20 Jan 2010
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 [DE] ; MIELKE MARTIN
2009-06-18
Classification: - international: A61L2/18; A01N25/30; A01N31/02;
A01N59/00; C11D3/00; A61L101/02; A61L101/34; A61L101/40; A61L2/18;
A01N25/30; A01N31/00; A01N59/00; C11D3/00 - European: A61L2/18;
A01N25/30; A01N31/02; C11D3/00B13; C11D3/02H; C11D3/20B1; C11D17/04B2L
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.
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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
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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
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Bertram, J., Mielke, M., Beekes, M., Lemmer, K., Baier, M. & Pauli,
G. (2004).
Inactivation and removal of prions in producing medical products. A
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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
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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
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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.