Table Of ContentRussell, Hugo & Ayliffe’s
Principles and
Practice of
Disinfection,
Preservation &
Sterilization
Russell, Hugo & Ayliffe’s
Principles and
Practice of
Disinfection,
Preservation &
Sterilization
EDITED BY
Adam P Fraise MB BS FRCPath
Consultant Medical Microbiologist and Director
Hospital Infection Research Laboratory
City Hospital
Birmingham, UK
Peter A Lambert BSc PhD DSc
Reader in Microbiology
Pharmaceutical and Biological Sciences
Aston University
Birmingham, UK
Jean-Yves Maillard BSc PhD
Senior Lecturer in Pharmaceutical Microbiology
School of Pharmacy and Biomolecular Sciences
University of Brighton
Brighton, UK
FOURTH EDITION
© 1982, 1992, 1999 by Blackwell Science Ltd
© 2004 by Blackwell Publishing Ltd
Blackwell Publishing, Inc., 350 Main Street, Malden, Massachusetts 02148-5020, USA
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK
Blackwell Publishing Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053,
Australia
The right of the Author to be identified as the Author of this Work has been asserted in
accordance with the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted, in any form or by any means, electronic, mechanical,
photocopying, recording or otherwise, except as permitted by the UK Copyright,
Designs and Patents Act 1988, without the prior permission of the publisher.
First published 1982
Second edition 1992
Reprinted 1994 (twice)
Third edition 1999
Fourth edition 2004
Library of Congress Cataloging-in-Publication Data
Russell, Hugo & Ayliffe’s Principles and practice of disinfection,
preservation and sterilization / edited by Adam P. Fraise, Peter A.
Lambert, Jean-Yves Maillard.—4th ed.
p. ; cm.
Rev. ed. of: Principles and practice of disinfection, preservation, and
sterilization, 1999.
Includes bibliographical references and index.
ISBN 1-4051-0199-7
1. Disinfection and disinfectants. 2. Sterilization. 3. Preservation
of materials.
[DNLM: 1. Disinfection—methods. 2. Sterilization—methods.
3. Anti-Infective Agents. 4. Preservatives, Pharmaceutical. WA 240 R963
2004] I. Title: Principles and practice of disinfection, preservation
and sterilization. II. Russell, A. D. (Allan Denver), 1936–. III. Hugo,
W. B. (William Barry). IV. Ayliffe, G. A. J. V. Fraise, Adam P.
VI. Lambert, Peter A. VII. Maillard, J.-Y. VIII. Principles and practice of
disinfection, preservation, and sterilization. IX. Title.
RA761.P84 2004
614.4¢8—dc22
2003017281
ISBN 1-4051-0199-7
A catalogue record for this title is available from the British Library
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Printed and bound in the United Kingdom by CPI Bath
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Contents
List of contributors, vii 7.2 Evaluation of the antibacterial and
antifungal activity of disinfectants, 220
Preface to the fourth edition, ix Gerald Reybrouck
8 Sensitivity of protozoa to disinfectants, 241
Preface to the first edition, x 8.1 Acanthamoeba, contact lenses and
disinfection, 241
Neil A Turner
Part 1: Principles
8.2 Intestinal protozoa and biocides, 258
1 Historical introduction, 3 Jean-Yves Maillard
Adam P Fraise 9 Viricidal activity of biocides, 272
2 Types of antimicrobial agents, 8 Jean-Yves Maillard
Suzanne L Moore and David N Payne 10 Transmissible degenerative encephalopathies:
3 Factors influencing the efficacy of inactivation of the unconventional causal
antimicrobial agents, 98 agents, 324
A Denver Russell David M Taylor
4 Biofilms and antimicrobial
resistance, 128
Part 2: Practice
Peter Gilbert, Alexander H Rickard and
Andrew J McBain 11 Evaluation of antimicrobial efficacy, 345
5 Mechanisms of action of biocides, 139 Ronald J W Lambert
Peter A Lambert 12 Sterilization, 361
6 Bacterial resistance, 154 12.1 Heat sterilization, 361
6.1 Intrinsic resistance of Gram-negative Grahame W Gould
bacteria, 154 12.2 Radiation sterilization, 384
David J Stickler Peter A Lambert
6.2 Acquired resistance, 170 12.3 Gaseous sterilization, 401
Keith Poole Jean-Yves Dusseau, Patrick Duroselle
6.3 Resistance of bacterial spores to chemical and Jean Freney
agents, 184 12.4 Filtration sterilization, 436
Peter A Lambert Stephen P Denyer and Norman A
6.4 Mycobactericidal agents, 191 Hodges
Peter M Hawkey 13 New and emerging technologies, 473
7 Antifungal activity of disinfectants, 205 Grahame W Gould
7.1 Antifungal activity of biocides, 205 14 Preservation of medicines and cosmetics, 484
Jean-Yves Maillard Sarah J Hiom
v
Contents
15 Reuse of single-use devices, 514 20 Other health-related issues, 595
Geoffrey W Hanlon 20.1 Special issues in dentistry, 595
16 Sterility assurance: concepts, methods and Jeremy Bagg and Andrew Smith
problems, 526 20.2 Veterinary practice, 604
Rosamund M Baird Anders Engvall and Susanna Sternberg
17 Special problems in hospital antisepsis, 540 20.3 Recreational and hydrotherapy pools,
Manfred L Rotter 614
18 Decontamination of the environment and John V Dadswell
medical equipment in hospitals, 563 21 Good manufacturing practice, 622
Adam P Fraise Elaine Underwood
19 Treatment of laundry and clinical waste in
hospitals, 586 Index, 641
Christina R Bradley
vi
List of contributors
Jeremy Bagg PhD FDS RCS (Ed) Anders Engvall DVM Sarah J Hiom PhD MRPharmS
FDS RCPS (Glasg) FRCPath Professor and Chief Epizootiologist Senior Pharmacist R&D, NHS Wales
Professor of Clinical Microbiology National Veterinary Institute SVA St Mary’s Pharmaceutical Unit
University of Glasgow Dental School Uppsala Cardiff, UK
Glasgow, UK Sweden
Norman A Hodges BPharm
Rosamund M Baird BPharm PhD Adam P Fraise MB BS FRCPath MRPharmS PhD
MRPharmS Consultant Medical Microbiologist and Principal Lecturer in Pharmaceutical
School of Pharmacy Director Microbiology
University of Bath Hospital Infection Research Laboratory School of Pharmacy and Biomolecular
Bath, UK City Hospital Sciences
Birmingham, UK University of Brighton
Christina R Bradley AIBMS Brighton, UK
Laboratory Manager Jean Freney PhD
Hospital Infection Research Laboratory Professor of Microbiology Peter A Lambert BSc PhD DSc
City Hospital Department of Bacteriology and Virology Reader in Microbiology
Birmingham, UK Faculty of Pharmacy Pharmaceutical and Biological Sciences
Lyon Aston University
John V Dadswell MB BS France Birmingham, UK
FRCPath
Former Director Peter Gilbert BSc PhD Ronald J W Lambert BA BSc PhD
Reading Public Health Laboratory Professor of Microbial Physiology CChem MRSC
Reading, UK School of Pharmacy and Pharmaceutical Director
Sciences R2-Scientific
Stephen P Denyer BPharm PhD University of Manchester Sharnbrook
FRPharmS Manchester, UK Beds, UK
Head of School
Welsh School of Pharmacy Grahame W Gould BSc MSc PhD Andrew J McBain
Cardiff University Visiting Professor of Microbiology Research Fellow
Cardiff, UK University of Leeds School of Pharmacy and Pharmaceutical
Leeds, UK Sciences
Patrick Duroselle PhD University of Manchester
Department of Bacteriology and Virology Geoffrey W Hanlon BSc PhD Manchester, UK
Faculty of Pharmacy MRPharmS
Lyon Reader in Pharmaceutical Microbiology Jean-Yves Maillard BSc PhD
France School of Pharmacy and Biomolecular Senior Lecturer in Pharmaceutical
Sciences Microbiology
Jean-Yves Dusseau MD University of Brighton School of Pharmacy and Biomolecular
Spécialiste des Hôpitaux des armees Brighton, UK Sciences
Hôpital d’instruction des armées Desgenettes University of Brighton
Département de Biologie Médicale Peter M Hawkey BSc DSc MB BS Brighton, UK
Lyon MD FRCPath
France Professor of Clinical and Public Health Suzanne L Moore BSc PhD
Bacteriology and Honorary Consultant External Innovation, Health and Personal
The Medical School, University of Care R&D
Birmingham Reckitt Benckiser Healthcare (UK)
Health Protection Agency, Birmingham Hull, UK
Heartlands and Solihull NHS Trust
Birmingham, UK
vii
List of contributors
David N Payne MIBiol CBiol Manfred L Rotter MD Dip Bact David J Stickler BSc MA DPhil
Microbiology Manager Director and Professor of Hygiene and Senior Lecturer in Medical Microbiology
Reckitt Benckiser Healthcare (UK) Medical Microbiology Cardiff School of Biosciences
Hull, UK Department of Hygiene and Medical Cardiff University
Microbiology of the University of Vienna Cardiff, UK
Keith Poole PhD Vienna
Professor of Microbiology and Immunology Austria David M Taylor PhD MBE
Queen’s University Consultant
Kingston, ON A Denver Russell BPharm PhD SEDECON 2000
Canada DSc FRCPath FRPharmS Edinburgh, UK
Professor of Pharmaceutical Microbiology
Gerald Reybrouck MD AggrHO Welsh School of Pharmacy Neil A Turner BSc PhD
Professor Cardiff University Postdoctoral Research Fellow
Hospital Hygiene and Infection Control Cardiff, UK Department of Medical and Molecular
Department Parasitology
Katholiecke Universiteit Leuven Andrew Smith BDS FDS RCS PhD New York University School of Medicine
Leuven MRCPath New York
Belgium Senior Lecturer and Honorary Consultant in USA
Microbiology
Alexander H Rickard BSc MSc University of Glasgow Dental School Elaine Underwood BSc PhD
PhD Glasgow, UK Wyeth Pharmaceuticals
Research Fellow SMA Nutrition Division
School of Pharmacy and Pharmaceutical Susanna Sternberg DVM PhD Maidenhead, UK
Sciences Laboratory Veterinary Officer
University of Manchester National Veterinary Institute SVA
Manchester, UK Uppsala
Sweden
viii
Preface to the fourth edition
It has been a privilege to take on the editing of this Inevitably much of the content of the previous
textbook. The major change that has taken place is editions is still valid and we are grateful for the ef-
that the organization of the chapters has been al- forts of the previous editorial team and authors,
tered such that Chapters 1–10 deal with the prin- without whom it would have been impossible to
ciples of disinfection, preservation and steriliza- achieve this fourth edition within the allotted
tion, and Chapters 11–21 deal with the practice. timescale. We are especially grateful to authors of
Although the book has always been aimed at micro- chapters in previous editions, who have allowed
biologists, physicians and pharmacists, the content their text to be used by new authors in this edition.
of this fourth edition has been modified to reflect We also thank all contributors (both old and new)
this clinical emphasis more. Consequently, chapters for their hard work in maintaining this text as one
on textile, leather, paint and wood preservation of the foremost works on the subject.
have been removed, whereas sections on biofilms,
prions and specific clinical areas such as dentistry A.P.F.
have been updated and expanded. All other chap- P.A.L.
ters have been revised, with new material added J.-Y.M.
where appropriate.
ix
Preface to the first edition
Sterilization, disinfection and preservation, all de- instrumentation of the patient. Although heat ster-
signed to eliminate, prevent or frustrate the growth ilization processes at high temperatures are pre-
of microorganisms in a wide variety of products, ferred whenever possible, medical equipment is
were incepted empirically from the time of man’s often difficult to clean adequately, and components
emergence and remain a problem today. The fact are sometimes heat-labile. Disposable equipment is
that this is so is due to the incredible ability of the useful and is widely used if relatively cheap but is
first inhabitants of the biosphere to survive and obviously not practicable for the more expensive
adapt to almost any challenge. This ability must in items. Ethylene oxide is often used in industry for
turn have been laid down in their genomes during sterilizing heat-labile products but has a limited
their long and successful sojourn on this planet. use for reprocessing medical equipment. Low-
It is true to say that, of these three processes, ster- temperature steam, with or without formaldehyde,
ilization is a surer process than disinfection, which has been developed as a possible alternative to
in turn is a surer process than preservation. It is in ethylene oxide in the hospital.
the last field that we find the greatest interactive Although aseptic methods are still used for
play between challenger and challenged. The surgical techniques, skin disinfection is still necess-
microbial spoilage of wood, paper, textiles, paints, sary and a wider range of non-toxic antiseptic
stonework, stored foodstuffs, to mention only a few agents suitable for application to tissues is required.
categories at constant risk, costs the world many Older antibacterial agents have been reintroduced,
billions of pounds each year, and if it were not for e.g. silver nitrate for burns, alcohol for hand
considerable success in the preservative field, this disinfection in the general wards and less corro-
figure would rapidly become astronomical. Disin- sive hypochlorites for disinfection of medical
fection processes do not suffer quite the same fail- equipment.
ure rate and one is left with the view that failure here Nevertheless, excessive use of disinfectants in the
is due more to uninformed use and naïve interpreta- environment is undesirable and may change the
tion of biocidal data. Sterilization is an infinitely hospital flora, selecting naturally antibiotic-resis-
more secure process and, provided that the proce- tant organisms, such as Pseudomonas aeruginosa,
dural protocol is followed, controlled and moni- which are potentially dangerous to highly suscep-
tored, it remains the most successful of the three tible patients. Chemical disinfection of the hospital
processes. environment is therefore reduced to a minimum
In the field of communicable bacterial diseases and is replaced where applicable by good cleaning
and some virus infections, there is no doubt that methods or by physical methods of disinfection or
these have been considerably reduced, especially in sterilization.
the wealthier industrial societies, by improved hy-
giene, more extensive immunization and possibly A.D.R.
by availability of antibiotics. However, hospital- W.B.H.
acquired infection remains an important problem G.A.J.A.
and is often associated with surgical operations or
x
Part 1
Principles
Description:Highly respected, established text - a definitive reference in its field - covering in detail many methods of the elimination or prevention of microbial growth"highly recommended to hospital and research personnel, especially to clinical microbiologists, infectioncontrol and environmental-safety spe