pathogens/infectious agents. A reduction of the infectious load
can also involve detachment and removal of the
pathogens/infectious agents, such as from an object or surface
thereof. Specifically, such term refers to a process whereby a
reduction of at least 4 logs (i.e. > 99,99% of the original
activity) is achieved. The term "inactivating" or "inactivation"
as used herein, is meant to refer to a process whereby pathogens
and/or infectious agents (such as bacteria, viruses or
vegetative forms of fungi) lose their biological activity, i.e.
their ability to cause a disease. Specifically, such term refers
to a process whereby a reduction of at least 4 logs (i.e. >
99,99% of the original activity) is achieved.
The disinfectant formulations of the invention allow efficient,
fast and non-fixating decontamination
The inventors developed a new formulation for chemical
disinfection without fixating effects and active on a broad
range of bacteria (including mycobacteria), viruses (including
non- enveloped viruses), fungi as well as prions. Strikingly,
inactivation of all these pathogens resulting in a reduction
factor of log 4 or more takes place at room temperature within
an incubation time of only 10-20 minutes. The new disinfectant
allows for fast and highly efficient decontamination at user and
instrument friendly conditions.
Key Features
Fast and efficient broad range disinfection including
non-enveloped viruses, mycobacteria and prions.
Non-protein fixating.
Active on agents enclosed in blood.
Easy to use.
Demands for improved disinfectants: According to national and
international recommendations disinfection so far requires a
preceding residue-free cleaning. Otherwise the disinfection
process usually leads to the fixation of proteins which corrupts
decontamination. The demand for initial manual cleaning is,
however, in conflict with demands for personal protection.
Therefore, an ideal disinfectant should i) have no protein
fixating effects ii) have fast, highly efficient decontaminating
/ inactivating activity on a broad range of bacteria, viruses,
fungi as well as on prions, iii) be non-corrosive to instruments
and easy to use. The inventors have developed a disinfectant
formulation which meets all these requirements including the
inactivation of prions. Details: The disinfectant of the present
invention is a formulation of three components: a detergent, an
alkali hydroxide and an alcohol. In former publications the
inventors have shown the efficacy of NaOH and SDS for
inactivating prions. Alcohols typically stabilize
prion-structures. However, in the formulation presented herein,
the alcohol is not compromising the inactivation of prions but
tremendously broadens the range of inactivated microorganisms.
The formulation has been tested under various conditions
including those in which the contaminants are enclosed in brain
homogenate or blood. Consequently, typical applications are the
decontamination of surgical, dental, diagnostic and laboratory
instruments and well as other medical devices.
Furthermore, in the following, reference is made to the figures,
wherein

Figure 1 shows Western Blot
results on the efficacy of (A) a mixture of 0.2% SDS and 0.3%
NaOH and (B) 70% ethanol used for decontamination of steel
surfaces from PrP<Sc>. More specifically Figure 1 shows
detection of full-length PrP and PrP27-30 in eluates from
contaminated steel wires after incubation with the reagents
without (- PK) and after proteinase K (+ PK) digestion. Samples
not subjected to PK digestion correspond to 46.2 mm<2>, PK
treated samples to 23.1 mm<2> of wire surface. A-B lanes
10<'6> or 10<"7> internal standards: PK digested
brain homogenate from scrapie hamsters corresponding to
IxIO<"6> g or 1x10<"7> g brain tissue. Lane M,
molecular mass marker. Numbered lanes represent protein eluates
from 30 contaminated wires incubated for 5 min (lanes 1 and 2)
or 20 min (lanes 3 and 4) at 23 [deg.]C in SDS/NaOH (A) or 70 %
ethanol (B). B, lanes 5 and 6: water controls; the contaminated
wires have been incubated in distilled water for 5 min at
23[deg.]C. The samples incubated in 70 % ethanol (B, lanes 1-4)
or in distilled water (B, lanes 5 and 6) were diluted 1:10 in
LPP/Urea before electrophoresis. These samples correspond to
4.62 mm<2> (lanes 1, 3 and 5) or 2.31 mm<2> (lanes
2, 4 and 6) of wire surface.

Figure 2 shows the Western Blot results on the efficacy
of a mixture of 0.2% SDS and 0.3% NaOH in 50% ethanol (A) and in
50% n-propanol (B) used for decontamination of steel surfaces
from PrP<Sc>.
More specifically Figure 2 shows detection of full-length PrP
and PrP27-30 in eluates from contaminated steel wires after
incubation with the reagents without (- PK) and after proteinase
K (+ PK) digestion. Samples not subjected to PK digestion
correspond to 46.2 mm<2>, PK treated samples to 23.1
mm<2> of wire surface. A-B lanes 10<'6> or
10<"7> internal standards: PK digested brain homogenate
from scrapie hamsters corresponding to 1x10<"6> g or
1x10<"7> g brain tissue. Lane M, molecular mass marker.
Numbered lanes represent protein eluates from 30 contaminated
wires incubated for 5 min (lanes 1 and 2) or 20 min (lanes 3 and
4) at 23<0>C in a mixture of 0.2% SDS and 0.3% NaOH in 50%
ethanol (A) and in 50% n-propanol (B). B, lanes 5 and 6: water
controls; the contaminated wires incubated in distilled water
for 20 min at 23[deg.]C. Both samples were diluted 1 :10 in
LPP/Urea before electrophoresis. These samples correspond to
4.62 mm2 (lanes 5) and 2.31 mm<2> (lanes 6) of wire
surface.

Figure 3 shows Western Blot
results on the efficacy of a mixture of 0.2% SDS and 0.3% NaOH
in 30% (A) and 20% (B) n-propanol used for decontamination of
steel surfaces from prpSc
More specifically figure 3 shows Western blot results showing
the efficacy of a mixture of 0.2 % SDS and 0.3 % NaOH in 30 %
(A) and in 20 % n-propanol (B) used for decontamination of steel
surfaces from PrP<Sc>. Detection of full-length PrP and
PrP27-30 in eluates from contaminated steel wires after
incubation with the reagents without (- PK) and after proteinase
K (+ PK) digestion. Samples not subjected to PK digestion
correspond to 46.2 mm<2>, PK treated samples to 23.1
mm<2> of wire surface. A-B lane 10<'6>, internal
standard: PK digested brain homogenate from scrapie hamsters
corresponding to 1x10<"6> g brain tissue. Lane M,
molecular mass marker. Numbered lanes represent protein eluates
from 30 contaminated wires incubated for 5 min (lanes 1 and 2)
or 10 min (lanes 3 and 4) at 23 [deg.]C in the solutions. B,
lanes 5 and 6: water controls; the contaminated wires incubated
in distilled water for 20 min at 23 [deg.]C. Both samples were
diluted 1 :10 in LPP/Urea before electrophoresis. These samples
correspond to 4.62 mm<2> (lanes 5) and 2.31 mm<2>
(lanes 6) of wire surface.
Figure 4 shows the results
of the examination of protein fixating effects by different
treatments for disinfection applied on blood or 10% (w/v)
hamster brain homogenate (GDA: glutardialdehyde; PES: peracetic
acid; -K or -KC: negative control).
Moreover reference is made to the following examples, which are
given to illustrate, not to limit the present invention.
EXAMPLES
Example 1
Preparation of stock solution of
SDS/NaOH and the various formulations
NaOH was used as a finely grained crystalline substance; SDS was
provided in form of a 5% w/v stock solution.
Among others, the following aqueous formulations are tested as
decontaminating mixtures/disinfectants :
a) 0.2% (w/v) SDS/0.3% (w/v) NaOH in aqua bidest.
b) 0.2% (w/v) SDS/0.3% (w/v) NaOH in 50% (v/v) ethanol. c) 0.2%
(w/v) SDS/0.3% (w/v) NaOH in 30% (v/v) n-propanol, and d) 0.2%
(w/v) SDS/0.3% (w/v) NaOH in 20% (v/v) n-propanol.
Additionally, the efficacy of 50% (v/v) ethanol and 30% (v/v)
and 20% (v/v) n-propanol alone is tested.
The solutions are prepared prior to use. It has to be noted that
a 10-fold concentrated SDS/NaOH-stock solution may show
precipitation after a few hours. The final mixture of 0.2% SDS /
0.3% NaOH does not show a precipitation effect.
First a ten-fold concentrated SDS-NaOH-solution (stock solution)
is prepared and is hereafter referred to as solution 1 :
To this end, 0,3 g NaOH is dissolved in 6 ml aqua bidest, and
thereafter 4 ml of a 5% SDS- solution is added and mixed. For
the experiments the solution is sterile filtered when necessary
and represents the aforementioned SDS/NaOH-stock solution or
solution 1.
To produce the above formulations a) - d) including a microbial
test sample (hereafter referred to as "microbial test
suspension"), the following mixtures are prepared:
a) 0.2% SDS/0.3% NaOH in aqua bidest (final concentrations): 8
ml aqua bidest + 1 ml solution 1 + 1 ml of microbial test
suspension
b) 0.2% SDS/0.3% NaOH in 50% ethanol (see above):
3 ml aqua bidest
+ 5 ml ethanol abs.
+ 1 ml solution 1
+ 1 ml of microbial test suspension
c) 0.2% SDS/0.3% NaOH in 30% n-propanol (see above):
5 ml aqua bidest + 3 ml n-propanol + 1 ml solution 1
+ 1 ml of microbial test suspension
d) 0.2% SDS/0.3% NaOH in 20% n-propanol (see above):
6 ml aqua bidest + 2 ml n-propanol + 1 ml solution 1
+ 1 ml of microbial test suspension.
Example 2 Analysis of protein fixating effects of disinfectants
Test objects
Frosted glass strips served as test objects (16 mm wide, 60 mm
long), which, prior to use, are cleaned in soap solution, rinsed
with aqua dest. and sterilized with hot air after drying.
Disinfectant (see example 1)
SDS/NaOH, SDS/NaOH in ethanol, SDS/NaOH in n-propanol.
Aqua bidest was used as control.
Contamination For contamination of the test objects sheep blood
that is capable of coagulation is used, to which during blood
withdrawal a heparin preparation has been added (0.1 ml Liquemin
5000 per 100 ml blood). The blood can be stored at 4[deg.]C for
approximately 14 days.
Prior to using this blood as contaminating agent, Protamin 1000
is added to the blood to start coagulation (0.15 ml per 10 ml
blood). Immediately thereafter, 50 [mu]l of the coagulating
blood are applied to each test object and homogeneously
distributed in the test field which is 1 x 2cm<2>, using a
pipette. Because the blood is cooled in ice water, the
coagulation only starts slowly, and there is sufficient time to
contaminate a sufficient number of test objects. In order to
avoid drying of the blood, the test objects are kept in a humid
chamber until full coagulation is achieved (ca. 15 - 20
minutes).
Analysis of protein fixating
effects
The contaminated test objects are separately placed into screw
cap vials, using pincers, together with 10 ml of the solution to
be tested for 10 and 30 minutes respectively at 20[deg.]C. The
solutions are incubated for approximately 30 minutes in a water
bath at 20[deg.]C. After the incubation period, the screw cap
vials are swirled 20 x. The test objects are separately taken
out using pincers, any remaining liquid is allowed to drip off
onto pulp or filter paper, the test objects are rinsed once in
aqua dest. and any remaining liquid is once more allowed to drip
off.
For staining, the test objects are placed separately into tubes
containing 15 ml Coomassie-blue of Bio-Rad 161-0400, after 45
minutes, the adhering colour solution is allowed to drip off,
and the test objects are subsequently rinsed 4 -5 times in
destaining solution (50% methanol, 10% glacial acetic acid in
aqua dest.). In each series of stainings, a non-contaminated
object was taken as a negative control.
The results of the examination of protein fixating effects by
different treatments for disinfection are shown in figures 4A-C.
Example 3
a) Efficacy against mycobacteria - quantitative suspension tests
1. Material Test bacteria
M. avium DSM 44156 (type strain, i. e. the species-defining
strain in the strain repository) and
M. avium DSM 44157 (as mentioned in European Norm EN 14348 /
Quantitative suspension test for chemical disinfectants and
antiseptics used in human medicine)
Nutrient medium
Middlebrook 7H10 Agar with OADC (OADC [Oleic acid, Albumin
fraction V, bovine, Dextrose, Catalase (beef)] is an additive to
the medium necessary for the growth of mycobacteria;Becton
Dickenson Art. Nr.: 254521)
Inactivating agents
0.2% SDS/0.3 NaOH in aqua bidest, ethanol or n-propanol (see
example 1) for preparation of the solutions, see example 1
Growth
From a cryo tube of a stock culture stored at -80[deg.]C 0.2 ml
suspension are plated out on Middlebrook 7H10 agar plates with
OADC enrichment (BD). The inoculated plates are protected from
drying by sealing them with insulating tape and are incubated
for 21 days at
36[deg.]C.
Preparation of Bacterial
Suspension
The bacterial lawn of 5 Middlebrook plates is washed off using 2
x 5ml 0.1% Tween 80 in aqua bidest ("Tween-bidest-solution") per
Petri dish, centrifuged (10 minutes at 0[deg.]C using 3000 rpm;
ca. 2000 x g) and is washed three times using
Tween-bidest-solution (see above). Each time, the sediment is
replenished up to the starting volume. After the last round of
centrifugation, the sediment is taken up in 5ml
Tween-bidest-solution and is homogenized in a 15ml glass/Teflon
homogenizer using ice cooling for 10 minutes. The homogenate is
diluted 1 : 10 using Tween-bidest-solution and is hereafter
referred to as bacterial suspension. The bacterial suspension is
stored in a screw cap vial together with glass beads in the
fridge up until use. The bacterial suspension can be used for a
period of up to 5 days. Prior to use, the suspension should be
shaken on a Vortex in order to bring the mycobacteria into a
homogenous solution again. The homogenisate should have a
bacterial content of at least 10<9> colony forming units
(CFU) /ml.
2. Experiment
Inactivation
The examination of efficacy is performed at 20<0>C in an
Eppendorf Thermomixer comfort on the lab bench. The disinfectant
solutions are incubated in the Thermomixer at least 20 minutes
before the experiment. 0.1 ml bacterial solution is mixed with
0.9 ml disinfectant (see above), and is vortexed for 20 seconds.
The experiments are performed in 2 ml Safe-Lock-tubes of
Eppendorf.
The exposure time is 5 and 20 minutes, respectively, at a mixing
frequency of 300 rpm. A constant exposure time during
inactivation experiments is to be safeguarded.
Determination of colony forming
units (CFU)
After the inactivation period, the samples are immediately
centrifuged in a cooled Eppendorf Centrifuge at 12000 rpm for 1
minutes. After careful pipetting off the supernatant, the
sediment is resuspended in 1 ml M/15 (i.e. 0,067 M) phosphate
buffer pH 7 (M/15 is a medium for neutralisation) + 3% Tween 80,
and vortexed for 20 seconds. Subsequently, dilutions at a ratio
of 1 : 10 in M/15 phosphate buffer pH 7 + 3% Tween 80 are
prepared. The experiment is performed in Deepwell-plates (Linbro
liquisystem) using a multi-channel pipette. The mixing is to be
done carefully, and the pipette tips are to be exchanged between
the separate dilution steps.
From the original experiment tube (= value 0) and from the
various dilution steps, 0.1 ml each are plated out on
Middlebrook 7H10 agar plates with O ADC-enrichment. The agar
plates are kept in polyethylene (PE) bags against drying out and
are incubated for four weeks at 36[deg.]C. The CFU grown on the
nutrient are counted using a counting device and recorded.
Determination of reference value
For the reference value (control) 0.1 ml bacterial suspension is
mixed with 0.9 ml aqua bidest and is processed under the same
conditions as described above.
3. Analysis
The efficacy of the inactivation agent (disinfectant) is
indicated by the reduction factor (RF). From the average values
of the numbers of CFU after exposure to the inactivation
solution (log N) and the numbers of CFU of the control (log No),
the reduction factor (RF) is calculated:
RF = log N0 - log N.
b) Efficacy against Enterococci - quantitative suspension tests
1. Material
Test bacteria
Enterococcus faecium DSM 2146 (DSM: German type culture
collection)
Nutrient medium
Brain Heart Infusion-Agar (BHI Agar)
Difco Nr.: 0418-17
Inactivation agent (disinfectant)
SDS/NaOH in aqua bidest., SDS/NaOH in Ethanol, SDS/NaOH in
n-propanol (see example 1)
The solutions need to be prepared 10-fold more concentrated,
since they become 1 : 10 diluted by the bacterial suspension in
the sample.
Growth of test culture
A subculture taken from a previously grown culture is plated out
onto BHI agar in 2 Kolle- flasks and is incubated for 24 h at
36[deg.]C. For each test, a new test culture is to be
established.
2. Experiment
Preparation of bacterial
suspension
The bacterial lawn of the test culture is washed with 10 ml aqua
bidest, filtered through glass wool, centrifuged for 10 minutes
at 0<0>C at 3000 rpm (ca. 2000 x g) in the Cryofuge 5000,
and is washed 3 times with aqua bidest. After the last
centrifugation, the pellet is resuspended in 5 ml aqua bidest,
transferred in a gradated centrifuge tube and is centrifuged for
ten minutes as indicated above. The pellet is diluted 1 : 100
using aqua bidest, and the bacterial suspension is vortexed
together with glass beads for 30 seconds in a screw cap vial.
Inactivation
The test of efficacy is performed in an Eppendorf Thermomixer
comfort at 20[deg.]C on the lab bench.
The disinfectant solutions are incubated at least 20 minutes
prior to the experiment in the Thermomixer.
The experiments are performed in 2 ml safe-lock-tubes of
Eppendorf. 150 [mu]l bacterial suspension is mixed with 1350
[mu]l of disinfectant and is vortexed for 20 seconds. The
exposure time is 5 and 20 minutes, respectively, at a mixing
frequency of 300 rpm. A constant exposure time during the
inactivation experiments is to be safeguarded.
Determination of number of colony
forming units (CFU)
After the exposure time, the sample is immediately centrifuged
in a cooled MiniSpin Plus Centrifuge for 1 minute at 12000 rpm.
The supernatant is carefully pipetted off, the pellet is
resuspended in 1.5 ml M/15 phosphate buffer pH 7 and the sample
is vortexed for 20 seconds.
Further processing of the sample is performed by preparing
serial dilutions (1 :10) using M/15 phosphate buffer pH 7 in 2.2
ml Deepwell-plates using a multi-channel pipette. 150 [mu]l
sample is added to 1350 [mu]l M/15 phosphate buffer pH 7 and
mixed. 1 ml each of the sample (= value 0) and from the
respective dilution steps is transferred into Petri dishes and
is poured together with 20 ml liquefied BHI Agar to form plates.
The plates are prevented from drying out by sealing foil and are
incubated 14 days at 36[deg.]C. The CFUs grown in and on the
nutrient are counted using a counting apparatus and are
recorded.
Determination of reference value
For the reference value (control) 150 [mu]l bacterial suspension
is mixed with 1350 [mu]l aqua bidest and is treated under the
same conditions as described above.
3. Analysis
The efficacy of the inactivating agent is indicated by the
reduction factor (RF). From the average values of the number of
CFUs after exposure to the disinfectant solution (log N) and of
the number of CFUs of the control (log No), the reduction factor
(RP) is calculated: RF = log N0 - log N
c) Efficacy against mycobacteria - quantitative carrier tests
with blood as test soil 1. Material
Test bacterium
M. avium DSM 44156
Nutrient medium
Middlebrook 7H10 Agar with OADC [(oleic acid, albumin fraction
V, Bovine, dextrose, catalase (beef)]
BD Art. No.: 254521
Carrier for bacteria
Frosted glass is used as carrier for bacteria. Strips of frosted
glass of 16 mm width and 60 mm length are placed into soap
solution (e.g. RBS 50) prior to their first use, washed in a
dish washer and thereafter boiled three times in Aqua bidest.
After drying, the strips are sterilized for two hours at
18O<0>C using hot air.
Contamination
Heparinized sheep blood (0.1 ml Liquemin 5000 per 100 ml blood)
Disinfectant
0.2 % SDS / 0.3 % NaOH in Aqua bidest, SDS / NaOH in ethanol,
SDS / NaOH in n-propanol
(see also example 1)
Growth
From a cryo-tube of a stock culture stored at -80<0>C, 0.2
ml are plated onto Middlebrook 7H10 Agar plates with OADC
enrichment (BD). The inoculated plates are protected from drying
by sealing them with insulating tape and are incubated for 21
days at 36[deg.]C.
Preparation of bacterial
suspension
The bacterial lawn of 10 Middlebrook-plates (see growth) is
washed off using 2 x 5 ml 0.1 %
Tween 80 in Aqua bidest ("Tween-bidest-solution") per Petri
dish, centrifuged (10 minutes at 4[deg.]C using 3000 rpm; ca.
2000 x g) and is washed three times using Tween-bidest-solution
(see above). Each time, the sediment is replenished up to the
starting volume. After the last round of centrifugation, the
sediment is stirred up using a glass rod and taken up in 2 ml
Tween-bidest-solution and is homogenized in a 5 ml glass/Teflon
homogenizer using ice- cooling for 10 minutes at 1500 rpm. The
homogenate = bacterial suspension is stored in the fridge until
use in a culture vial containing glass beads. The bacterial
suspension can be used for a period of up to 5 days. Prior to
use, the suspension should be shaken on a vortex in order to
bring the mycobacteria into a homogenous solution again. The
bacterial suspension should have a bacterial content of at least
10<9> colony forming units (CFU/ml).
2. Experiments
Preparation of
disinfectant-solutions
For the preparation of the disinfectants, see example 1. The
solutions are incubated in screw- cap vials in a water bath at
20[deg.]C (for at least 30 minutes).
Preparation of bacterial
suspension
On the day of the experiment, 0.5 ml bacterial suspension (see
above) is mixed with 4.5 ml sheep blood in a small Erlenmeyer
flask and is kept on ice.
Contamination of test objects
Immediately prior to application onto the test objects (=
frosted glass strips, see above), the bacterial suspension is
mixed with 75 [mu]l Protamin 1000 for coagulation and carefully
mixed. Cooling of the suspension is continued to slow down the
onset of coagulation. 50 [mu]l bacterial suspension each are
pipetted homogenously onto the test field (10 mm wide, 20 mm
long - template, see above) on the test object. In order to
avoid drying of the blood, all contaminated test objects are
stored in a humid chamber immediately up until disinfection. At
room temperature, the blood is coagulated after 15-20 minutes.
Disinfection
Using pincers, each of the contaminated test objects is placed
into 10 ml disinfectant dilution to be tested for the intended
exposure period. The solutions are in 15 ml screw-cap vials and
should be kept in a water bath at 20[deg.]C without any
vibrations. Each experiment is to be performed in at least
duplicate. A strict adherence to the intended exposure period is
to be observed. Hence, it is prudent to introduce the samples in
a temporarily staggered manner.
Examination for surviving bacteria
After completion of the exposure period, each test object is
taken out using sterile pincers and placed into a screw-cap vial
with 5 ml 3 % Tween 80 in M/15 phosphate buffer pH 7. The vial
is shaken several times carefully such that the test object is
rinsed by the neutralization solution (i.e. M/15 phosphate
buffer + 3 % Tween 80).
Subsequently, the test object is taken out using sterile
pincers, placed in a mortar, and the adhering contaminants are
taken off using a scalpel and rinsed off with 0.5 ml
neutralization solution from the screw-cap vial. The mortar is
subsequently covered again using aluminum foil and frozen for 20
minutes at -20<0>C. The test object is placed back into
the vial, sterile glass beads are added, and the vial is
vortexed for 20 seconds and subsequently placed on ice. The
frozen contaminants in the mortar are carefully ground using a
pestle, are mixed after the remaining amount of neutralization
solution in the respective vial has been added, and are returned
into the screw-cap vial. After processing of all samples, the
vials are shaken in a basket for 5 minutes on a universal
shaker, whilst being in a horizontal position (frequency
400/min).
Further processing is done by preparing serial dilutions (1 :10)
using 3 % Tween 80 in M/15 phosphate buffer pH 7 in 1.1 ml Deep
Well-plates using a multi-channel pipette. From the screw-cap
vial (= 0 value) and from the dilution steps, 0.1 ml each is
plated out on Middlebrook 7H10-plates. The Agar plates are
incubated for 4 weeks at 36[deg.]C (in bags of PE (polyethylene)
to prevent drying out). The grown colony forming units (CFU) on
the nutrient medium are counted using a counting device and are
recorded.
Determination of reference value
Contaminated test objects which had been placed in Aqua bidest
and processed under the same conditions as described above,
served as a reference value (control).
3. Analysis
The efficacy of the disinfectant is given by the reduction
factor (RF). From the average number of CFUs after exposure to
the disinfectant dilution (log N) and the number of CFUs of the
control (log N0), the reduction factor (RP) is calculated: RF =
log N0 - log N.
d) Efficacy against Enterococci - quantitative carrier tests
with blood as test soil
1. Material
Test bacterium
Enterococcus faecium DSM 2146
Nutrient medium
Brain Heart-Infusion- Agar (BHI Agar)
Difco Nr.: 0418-17
Carrier for bacteria in test soil
Frosted glass is used as carrier for bacteria in test soil
(blood). Strips of frosted glass of 16 mm width and 60 mm length
are placed into soap solution (e.g. RBS 50) prior to their first
use, washed in a dishwasher and thereafter boiled three times in
aqua bidest. After drying, the strips are sterilized for two
hours at 180[deg.]C using hot air.
Contamination
Heparinized sheep blood (0,1 ml Liquemin 5000 per 100 ml blood;
see also "Carrier for bacteria in test soil")
Disinfectant
SDS/NaOH in Aqua bidest., SDS/NaOH in ethanol, SDS/NaOH in
n-Propanol (see also example 1)
Growth
An inoculum is taken from a previously grown culture and is
plated out on BHI agar in two
Kolle-plates and is incubated for 24 h at 36[deg.]C.
2. Examination
Preparation of disinfectant
For the preparation of the disinfectants see example 1. The
disinfectant-dilutions are incubated in screw cap vials in a
water bath at 20[deg.]C (for at least 30 minutes). Preparation
of bacterial suspension
The bacterial lawn is washed using 10 ml aqua bidest, filtered
through glass wool, centrifuged for 10 minutes at 0[deg.]C (3000
rpm, ca. 2000 x g) and washed once with aqua bidest. The
sediment is resuspended in 5 ml aqua bidest and centrifuged in a
gradated centrifuge tube for 10 minutes. The sediment (the
amount of which is to be recorded) is taken up in 10 ml sheep
blood and carefully mixed. This suspension is placed on ice.
Contamination of test objects
Immediately prior to application onto the test objects (=frosted
glass strips, see above), the bacterial suspension is mixed with
150 [mu]l protamin 1000-treated heparinized sheep blood and
carefully mixed. 50 [mu]l bacterial suspension each are pipetted
homogeneously onto the test field (10 mm wide, 20 mm long) on
the test objects. A template for such test field is used. In
order to avoid drying of the bacterial suspension, the
contaminated test objects are stored in Petri dishes in humid
chambers until disinfection. At room temperature, the bacterial
suspension is coagulated after 15 to 20 minutes.
Disinfection
Using pincers, each of the contaminated test objects is placed
into 10 ml disinfectant dilution for the intended exposure
period. The solutions are in 15 ml screw cap vials and should be
kept in a water bath at 20[deg.]C without any vibrations. Each
experiment is to be performed in duplicate. A strict adherence
to the intended exposure period is to be observed.
Examination for surviving bacteria
After completion of the exposure period each test object is
taken out using sterile pincers and placed into a screw cap vial
with 5 ml M/ 15 phosphate buffer pH 7. The vial is shaken
several times carefully such that the test object is rinsed by
the neutralization solution (i. e. M/15 phosphate buffer + 3%
Tween 80).
Subsequently, the test object is taken out using sterile
pincers, placed in a mortar, and the adhering contaminants are
taken off using a scalpel, and rinsed off with 0.5 ml
neutralization solution from the screw cap vial. The mortar is
subsequently covered again using aluminium foil and frozen for
20 minutes at -18[deg.]C. The test object is placed back into
the vial, sterile glass beads are added, and the vial is
vortexed for 20 seconds and subsequently placed on ice. The
frozen contaminants in the mortar are carefully ground using a
pestle, are mixed after the remaining amount of neutralization
solution in the respective vial, has been added, and are
returned into the screw cap vial. After processing of all
samples, the vials are shaken in a basket for 5 minutes on a
universal shaker, whilst being in a horizontal position
(frequency 400/min).
The further processing is done by preparing serial dilutions
(1:10) using M/15 phosphate puffer pH 7 in 2.2 ml
Deepwell-plates using a multichannel pipette. 1 ml each from the
shaking vials and from the dilution steps are poured together
with 20 ml liquefied BHI agar, to form plates. The plates are
wrapped in foil to avoid drying and are incubated for 2 weeks at
36[deg.]C. The CFUs grown in and on the nutrient are counted
using a counting apparatus and are recorded.
Determination of reference value
Contaminated test objects which had been placed in aqua bidest
only but are otherwise processed under the same conditions as
described above, served as reference value (control).
3. Analysis
The efficacy of the disinfectant is given by the reduction
factor (RF). From the average number of CFUs after exposure to
the disinfectant-dilution (log N) and the number of CFUs of the
control (log No) the reduction factor (RP) is calculated:
RF = log N0 - log N.
e) Efficacy against poliovirus-l-LSc-2ab - quantitative carrier
tests with blood as test soil
1. Material
Test virus
Polio- l-Lsc-2ab (10<9> infectious viruses/ml)
Cells L20B Media
First growth medium: MEM Hank Salt Solution with Hepes buffer
10% foetal calf serum, from company PAA
1% L-glutamin, from company ICN
1% antibiotics (AB), consisting of penicillin + streptomycin,
from company PAA
1% non-essential amino acids: from company Biocrom
AG
0.8 % Na2HCO3
1.2 Maintenance medium: MEM Hanks Salt Solution with Hepes
buffer
2% foetal calf serum, from company PAA
1% L-glutamin, from company ICN
1% antibiotics (AB), consisting of penicillin + streptomycin,
from company PAA
1% non-essential amino acids: from company Biocrom
AG
0.8 % Na2HCO3
1.3 Test medium (Titration of virus):MEM Hanks Salt Solution
with Hepes buffer
5% foetal calf serum, from company PAA
1% L-glutamin, from company ICN
1% antibiotic (AB), consisting of penicillin + streptomycin,
from company PAA
1% non-essential amino acids: from company Biocrom
AG
0.8 % Na2HCO3
1.4 Water 3x distilled water (low pyrogen content)
Virus inoculation (stock virus suspension<*>)
Desired starting titre: 10<9>AnI (start of a new batch
using the virus of an earlier batch; IMPORTANT: never passage a
polio batch more than ten times because of the risk of a
(back)mutation of the strain; hence keeping record and track of
the passaging number of the virus is very important)
Ratio of cell number to virus: 1 : 1 to 1 : 10
Incubation at 37[deg.]C and 5% CO2 in 25 cm<2>-bottles
Amount of virus required for obtaining a new batch: Four bottles
(and one cell control bottle without virus) are inoculated using
0.1 ml, 0.2 ml, 0.5 ml and 1.0 ml virus suspension and
incubated. It is recorded on a daily basis how the
cytopathogenic effect (CPE) is formed and whether or not at the
end of the incubation the entire cell lawn has a CPE (once a
complete CPE has been reached after 4-5 days, this dosage will
be used for the subsequent virus production).
Course of infection and virus passaging is recorded.
Production of polio virus-
concentrate
Cell detritus is removed by centrifugation at 5000 rpm, 30
minutes. Thereafter a virus concentrate is obtained by
concentrating the supernatants of infected L20B-cell cultures
via ultra centrifugation (19000 rpm (53900 x g), 4 hours). For
the production of 10 ml virus concentrate, approximately 3
batches are required (depending on the titre of the virus
supernatant and the titre necessary for the corresponding
experiments).
Cultivation of L20B-cells for
virus titration in 96 well plates
The cell suspension (about 1-2 x 10<5> cells/ml) is
diluted using growth medium, and 100 [mu]l per well are
subsequently placed onto the 96 well plate. The plate is
thereafter sealed in cling film and incubated at 37[deg.]C and
5% CO2. On the day of use, a microscopy examination is performed
to test whether or not the cells have really grown well and
uniformly (cell lawn must not be showing gaps nor must it be
overgrown).
Germ (<">virus) carrier-test
Frosted glass is used as carrier for virus suspensions. Strips
of frosted glass (16 mm width and
60 mm length) are placed into soap solution (e.g. RBS 50) prior
to their first use, washed in a dish washer and thereafter
boiled three times in aqua bidest. After drying, this strips are
sterilized for two hours at 180[deg.]C using hot air.
Contamination (test soil)
Heparinized sheep blood (0.1 ml liquemin 5000 per 100 ml blood)
Disinfectant
0.2% SDS / 0.3% NaOH in aqua bidest, SDS/NaOH in ethanol, SDS /
NaOH in n-propanol, see also example 1
2. Examination
Preparation of
disinfectant-solutions
For the preparation of the disinfectants see example 1. The
disinfectant-solutions are incubated in screw cap vials in a
water bath at 20[deg.]C (for at least 30 minutes).
Preparation of suspension to be
tested
On the day of the experiment, 200 [mu]l virus concentrate is
mixed thoroughly with 1750 [mu]l sheep blood in a little vial
and placed on ice. For the examination of toxicity, in the
negative- control, 200 [mu]l PBS are used instead of the virus
concentrate.
Contamination of virus carriers
Immediately prior to application onto the carriers, the
suspension (200 ul of virus concentrate in 1750 ul sheep blood)
to be tested is mixed with 50 [mu]l protamin 1000 and carefully
mixed. Cooling of the suspension is maintained such that
coagulation only starts slowly. 50 [mu]l test suspension each
are pipetted homogeneously onto the test field (10 mm wide, 20
mm long, using a template) on the virus carrier. A template for
such test field is used. In order to avoid drying of the blood,
all the virus carriers are stored in a humid chamber immediately
after contamination until disinfection. At room temperature, the
blood is coagulated after 15-20 minutes.
Disinfection
Using pincers, each of the contaminated virus carriers is placed
into 10 ml disinfectant dilution to be tested for the intended
exposure period. The solutions are in 15 ml screw cap vials and
should be kept in a water bath at 20[deg.]C without any
vibrations. A strict adherence to the extended exposure period
is to be observed. Therefore it is useful to place the sample
into the water bath in a temporally staggered manner.
Examination for surviving viruses
After completion of the exposure period, each virus carrier is
taken out using sterile pincers and placed into a screw cap vial
with 2.5 ml neutralization solution (maintenance medium plus 2%
sodium sulfite, sterile filtered). The vial is shaken several
times carefully such that the carrier is rinsed by the
neutralization solution. Subsequently, the virus carrier is
taken out using sterile pincers, placed in a mortar, and the
adhering contaminants are taken off using a scalpel, and rinsed
off with 0.5 ml neutralization solution from the screw cap vial.
The mortar is subsequently covered again using aluminium foil
and frozen for 20 minutes at -20<0>C. The virus carrier is
returned into the vial, sterile glass beads are added, and the
vial is vortexed for 20 seconds and subsequently placed on ice.
The frozen contaminants in the mortar are carefully ground using
a pestle, are mixed after the remaining amount of neutralization
solution in the respective vial has been added, and are returned
into the screw cap via
l. After processing of all samples, the vials are shaken in a
basket for 5 minutes on a universal shaker, the vials being in a
horizontal position (frequency 400/min). For the positive
control, a contaminated carrier is placed in phosphate buffer
and aqua bidest, respectively. The negative control serves to
test for toxicity of the disinfectant. For a suspension control,
50 [mu]l virus suspension is directly transferred into 2.5 ml
phosphate buffer prior to coagulation.
Determination of reference value
Contaminated virus carriers which had been placed in phosphate
buffer and aqua bidest, respectively, and processed under the
same conditions as described above, served as reference value
(control).
3. Determination of virus titer
Dilution series
Dilutions are prepared using maintenance medium as dilution
medium in l :10-steps. The total amount in each dilution step
was 2.0 ml:
1.8 ml medium + 0.2 ml of experiment or 0.2 ml of prior dilution
step. After each dilution, vortexing is performed for 20 seconds
(dilution tube) or the multi channel pipette is operated at
least 20 to 30 times (deep well plate), and only thereafter
pipetting is continued.
Virus titration
0.1 ml of each dilution per well is placed into the prepared 96
well plate, i.e. the final volume is 0.2 ml. The cell lawn must
be thin but close (monolayer). Each dilution step is placed onto
the plate eight times.
Cell control:
On each plate, there must be at least eight adjacent (i.e. one
row of) wells as cell control, onto which only maintenance
medium (without virus) is placed.
Incubation
Subsequently, the 96 well plates are wrapped in cling film and
incubated for 5 days at 37[deg.]C and 5% CO2. Thereafter, the
experiment is analyzed.
4. Analysis
The protocol contains the following data: experiment number,
experiment date, recoding date, virus used (date of pooling,
dilutions), cell type, exposure time, used disinfectant and
concentration, exposure temperature.
The analysis of the cell control is also recorded. If the cell
control is not regular on a plate, this plate must not be
analyzed. The samples are applied again onto a new 96 well
plate, and this must be recorded in the protocol. If necessary,
the whole experiment needs to be repeated. The protocols also
indicate for all wells of all samples and controls whether or
not a beginning, a complete or no cytopathic effect (CPE) is
observed: + (complete CPE), (+) (beginning CPE), - (no CPE). All
wells must be analyzed for all samples. The examination of
efficacy of a disinfectant must be performed at least three
times in separate experiments.
5. Calculation
Calculation of titre (example):
The positive wells for each dilution step are indicated in
percentage (see table/example); in the end all percentage values
are added and inserted in the following formula (formula for
TCID50 [Tissue Cell Infection Dosage 50%]):
loglO TCID50 = [neg. log 10 highest virus concentration]- [sum
percentage positive/100-0.5] x loglO dilution factor.
The value obtained after calculation is always negative. As
titre (1 TCID50), the number is however indicated as log10 as a
positive value.
The lower level for indication of the titre is positive with
four wells. If only three or less wells are positive, the value
is indicated as smaller than or equal to 1 (<1.0).
If deviations from the already known titre (titre control) are
observed, the courses thereof must be determined. Possibly, the
experiment cannot be used for evaluation.
Example (see numbers of table)
logl0TCID50= - 1 - (450 : 100 - 0,5) x 1 logl0TCID50= - 1 - (4,5
- 0,5) logl0TCID50= - 1 - 4 logl0TCID50= - 5
I TCID5O = = I i O ns.o Reduction factor
The efficacy of the disinfectant is given by the reduction
factor (RF).
Calculation of reduction factor:
Except for the positive- and negative control, the reduction
factor is indicated. The logarithm of the calculated titre of
the sample treated with the respective disinfectant is
subtracted from the logarithm of the infection titre (which is
the untreated virus titre) [positive control] determined de novo
for each experiment. This difference is the reduction factor.
The higher the reduction factor the more efficient the tested
disinfectant. The lower the reduction factor the less efficient
is the disinfectant. Also the reduction factor is indicated as
an exponential having 10 as a base (i0<reduction factor>).
Also the cytotoxicity control must be observed when titre and
reduction factors are indicated.
Cytotoxicity
The cytotoxicity (negative control) is indicated in log-steps,
i.e. even if in the respective steps only one well is positive,
the respective disinfectant at this concentration must not be
taken into account for this step.
f) Efficacy against Polio virus - quantitative suspension tests
1. Required Materials:
1.1. Test Virus: Polio - 1 - LS c
- 2 ab - Virus (WHO); concentrate thereof
1.2. Instruments and Materials:
- Millipore Ultrafree-4 and Amicon Ultra-4-centrifuge-filter
units having a Biomax-IOOK- membrane
- Bender and Hobein AG - Vortex
- Eppendorf Thermomixer Comfort
- Heraeus Cryofuge 5000
- Eppendorf tubes having 2 ml capacity for incubation in
thermomixer
- sterile dilution tubes (Sarstedt 5 ml tube) and Deep Well
plates (Nunc) with corresponding lid (sterile) for dilutions -
Sarstedt 15 ml-tube for preparation of disinfectant solution
- Eppendorf-one-channel pipette (10 [mu]l - 100 [mu]l, 20 [mu]l
- 200 [mu]l, 100 [mu]l - 1000 [mu]l, 500 [mu]l - 5000 [mu]l) and
Capp-multi-channel pipette (20 [mu]l - 200 [mu]l) with sterile
tips which have been additionally stuffed (for virus pipetting)
- ice for cooling PBS and Amicon vessels
- prepared 96 Well plates (company Costar, previously sterile
packed) having monolayer (L20B - transgenic mouse cells)
- CC"2-incubator, 37[deg.]C, humidity conditioning: Labotect and
Heraeus
- benches from Baker and Thermo Electron LED
- freezer -20[deg.]C Liebherr
1.3. Chemicals:
- PBS pH 7.2
- disinfectant to be tested
- sterile Aqua bidest
- 0.1 M phosphate buffer pH 7.0
- MEM Hanks Salt Medium with Hepes buffer + 2 % FCS + 1 %
Glutamine + 1 % Penicillin/Streptomycin + 1 % non-essential
amino acids + 0.8 % NaHCO3
2. Experiment:
2.1. Preparation of disinfectants
For the preparation of the disinfectants see example 1.
The disinfectant to be tested is diluted using Aqua bidest or
0.1 M phosphate buffer on the day of the experiment. The
dilutions are prepared such that the concentration of the
disinfectant is achieved in the experiment.
All solutions are incubated for at least 20 minutes in the
thermomixer.
2.2. Experiments
The virus concentrate is filtered (using a 0.2 [mu]m filter) and
pre-diluted, depending on the concentration known (titre) using
PBS.
Amounts for 2.0 ml final volume: a) Sample: 0.2 ml virus
suspension + 1.8 ml disinfectant b) Positive control : 0.2 ml
virus suspension + 1.8 ml PBS c) Negative control : 0.2 ml PBS +
1.8 ml disinfectant
All samples are mixed for 20 seconds and kept at 2O<0>C at
300 RPM in the thermomixer for the times indicated in the
experiment protocol.
2.3. Controls
The positive control is a virus titre control. Hence, the titre
already known should be reached in each test again. If there are
significant deviations, one should test whether or not the virus
can no longer be used or whether the cell quality is not
sufficient in order to reach the titre again.
In each suspension test, formaldehyde is also tested as a
reference in two different concentrations (normally 1.0 % and
0.7 %) as controls. These controls are treated like the
remaining experiments ("neutralized" via Amicon-filter).
For each concentration of the disinfectant used, a cytotoxicity
control must also always be performed in order to recognize
possible effects of the pure disinfectant onto the cells (in the
experiments in the respective log-step, these effects might not
be distinguishable from cytopathic effects caused by the virus).
If cytotoxicities occur, the respective log-step may not be
relied upon in the experiment.
It should also be noted that never two "highest virus
concentrations" may be applied next to each other. Always the
"lowest virus concentration" or a cell control must be applied
next to a "high" virus concentration in order to avoid false
positive results caused by splashing.
For each plate, a cell control must be performed as well (see
2.5.2 below).
2.4. "Neutralization" by dilution
and filtration
2.4.1. Filtration via
Amicon-centrifuge units
After completion of exposure time, the entire volume of the
sample is pipetted to 3 ml PBS into the Ultrafree-4 (Amicon
Ultra-4) filter unit which has been kept ice-cold. It should be
noted that with experiments involving ethanol, there is no
filtration but there is a direct dilution from the experiment
that has been thoroughly mixed again.
5 minutes centrifugation at 5000 x g at 20[deg.]C. Thereafter,
there is a rinse using 5 ml PBS and another centrifugation as
indicated above.
Thereafter, the concentrate (amount to be recorded in the
protocol) is replenished with medium (supplemented with 2 % FCS,
1 % L-Glutamine, 1 % Penicillin/Streptomycin, 1 % non-essential
Amino acids and 0.8 % NaHCO3) to the original amount of the
experiment (i.e. 2.0 ml, 1.5 ml or 1.0 ml) and vortexed for at
least 20 seconds.
2.4.2. Direct dilutions
For each disinfectant (in all concentrations) which is
"neutralized" via an Amicon-filter, there must be once a direct
dilution without filtration in order to check that there are no
losses occurring via the filter. Samples containing ethanol are
always directly diluted since protein precipitations clog up the
filter and lead to significant losses, and the Amicon-filters
are not suitable for ethanol concentrations > 70 %.
In the direct dilution, 0.2 ml are removed from the sample after
completion of the exposure time and diluted into 1.8 ml medium
(for dilutions in Deep Well plates, 0.1 ml are removed and
diluted in 0.9 ml medium), and the further dilution series is
prepared.
2.5. Titrations
2.5.1. Titration series
Dilutions are prepared in l :10-steps using medium as diluent.
The total amount in each log- step is either 2.0 ml (1.8 ml
medium + 0.2 ml sample added or + 0.2 ml previous dilution or
(for Deep Well plates because of better mixing) 1.0 ml (0.9 ml
medium + 0.1 ml sample added or + 0.1 ml previous dilution.
After each dilution, vortexing is performed (dilution tubes) or
the liquid is taken up 20-30 times in a multi-channel pipette
(Deep Well plate), and only thereafter pipetting is continued.
2.5.2. Applying test
solutions onto plate 0.1 ml sample per well are applied to a
prepared 96 well plate. The cell lawn must be thin and closed
(monolayer), each well contains 0.1 ml medium (MEM Hanks Salt
Medium and Hepes buffer supplemented with 10 % FCS, 1 %
L-Glutamine, 1 % Penicillin/Streptomycin, 1 % non-essential
amino acid and 0.8 % NaHCO3) in which the cells have grown. To
this volume, 0.1 ml are added from the dilution, and the final
volume on the plate per well is 0.2 ml. Each log-step is applied
eight times to the plate.
In each plate, there must be at least eight adjacent (one row)
wells as a cell control, onto which only medium (supplemented
with 2 % FCS, further supplements as indicated above) has been
added. In order to prevent unspecific reaction of cells on the
plate, the cells must have healthy appearance on the day of
evaluation.
2.5.3. Incubation
Subsequently, the 96 Well plates are wrapped in cling film and
incubated for five days at
37<0>C and 5 % CO2. Thereafter, the experiment is
recorded.
3. Recording
The protocol must indicate experiment number, experiment date,
recordal date, used virus (date of pooling, dilution), cell
type, exposure time, used disinfectant and concentration
thereof, exposure temperature.
The protocol contains an evaluation for all wells of all samples
and controls whether or not there has been a beginning, a
complete or no cytopathic effect (CPE). Usually, the following
symbols are used: + (complete CPE), - (no CPE) and (+)
(beginning CPE).
All wells must be recorded for all samples.
4. Calculation:
Calculation of titre (see above)
g) Efficacy against hepatitis A virus - quantitative suspension
tests
Test virus: Hepatitis A-virus 1. Instrumental materials:
Bender und Hobein AG - Vortexer
EppendorfThermomixer Comfort
Heraeus Cryofuge 5000
C[theta]2-Incubator, 37[deg.]C, humidity conditioning by
Labotect und Heraeus benches from companies Baker und Thermo
Electron LED
- Freezer -20[deg.]C Liebherr
Millipore Ultrafree-4 and. Amicon Ultra-4
Centrifugal-Filter-devices having a Biomax- lOOK Membran
- Eppendorf- single channel pipettes (10 [mu]l - lOO[mu]l, 20
[mu]l - 200 [mu]l, 100 [mu]l - 1000 [mu]l, 500 [mu]l - 5000
[mu]l) and Capp - multi channel pipette (20[mu]l - 200 [mu]l)
with tips which are sterile and, for virus pipetting, have been
additionally stuffed
Eppendorf tubes having 2 ml capacity for incubation in
thermomixer sterile dilution vessels (Sarstedt 5 ml tube) and.
Deep Well-plates (Nunc) corresponding closing lid (sterile) for
dilutions
Sarstedt 15 ml - tubes for preparation of disinfectant solutions
prepared 96 Well plates (Costar, sterile packed) having
monolayer of Rh/K-cells
(kidney cells from Rhesus monkeys),
Ice for cooling PBS and amicon vessels
2. Chemicals:
Maintenance medium: MEM Hanks Salt Solution with Hepes buffer,
GIBCO
- 5 % foetal calf serum, company. PAA - 1% L- Glutamin, company
ICN
- 1% antibiotics (AB), consisting of Penicillin + Streptomycin,
Company PAA
- 1 % Non-essential amino acids: Biocrom AG
- 0,8 % Na2HCO3 disinfectant to be tested
- PBS pH 7.2 sterile aqua bidest.
- 0, 1 M phosphate buffer pH 7,0 3. Experiment:
3.1 Preparation of disinfectants
solutions
The disinfectant to be tested is diluted using aqua bidest or
0.1 M phosphate buffer on the day of the experiment. The
dilutions are prepared such that the final concentration of the
disinfectant is achieved in the actual experiment.
The solutions are incubated in the thermomixer at 20[deg.]C for
at least 20 minutes.
3.2 Preparation of test samples
Virus concentrate is filtered (using a 0.2 [mu]m filter) and is
used prediluted with PBS if concentration is known (titre) or is
used undiluted if the initial concentration is very low (titre
< 10<60>).
Amounts for 1.0 ml final volume: a) sample: 0.1 (0.05) ml virus
suspension + 0.9 (0.45) ml disinfectant b) titre control: 0.1
(0.05) ml .virus suspension + 0.9 (0.05) ml PBS c) cytotoxicity
control: 0.1 (0.05) ml PBS + 0.9 (0.05) ml disinfectant
The samples are mixed for 20 seconds and are exposed at
2O<0>C in a thermomixer at 300 rpm for the time period in
minutes indicated in the experiment.
3.3 Controls
Titre control: Control of titre of used virus suspension,
formaldehyde control
In each suspension test, formaldehyde is also tested in two
different concentrations (2.0% and 0.7%). These controls are
treated like the other experiments (always "neutralized" via an
amicon-filter).
Cytotoxicity control:
A cytotoxicity control is performed with respect to all
concentrations of all used disinfectants in order to recognize
possible effects of the disinfectant on the cells (in the
experiments in the respective dilution step, this might not be
distinguishable from cytopathic effects caused by the virus).
CeIl control:
On each plate in at least 8 wells, there must be a cell control
(see below 3.5.2).
3.4 "Neutralization" by dilution
and filtration
3.4.1 Filtration using ami con -
filter unit
After completion of exposure time 0.9 ml of sample is pipetted
to 4 ml PBS in the (ice cold ultrafree-4-Amicon ultra-4) filter
unit.
It should be noted that in experiments involving alcohols, there
is no filtration but there is a direct dilution from the
thoroughly mixed sample (see 3.4.2).
Centrifugation for 5 minutes at 5000 x g at 20[deg.]C.
Thereafter rinse with 5 ml PBS and centrifuge again as indicated
above.
The residue on the filter (amount must be recorded in the
protocol) is replenished with maintenance medium to the initial
amount of the sample (0.9 ml) and mixed for at least 20 seconds
on a vortex.
3.4.2 Direct dilution
To check that the result is not influenced by the filtration, in
each series of experiments an experiment is performed with
direct dilution without filtration. Experiments with ethanol are
always perfomed using the dilution method (i.e. without
filtration), since protein precipitations may clog the filters
(according to the manufacturers, Amicon filters are not suitable
for ethanol concentrations > 70%).
In the direct dilution, immediately after completion of the
exposure time and after the sample has been mixed thoroughly
again, 0.2 ml are removed and diluted in 1.8 ml medium (for
dilutions in deep well plates, 0.1 ml are removed and diluted in
0.9 ml medium), and the further dilution series is prepared
using a ratio of 1 : 10.
3.5 Titrations
3.5.1 Titration series
- Dilutions are prepared in 1 : 10-steps using medium as
diluents.
- total amount per dilution step 2.0 ml: 1.8 ml medium + 0.2 ml
experiment or + 0.2 ml of previous dilution step: for deep well
plates 1.0 ml:
0.9 ml medium plus 0.1 ml experiment or plus 0.1 ml of previous
dilution step. - After each dilution mixing for at least 20
seconds on vortex (dilution tube) or mixing with multi channel
pipette by taking up sample for at least 20-30 times (deep well
plate), and only thereafter pipetting is continued.
3.5.2 Application to plates
0.1 ml of each dilution per well is applied to prepared 96 well
plates, final volume is 0.2 ml. Cell lawn must be thin and close
(mono layer). Each dilution step is applied eight times to the
plate.
3.5.3 Incubation
Subsequently, the 96 well plates are wrapped in cling film and
incubated for 14 days at 37[deg.]C and 5% CO2. Thereafter, the
experiment is evaluated.
4. Evaluation
The protocol indicates experiment number, experiment date,
evaluation date, virus used (date of pooling, dilution), cell
type, exposure time, used disinfectants and their
concentrations, exposure temperature.
For all wells of all samples and controls, the protocol also
indicates an evaluation whether or not a beginning, a complete
or no cytopathic effect (CPE) is observed:
+ (complete CPE), (+) (beginning CPE), - (no CPE). For all
samples all wells must be evaluated.
Calculation: see above
4.3 Reduction factor
The reduction factor is calculated: logarithm of infection titre
of titre control - logarithm of calculated titre of sample
treated with respective disinfectant. The higher the reduction
factor, the more efficient the respective disinfectant tested.
The lower the reductent factor, the less efficient the
disinfectant tested. When determining the reduction factor, also
the cytotoxicity control needs to be observed.
4.4 Cytotoxocity
If cytotoxicity occurs, the respective dilution steps in the
experiment may not be evaluated (if for a given dilution step
even only one well is positive, this step must not be taken into
account for the respective disinfectant in the respective
concentration).
This means that if the cytotoxicity is positive up until the
same step as the respective disinfectant tested in the
respective concentration, one cannot indicate a precise number
for the respective disinfectant.
h) Efficacy against murine
norovirus - quantitative suspension tests
Test virus: murine norovirus (MNV)
The conditions as decribed above for HAV and poliovirus in
example f) and g) were also used for testing the efficacy
against MNV.
The resulting efficacies of tested formulations on viruses when
applied in suspension with or without interfering substance
(organic load: 10% FCS) for 5 or 20 minutes at 20[deg.]C are:
formulation reduction factors (RF) a) 0.2% SDS - 0.3% NaOH RF
> 5 (5 and 20 min) b) 0.2% SDS - 0.3% NaOH in 50% Ethanol RF
> 5 (5 and 20 min) c) 0.2% SDS - 0.3% NaOH in 20% n-Propanol
RF > 5 (5 and 20 min) d) 20% n-Propanol RF < 1 (20 min)
These results show that the formulations of the invention are
effective against further non- enveloped viruses, showing the
general suitability against non-enveloped viruses. The results
of the studies are summarized in the following tables:
Table 1 Efficacy of tested formulations on bacteria when applied
in the carrier test with blood as test soil for 5, 20 or 60
minutes at 20<0>C
The formulations were examined in a quantitative carrier test
(instrument disinfection test) with coagulated blood as test
soil (method as established at the Robert Koch-Institut). The
reduction factor is indicated with reference to a control (i. e.
water without the formulation to be tested). The particular
efficacy of 0.2% SDS - 0.3% NaOH in 20% n-propanol on E. faecium
and M. avium in the instrument disinfection (20 minutes) is to
be emphasized. The formulation of SDS-NaOH without alcohol has
no significant inactivating effect. The carrier test with
bacteria in blood represents more stringent conditions than the
suspension test, i.e. all formulations active in the carrier
test are also at least as active in the quantitative suspension
test (data not shown). Table 2 Efficacy of tested formulations
on viruses when applied in suspension with or without
interfering substance (organic load: 10% FCS) for 5 or 20
minutes at 20[deg.]C
The formulations were tested in a quantitative suspension test
as established at the Robert Koch-Institut (see above). The
reduction factors (RF) are indicated, each time with reference
to the control (i. e. water without formulation to be tested and
with or without protein load; 10% FCS). The efficacy of 0.2% SDS
- 0.3% NaOH in 20% n-propanol (5 and 20 minutes) on polio and
hepatitis A virus (HAV) in a suspension with organic load is to
be emphasized. Polio- and hepatitis A virus are human pathogenic
viruses which are most resistant against common available
disinfectants as well as against the tested formulations
(vaccinia virus, adenovirus and SV40 were found to be less
resistant; data not shown). Ethanol or propanol do not have a
significant inactivating effect on these viruses. Table 3
Efficacy of tested formulations on polio virus when applied in
the carrier test with blood for 5, 20 or 60 minutes at 20[deg.]
C
The formulations were examined in a quantitative carrier test
(instrument disinfection test as established at the Robert
Koch-Institut) with coagulated blood as described above. The
reduction factor are indicated with reference to a control (i.
e. water without the formulation to be tested). The particular
efficacy of 0.2% SDS - 0.3% NaOH in 20% n-propanol on Poliovirus
in the instrument disinfection test is to be emphasized. 20%
n-propanol alone is inefficient. Example 4 Decontamination
efficiency of SDS (0.2 %) / NaOH (0.3 %) in combination with
alcoholic components on PrP<Sc> bound to steel surfaces
In vitro and in vivo studies a)
Materials
Reagents for decontamination
The following reagents were tested for their decontaminating
activities on steel wires coated with 263K scrapie brain
homogenate (for providers and further details see: Lemmer et
al., 2004): ethanol (70 %), the mixture of sodium hydoxide
(NaOH, 0.3 %) and sodium dodecyl sulfate (SDS, 0.2 %) (Lemmer et
al., 2004); the SDS / NaOH components in 50 % ethanol as well as
in 30 % ethanol; the SDS / NaOH components in 50 %, 30 % or 20 %
n-propanol, respectively. Distilled water served as a control.
h) Methods
In vitro carrier assay
A stock of 10 % 263K scrapie brain homogenate, containing
~10<8> 50% intracerebral lethal doses (LD5Oi C.) of 263K
agent and -10 [mu]g of pathological prion protein (PrP<Sc>
/ PrP27-30) per ml. was prepared from brains of Syrian hamsters
in the terminal stage of scrapie (Beekes et al., 1995, 1996),
aliquoted and stored at -70[deg.]C. Stainless steel wire
(DIN-No. 1.4301, Forestadent, Pforzheim, Germany; diameter: 0.25
mm) was cut in small pieces of defined length (5 mm). These wire
pieces (in the following called "wires") with a surface of ~4
mm<2> (2[pi]rh + 2[pi]r<2>) were washed in 2 %
Triton X-IOO for 15 min under constant ultrasonication (Sonorex
RK 102 P; Bandelin Electronics), rinsed in distilled water,
dried and sterilized in a steam autoclave at 121 <0>C for
20 minutes. In order to contaminate the carriers in vitro with
prp<Sc> i prp27-30, batches of 30 wires were incubated in
150 [mu]l 10 % scrapie brain homogenate for 2 h under constant
shaking at 37[deg.]C with 700 r.p.m. in a thermomixer (Amersham
Biosciences). Following removal of the homogenate, wires were
transferred to and placed separately from each other in Petri
dishes, air-dried for 1 h, and stored over night (-16 h) at room
temperature. Subsequently, batches of 30 contaminated wires were
incubated, in a volume of 1.5 ml, in the reagents to be tested
for decontaminating activity. These incubations were performed
in a thermomixer (400 r.p.m.) at 23[deg.]C for the times
specified in the legend of Figures 1-3. Finally, the wire
batches were rinsed in distilled water for 1x1 min followed by 4
x 10 min in a volume of 45 ml each under constant shaking at
room temperature. Processing of wires was finished by air-drying
in Petri dishes for 1 h, storing over night (-16 h) at room
temperature, and recollection of batches in test tubes. Residual
prion-protein contaminations of wires, which were still present
after processing as outlined above, were eluted from the carrier
surface as follows: Half the number of the various batches
independently processed per test reagent were boiled for 5
minutes in 52 [mu]l of electrophoresis sample loading buffer
(62.5 mM Tris, pH 6.8, 10 % glycerol, 5 % mercaptoethanol, 2 %
SDS, 0.025 % bromphenol blue) containing 4 M urea; the remaining
batches were treated with 150 [mu]g PK ml<"1> in a volume
of 52 [mu]l of TBS-sarcosyl (50 mM Tris/HCl, 15O mM NaCl, pH
7.5, 1 % Sarcosyl) for Ih at 37[deg.]C, subsequently mixed with
an equal volume of 2 x sample loading buffer containing 8 M
urea, and boiled for 5 min. Aliquots of wire eluates (20 [mu]l)
were removed (leaving the wires on the bottom of the tube) and
analysed by SDS-PAGE and Western blotting for the presence of
prion protein.
SDS-PAGE and Western
blottin[epsilon]
SDS-PAGE and Western blot analyses using the monoclonal anti-PrP
antibody 3F4 (Kascsak, R.J., Rubenstein, R., Merz, P.A.,
Tonna-Demasi, M, Fersko, R., Carp., R.I., Wisniewski, H.M. &
Diringer, H. (1987). J. Virol. 61, 3688-3693) were performed as
described elsewhere (Beekes et al., 1995, 1996) with recently
published modifications (Thomzig et al., 2003). PrP signals were
visualized on a X-OMAT AR film (Kodak, Sigma-Aldrich, Steinheim,
Germany) after various exposure times individually adjusted to
optimize the signal-to-noise ratio of each blot. Molecular mass
(MW) marker proteins of 14.4, 20.1, 30.0, 45.0, 66.0 and 97.0
kDa were used (Amersham Biosciences). PK-digested homogenate
from scrapie hamster brains, used as internal PrP27-30 standards
in the Western blot analyses (see Figures 1-3: 10<'6> or
10<"7> g brain tissue), were prepared as outlined
previously (Beekes et al., 1995; Thomzig et al., 2003). Based on
the infectivity titre and content of PrP<Sc> determined
previously in brain homogenates from our 263K scrapie hamsters
(Beekes et al., 1995, 1996), 1 x 10<"6> g of
scrapie-infected hamster brain homogenate contains ~l-3 x
10<3> LD50j.c., and, after digestion with PK, -100 pg of
PrP27-30. The processed batches of 30 wires represented a total
steel surface of 120 mm each. To facilitate quantification and
comparison of PrP immunostaining, the amount of sample material
blotted in Figures 1 -3 is specified by the wire area
[mm<2>] it corresponded to.
It should be noted that cellular PrP (PrP ), which is present at
significant levels in scrapie brain homogenate, may contribute
partially to PrP immunostaining in samples not subjected to PK
treatment and treated with reagents unable to interfere with
cellular proteins, e. g. in case of distilled water.
In vivo carrier assay
In order to contaminate the carriers with PrP<Sc>/
PrP27-30 for the in vivo experiments, batches of 12 wires of 4
mm length each were incubated in 150 [mu]l 10 % scrapie brain
homogenate as described above. Subsequently, the 263K
contaminated wires were incubated in a volume of 1.5 ml with 0.2
% SDS and 0.3 % NaOH in 30 % n-propanol as well as 0.2 % SDS and
0.3 % NaOH in 20 % n-propanol for 10 min at 23[deg.]C. These two
solutions were selected for in vivo validation, only. The reason
for this selection is based I) on the results of the in vitro
carrier assay, which suggested in case of both solutions
sufficient decontamination efficiency resulting from
destabilization and detachment of PrP<Sc> from the wire
surface (Figure 3), II) on the results of the decontamination
studies with various bacteria and viruses (Tables 1-4), and III)
the aim to use low alcohol concentrations only. The mixture of
SDS/NaOH alone did not contribute to the reduction of bacteria,
whereas in combination with > 20 % n-propanol a reduction
>6 log steps was achieved e. g. with bacteria even after 5
min incubation in the suspension assay (Table 1).
The decontamination step was performed in a thermomixer (400
r.p.m.) at 23[deg.]C for 10 min. In parallel, PrP<Sc>
contaminated wires were incubated in distilled water, only, for
10 min at 23<0>C. After the decontamination procedures the
wires were rinsed in distilled water (five times in 45 ml),
air-dried in Petri dishes for 1 h and stored over night (~16 h)
at room temperature. The wires were now ready for implantation
into the brain of the laboratory animals for bioassay.
Approximately 8-week-old Syrian hamsters (Charles River
Laboratory) were used in the experiment. Implantation was done
with a stereotaxic apparatus (Stoelting, Wood Dale, Illinois,
USA). The hamsters (weight: 80 - 120 g) were sedated with
isofluran for anaesthesia by intramuscular injection of 0.2-0.4
ml of a mixture of 10 % ketamin and 2 % xylazin. Final
concentrations of 11 mg xylazin / kg of body weight and 190 mg
ketamin / kg of body weight were administered to the animals.
Anesthetized hamsters were placed in the stereotaxic apparatus
using ear bars with short tips. One wire was implanted into each
animal at the following coordinates: bregma, -2 mm /
mediolateral, 2 mm (Yan, Z.X., Stitz, L., Heeg, P., Pfaff, E.
& Roth, K. (2004). Infect Control Hosp Epidemiol 25,
280-283). For exact dorsoventral positioning of the wires in a
depth of 4 to 8 mm (upper end and lower end, respectively) below
the outer skull surface we used a specially crafted needle with
a mandrel as a pushing bar (Hero, Berlin, Germany). All
recipients of wires were marked with a transponder. The
intracerebral implantation of wires was well tolerated by the
animals and never caused complications due to the invasive
intervention.
Hamsters were monitored at least twice a week for clinical signs
of scrapie. The individual disinfectants have been tested in two
independent animal groups, each of six hamsters. The control
group was carried out with six hamsters which received the wires
treated with distilled water, only. When terminally affected
with scrapie (a disease stage which is accompanied by fully
developed clinical symptoms and indications that the animals
become unable to take up sufficient quantities of drinking
water) hamsters were sacrificed by CO2 asphyxiation.
Endpoint titration
For endpoint titration wires were incubated as described above
in 263 K scrapie hamster brain homogenates that had been
serially diluted in logarithmic steps in normal brain homogenate
over a range from IxIO<"1> to IxIO<"9>. Wires were
air-dried in Petri dishes for 1 h, stored over night (-16 h) at
room temperature and rinsed in distilled water (1 x 1 min,
followed by 4 x 10 min in a volume of 45 ml each) in order to
remove unfixed tissue debris that may have affected the
titration by being unevenly attached to different carriers.
Prior to implantation wires were again air-dried in
Petri-dishes. Survival times and attack rates for the
development of terminal scrapie were monitored in hamsters for
an observation period of 500 days after wire implantation. The
endpoint dilution of infectivity was calculated from the
observed rates of terminal scrapie per dilution according to the
Spearman-Karber method as described by Bonin (Bonin, O. (1973).
Quantitativ-virologische Methoden. Pp. 183-186. Stuttgart: Georg
Thieme Verlag).
PET blot analysis
PET blot analysis of PrP<Sc> deposition in coronal brain
slices was performed as described elsewhere (Schulz-Schaeffer et
al., 2000; Thomzig et al. 2004) in order to detect sublinical
scrapie infections in animals that did not show an onset of
disease during the period of clinical observation in the
endpoint titration experiment. For PET blotting brains were cut
coronally in 4 blocks. The brain tissue block containing the
wire was fixed in 4 % paraformaldehyde (PFA), while the
remaining blocks were stored at -70[deg.]C. After fixation, the
wire was removed. In order to avoid tissue damage in the area of
the wire channel, in most cases the upper part of the tissue
block was separated from the lower part by a horizontal cut near
the upper wire end before the steel carrier was removed. The
tissue blocks with the wire channels (and, if prepared, their
upper counterparts) were embedded in paraffin, and 6 [mu]m
coronal sections of the specimens containing the wire channels
were cut on a microtome. Tissue sections were fixed on a
nitrocellulose membrane (BioRad) by drying over night at
55[deg.]C. After deparaff[iota]nization, rehydration, drying
(>20 min) and pre wetting in TBS/Tween (TBST) the blots were
incubated with 15 [mu]g/ ml proteinase K for 2 h at 55[deg.]C.
Following washing in TBST and denaturation by exposure to 3 M
guanidine thiocyanate for 10 min PET blots were incubated with
the primary monoclonal antibody 3F4 (1 :2500) over night.
Negative controls were incubated with normal mouse serum (Dako,
Denmark) diluted 1 :25000. Visualization of labelled
PrP<Sc> was performed with an alkaline phosphatase-coupled
rabbit anti mouse antibody (Dako, diluted 1 :2000) using
BCIP/NPT (AppliChem GmbH, Darmstadt, Germany) as substrate.
Stained PET blots were examined with a Leica binocular MS 5 and
scanned with Microtec Scan Wizard 5.
c) Results
In vitro carrier assay
In contrast to the Western blot results obtained with the
mixture of 0.2 % SDS and 0.3 % NaOH, in which almost no PrP was
detectable in the samples without PK digestion and no more
PrP<Sc> was detectable after PK digestion (Figure IA),
latter known to be detached and destabilized by the mixture
(Lemmer et al, 2004), PrP<Sc> seems virtually completely
resistant against 70 % ethanol. The protein fixating effect of
ethanol was clearly demonstrated by very strong Western blot
signals. Intense signals were also obtained with the control
samples, but always less strong than observed after ethanol
treatment. These differences result from the detaching effect of
water, which however is limited by drying the wires after
contamination (Lemmer et al., 2004).
Reduction of the ethanol concentration down to 50 % and addition
of 0.3 % sodium hydroxide and 0.2 % SDS reduced the load of PrP
attached to the steel surfaces in a time dependent manner, and
remaining PrP<Sc> had become PK sensitive (Figure 2A).
Combining SDS and NaOH with 50 % n-propanol, only traces of PrP
were detectable in the Western blot after 5 min of incubation,
and, as with 50 % ethanol, no more PK resistant PrP<Sc>
was detectable. Reduction of the alcoholic component to 30 % or
20 % accelerated the reduction of the PrP as demonstrated for
n-propanol after 5 min of incubation. The results suggested that
the fewer the percentage of alcohol the better the cleaning of
the steel surface and the detachment of destabilized
PrP<Sc>. Since low concentrated n-propanol (30 % and 20 %)
combined with SDS and NaOH was able to reduce the infectivity of
bacteria and viruses about > 6 or > 4 log steps,
respectively, this solution is suggested as a candidate of
choice for validation in the prion bioassay, which is still the
most sensitive method to detect TSE infectivity.
Endpoint titration
In order to define the sensitivity of the steel wire bioassay
and to establish a dose-response relationship for the assessment
of titre reductions achieved by the tested decontamination
procedures we performed an endpoint titration experiment. Sets
of wires were incubated in 150 [mu]l of 263K scrapie brain
homogenate diluted in the range from 1x10<"1> to
10<~9>, and after coating and drying wires were irrigated
in water and again air-died. Following cerebral implantation of
the wires survival times and attack rates for the development of
terminal scrapie were monitored in hamsters for an observation
period of 500 days. The results are summarized in Table 4.
The scrapie brain homogenate used for the endpoint titration was
produced from donor hamsters in the terminal stage of scrapie.
As demonstrated repeatedly in our laboratory during the last two
decades such brain tissue contains an infectivity titre of about
10<9> 50% lethal intracerebral doses (LD50, c ) per gram
of tissue. The endpoint titration experiment revealed that the
dilution of scrapie brain homogenate leading to one 50% lethal
dose of infectivity upon intracerebral implantation (LD50, C
imp) of wires prepared as described above should be 10<"6
5>. Therefore, carriers incubated in the 1x10<"7>
dilution of the scrapie brain homogenate were associated with
about 0.3 LD50, C imp per wire. Accordingly, wires coated with
the 1 x 10<"1> diluted scrapie brain homogenate can be
expected to carry an initial infectious load of about 3 x
l0<5> (10<5 5>) LD50l c imp.
In none of the animals, which survived free of scrapie symptoms
until the end of the endpoint titration experiment a subclinical
TSE infection could be detected by PET blotting.
Table 4
Endpoint titration of infectivity attached to steel wires that
were coated with serially diluted 263K scrapie brain homogenates
and subsequently implanted into the brain of Syrian hamsters.
For contamination, wires were incubated in 150 [mu]l of the
serially diluted scrapie brain homogenates. LD50j.c.: 50% lethal
doses of infectivity upon intracerebral injection of homogenate;
LD50.c.imp: 50% lethal doses of infectivity upon intracerebral
implantation of wires. Attack rates for terminal scrapie are
specified as number of animals that developed terminal symtoms
per total number of challenged animals. Survival times until the
development of terminal scrapie are provided in days post
implantation (dpim; means +- SD), and survival times provided in
italics (> 500 dpim) refer to hamsters that were sacrificed
at the indicated time points without having developed clinical
symptoms of scrapie. In vivo carrier assay
The animal experiment is still going on. Till now, at more than
250 dpim, all animals which received wires treated with 30 % or
20 % n-propanol containing 0.2 % SDS and 0.3 % NaOH are alive
without any symptoms of preclinical TSE. In contrast, the
animals of the control group reached the terminal stage of TSE
after a mean survival time of 86 dpim. According to the results
of the endpoint titration achieved so far (Table 4) it can be
preliminarily assumed that the mixtures caused a reduction of
prion infectivity of at least 4 logs (i. e. a reduction of >
99,99% of the original prion activity). The definitive titre
reduction can be determined only after termination of the
bioassay experiment after 500 dpim, but on the basis of the data
available so far a titre reduction of at least 5 logs appears
probable and may be even exceeded.
From the foregoing examples it can be seen that a formulation in
accordance with the present invention, comprising a detergent,
an alkali hydroxide, an alcohol, preferably an alcohol having 1
to 4 C-atoms, and water, provides excellent disinfecting
qualities whilst maintaining its highly potent prion
decontamination qualities. The presence of the alcohol does not
appear to compromise the prion decontaminating activity which is
very surprising given the stabilizing and fixating effect that
alcohol usually has on protein structures in general and, in
particular, on the structure and tenacity of the prion protein.
The features of the present invention disclosed in the
specification, the claims and/or in the accompanying drawings,
may, both separately, or in any combination thereof, be material
for realising the invention in various forms thereof.
References
- for Example 4 a) and b)
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- for Example 4c)
Baxter R. L., Baxter, H. C, Campbell, G.A., Grant, K., Jones,
A., Richardson, P. & Whittaker, G. (2006). Quantitative
analysis of residual protein contamination on reprocessed
surgical instruments. J Hosp Infect 63, 439-444.
Beekes, M., Baldauf, E., CaBens, S., Diringer, H., Keyes, P.,
Scott, A. C, Wells, A. H., Brown, P., Gibbs, C. J. Jr. &
Gajdusek, D. C. (1995). Western blot mapping of disease-
specific amyloid in various animal species and humans with
transmissible spongiform encephalopathies using a high-yield
purification method. J Gen Virol 76, 2567-2576.
Beekes, M., Baldauf, E. & Diringer, H. (1996). Sequential
appearance and accumulation of pathognomonic markers in the
central nervous system of hamsters orally infected with scrapie.
J Gen Virol 11, 1925-1934.
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Pauli, G. (2004). Inactivation and removal of prions in
producing medical products. A contribution to evaluation and
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Hause-Reitner, D., Giese, A., Groschup, M. H. & Kretzschmar,
H. A. (2000). The paraffin-embedded tissue blot detects PrP(Sc)
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