Fresenius Environmental Bulletin, cilt.29, sa.9, ss.7189-7197, 2020 (SCI-Expanded)
Nosocomial
infections are a substantial concern as the major cause of morbidity and
mortality of hospitalized patients’ in the world. Disinfection of inanimate environment, equipment and hospital setting
is important to prevent nosocomial infections. Sodium dichloroisocyanurate dihydrate (NaDCC) can be used for disinfection of environment and medical devices. The aims of this
study were to determine the efficacy of NaDCC at various concentrations and times against multi-drug resistant Acinetobacter
strains.
In the first phase of the study, the bactericidal
activity of NaDCC to A. baumannii
was investigated by quantitative suspension test. In the second phase, the
surface activity of NaDCC was
tested by surface disinfection
application test. In the third phase, before
the cleaning of randomly
selected patient's room A. baumannii contamination
on the inanimate environment objects and equipment was investigated. After the
cleaning of the room the effect of NaDCC was tested.
As a result of the
quantitative suspension test; NaDCC was inhibited the all A. baumannii and ATCC strains. In the surface
disinfection application test, it was determined that at the concentration of
1000 ppm and 500 ppm, the activity of NaDCC; at 5th, 30th and 60th minutes was
effective to microorganisms at 5 log level, respectively. But at 100 ppm concentration
it was effective to at 5th minutes three, at 30th and 60th
minutes seven A. baumannii strains
at 5 log levels, while it was effective at log 1 level to other A. baumannii strains and S. aureus, E. coli
and P. aeruginosa ATCC. As a result
of investigation the A. baumannii contamination
in patient's room; before the cleaning, we determined A. baumannii contamination
on the inanimate objects of room (such as bed surface, bed edges,
control device, nightstand, chair) and on equipment (such as stethoscope,
steam appliance,
blood pressure device,
aspirator heads, ventilator surfaces). After the cleaning it was determined that
at 1000 ppm concentration at 5th, 30th and 60th minutes NaDCC was effective to A. baumannii
at 5 log levels. However, at
500 ppm concentration at 5th minute it was effective at log 5 level
except control device. At 30th
and 60th minutes of 500 ppm concentration of NaDCC was effective at log 5 level to A. baumannii. At 100 ppm concentration at 5th,
30th and 60th minutes it was effective to A. baumannii strains at log 1 level on inanimate
objects and equipment.
In
low concentration, NaDCC efficacy was reduced
against A. baumannii. The application concentration and time of the
disinfectant to clean up the equipment and the environment is very important
for preventing nosocomial infections and the spread of A. baumannii.
Thus, it is necessary to check and follow
up the staff and to create clean and disinfection training programs for educating staff.