THE EFFECT OF SODIUM DICHLOROISOCYANURATE DIHYDRATE TO PREVENT THE ENVIRONMENTAL TRANSMISSION OF MULTIDRUG-RESISTANT ACINETOBACTER BAUMANNII IN HOSPITAL SETTINGS


DUMAN Y. , KUZUCU Ç. , ERSOY Y. , OTLU B.

Fresenius Environmental Bulletin, cilt.29, no.2, ss.71891-7197, 2020 (SCI İndekslerine Giren Dergi)

  • Cilt numarası: 29 Konu: 9
  • Basım Tarihi: 2020
  • Dergi Adı: Fresenius Environmental Bulletin
  • Sayfa Sayıları: ss.71891-7197

Özet

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.