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)
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. JHosp 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.
Bertram, J., Mielke, M., Beekes, M., Lemmer, K., Baier, M. &
Pauli, G. (2004).
Inactivation and removal of prions in producing medical products.
A contribution to evaluation and declaration of possible methods.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 47,
36-40.
Bonin, O. (1973). Quantitativ-virologische Methoden. pp. 183-186.
Stuttgart: Georg Thieme Verlag
Kascsak, R.J., Rubenstein, R., Merz, P.A., Tonna-Demasi, M,
Fersko, R., Carp., R.I., Wisniewski, H.M. & Diringer, H.
(1987). Mouse polyclonal and monoclonal antibody to
scrapie-associated fibril protein. J Virol 61, 3688-3693.
Lemmer, K., Mielke, M., Pauli, G. & Beekes, M. (2004).
Decontamination of surgical instruments from prion proteins: in
vitro studies on the detachment, destabilization and degradation
of PrPSc bound to steel surfaces. J Gen Virol 85, 3805-3816.
Saa, P., Castilla, J. & Soto, C. (2006). Presymptomatik
detection of prions in blood. Science 313, 92-94.
Schulz-Schaeffer, W. J., Tschoke, S., Kranefuss, N., Drose, W.,
Hause-Reitner, D., Giese, A., Groschup, M. H. & Kretzschmar,
H. A. (2000). The paraffin-embedded tissue blot detects PrP(Sc)
early in the incubation time in prion diseases. Am J Pathol
156,51-56.
Thomzig, A., Kratzel, C, Lenz, G., Kr[upsilon]ger, D. &
Beekes, M. (2003). Widespread PrP<Sc> accumulation in
muscels of hamsters orally infected with scrapie. EMBO reports 4,
530-533.
Yan, Z.X., Stitz, L., Heeg, P., Pfaff, E. & Roth, K. (2004).
Infectivity of prion protein bound to stainless steel wires: a
model for testing decontamination procedures for transmissible
spongiform encephalopathies. Infect Control Hosp Epidemiol 25,
280-283
- 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.
Bertram, J., Mielke, M., Beekes, M., Lemmer, K., Baier, M. &
Pauli, G. (2004). Inactivation and removal of prions in producing
medical products. A contribution to evaluation and declaration of
possible methods. Bundesgesundheitsblatt Gesundheitsforschung
Gesundheitsschutz 47, 36-40.
Lemmer, K., Mielke, M., Pauli, G. & Beekes, M. (2004).
Decontamination of surgical instruments from prion proteins: in
vitro studies on the detachment, destabilization and degradation
of PrPSc bound to steel surfaces. J Gen Virol 85, 3805-3816.
Saa, P., Castilla, J. & Soto, C. (2006). Presymptomatik
detection of prions in blood. Science 313, 92-94.
Schulz-Schaeffer, W. J., Tschoke, S., Kranefuss, N., Drose, W.,
Hause-Reitner, D., Giese, A., Groschup, M. H. & Kretzschmar,
H. A. (2000). The paraffin-embedded tissue blot detects PrP(Sc)
early in the incubation time in prion diseases. Am J Pathol
156,51-56.
Thomzig, A., Kratzel, C, Lenz, G., Kr[upsilon]ger, D. &
Beekes, M. (2003). Widespread PrP<Sc> accumulation in
muscels of hamsters orally infected with scrapie. EMBO reports 4,
530-533.