Russell, Hugo and Ayliffe's Principles and Practice of Disinfection, Preservation and Sterilization (eBook)

Title page 5
Copyright page 6
Contents 7
List of Contributors 9
Preface to the Fifth Edition 12
Preface to the First Edition 13
SECTION 1: Principles 15
1: Historical Introduction 15
Early concepts 15
Chemical disinfection 16
Sterilization 17
Future developments for microbicides 18
References 18
Further reading 18
2: Types of Microbicidal and Microbistatic Agents 19
Introduction 19
Phenols 19
Chemistry of phenols 20
Mode of action 20
Sources of phenols: the coal-tar industry 20
Properties of phenolic fractions 20
Formulation of coal-tar disinfectants 20
Modern range of solubilized and emulsified phenolic disinfectants 21
Non-coal-tar phenols 22
Halo and nitrophenols 23
Pine disinfectants 25
Bisphenols 25
Organic and inorganic acids: esters and salts 27
Chemistry of organic and inorganic acids 27
Mode of action 28
Individual compounds 28
Aromatic diamidines 31
Mode of action 32
Propamidine 32
Hexamidine diisethionate 32
Dibromopropamidine 32
Biguanides 32
Mode of action 32
Chlorhexidine 32
Alexidine 34
Polymeric biguanides 34
Surface-active agents 35
Cationic agents 35
Anionic agents 37
Non-ionic surface-active agents 37
Amphoteric (ampholytic) agents 38
Aldehydes 38
Mode of action 38
Glutaraldehyde (pentanedial) 38
Formaldehyde (methanal) 40
Ortho-phthalaldehyde 42
Other aldehydes 42
Microbicidal dyes 43
Acridines 43
Triphenylmethane dyes 44
Quinones 44
Halogenated fluorescein (hydroxyxanthene) 45
Halogens 45
Iodine compounds 45
Chlorine compounds 47
Bromine 49
Quinoline and isoquinoline derivatives 49
8-Hydroxyquinoline Derivatives 49
4-Aminoquinaldinium derivatives 49
Isoquinoline derivatives 49
Alcohols 50
Mode of action 50
Ethyl alcohol (ethanol) 51
Methyl alcohol (methanol) 51
Isopropyl alcohol (isopropanol) 51
Benzyl alcohol 51
Phenylethanol (phenylethyl alcohol) 52
Bronopol 52
Phenoxyethanol (phenoxetol) 52
Chlorbutanol (chlorbutol) 52
2,4-Dichlorobenzyl alcohol 52
Peroxygens 52
Hydrogen peroxide 52
Peracetic acid 53
Performic acid 53
Chelating agents 53
Ethylendiamine tetraacetic acid 53
Other chelating agents 54
Permeabilizers 55
Polycations 55
Lactoferrin 55
Transferrin 55
Citric and other acids 55
Heavy metal derivatives 55
Copper compounds 56
Silver compounds 56
Mercury compounds 57
Tin and its compounds (organotins) 58
Titanium 58
Anilides 58
Mode of action 59
Salicylanilide 59
Diphenylureas (carbanilides) 59
Miscellaneous preservatives 59
Derivatives of 1,3-dioxane 59
Derivatives of imidazole 60
Isothiazolones 61
Derivatives of hexamine 62
Triazines 63
Oxazolo-oxazoles 63
Sodium hydroxymethylglycinate 64
Methylene bisthiocyanate 64
Captan 64
1,2-dibromo-2,4-dicyanobutane (Tektamer 38) 64
Glucoprotamin 64
Essential oils 64
General statement 65
Vapor-phase disinfectants 65
Ethylene oxide 65
Formaldehyde-releasing agents 65
Propylene oxide 67
Ozone 67
Carbon dioxide 67
Mode of action 67
Aerial disinfectants 67
Inactivation of prions 68
Other uses of microbicidal and microbistatic agents 68
Use in the food, dairy, pharmaceutical and cosmetic industries 68
Disinfectants in recreational waters 68
Which microbicidal or microbistatic agent? 69
Regulatory requirements 69
Which preservative? 69
Other concepts 69
Additional considerations 70
Nanotechnology 70
References 71
3: Factors Affecting the Activities of Microbicides 85
Introduction 85
Factors affecting microbicidal activity during the development of a given formulation 85
Culturing microorganisms for test inocula 86
Composition of growth medium and physical parameters 86
Pretreatments 86
Factors affecting microbicidal activity during field use 87
Factors inherent to microbicides 87
Factors depending upon treatment conditions 89
Factors inherent to microorganisms 91
Factors affecting recovery: microbial viability after microbicide exposure 94
Injury repair: viable but non-culturable microorganisms 94
Neutralization of microbicidal activity 94
Recovery media 94
Incubation temperature 94
Conclusions 95
References 95
4: Biofilm Recalcitrance: Theories and Mechanisms 101
Introduction 101
The matrix 102
Biofilm matrix as a barrier to antibacterial agents 102
Biofilm matrix as an interactive barrier to antibacterial penetration 102
Enzyme-mediated reaction – diffusion resistance 102
Cellular phenotype in biofilm communities as a moderator of recalcitrance 103
Drug-resistant phenotypes 104
Efflux pumps 104
Quiescence and persistence 104
Biofilms as highly selective environments 105
Conclusions 106
Acknowledgments 106
References 106
5: Mechanisms of Action of Microbicides 109
Introduction 109
Methods for studying the mechanism of action of microbicides 110
Physical and biochemical approaches to the study of microbicide action 110
Molecular approaches to the study of microbicide action 112
Variable parameters in mechanism of action studies 112
Uptake, binding and penetration 112
Action on the cell wall 113
Action on the cell membrane 113
Leakage of cell constituents 113
Inhibition of energy processes 114
Interaction with the cytoplasm 114
Protein denaturation and coagulation 114
Effects on enzymes 114
Effects on nucleic acids 114
Effects of microbicides on the microbial transcriptome and proteome 115
Action of individual classes of microbicidal agents 115
Oxidizing agents 115
Alkylating and halogenating agents 116
Metal ion-binding agents 116
Nucleic acid-binding agents 116
Protein denaturants 116
Interaction with lipids 116
Conclusions 116
References 117
6: Bacterial Sensitivity and Resistance to Microbicides 122
6.1: Mechanisms of Bacterial Resistance to Microbicides 122
Introduction 122
Definitions 123
Occurrence of bacterial resistance to microbicides 123
Mechanisms of bacterial resistance to microbicides 124
Principles 124
Overview 124
Mechanisms 124
Induction of gene expression conferring bacterial resistance 127
Bacterial biofilms 127
Change in bacterial populations 127
Dissemination of resistance 127
Measuring bacterial resistance to microbicides 127
Cross-resistance to unrelated chemicals 129
Conclusions 129
References 129
6.2: Resistance of Bacterial Spores to Chemical Agents 135
Introduction 135
Spore structure 135
Exosporium 136
Coat 136
Outer membrane 136
Cortex and germ cell wall 136
Inner membrane 136
Core 137
Variables affecting spore chemical resistance 137
Species/strain 137
Sporulation conditions 137
Spore purity 138
Spore storage and recovery conditions 138
Mechanisms of spore killing by chemicals 138
Spore killing by DNA damage 138
Spore killing by inactivation of spore core enzymes 139
Spore killing by preventing germination 139
Spore killing by damage to the inner membrane 139
Factors important in spore resistance to various chemicals 139
Disinfectants 139
Genotoxic chemicals 140
Hydrogen peroxide 141
Oxidizing agents other than hydrogen peroxide 141
Dialdehydes 141
Acid and alkali 141
Plasma 141
Supercritical carbon dioxide 141
Factors important in chemical resistance of spores of clostridium species 142
Conclusions 142
Acknowledgments 142
References 142
6.3: Testing of Chemicals as Mycobactericidal Agents 145
Introduction 145
Spread of mycobacteria 146
Microbicides and mycobacteria 146
Testing microbicides against mycobacteria 146
Types of tests for mycobactericidal activity 146
Standard test protocols for mycobactericidal activity 147
AOAC International 147
ASTM international 147
Quantitative carrier tests of ASTM international 148
Comité Européean de Normalisation 149
Guidance on testing and registration of chemicals as mycobactericides 149
Health Canada 149
United States environmental protection agency 149
United States food and drug administration 149
Conclusions 150
Acknowledgments 153
References 153
7: Fungicidal Activity of Microbicides 156
Introduction 156
General fungal ecology 156
Fungicidal activity of microbicides 157
Standards 157
Chemicals with fungicidal activity 158
Acids and alkalis 158
Alcohols 159
Aldehydes 159
Halogens 160
Metals 161
Oxidizing agents 162
Phenols 163
Surfactants 163
Microbicide resistance in fungi 164
Safety, handling and discharge measurements for fungal microbicides 164
References 165
8: Sensitivity and Resistance of Protozoa to Microbicides 169
Introduction 169
General descriptions and life cycles 169
Waterborne parasitic protozoa other than amoebae 169
Parasitic and free-living amoebae 171
Microsporidia 172
Dormant-form cell wall structures: a key to understanding resistance to microbicides 173
Sensitivity and resistance of protozoa to microbicides 175
Chemical microbicides 176
Physical microbicides 181
Conclusions 184
References 184
9: Virucidal Activity of Microbicides 192
Introduction 192
Interrupting the spread of viruses with microbicides 192
Evaluation of virucidal activity 193
Viral propagation, detection and enumeration 194
Virucidal tests and their significance 194
Virucidal testing methods 195
Approved tests for virucidal activity 196
Assessment of virucidal activity with bacteriophages 197
Virucidal efficacy of microbicides 197
Mechanisms of virucidal action 200
Viral structures and targets 201
Mechanisms of action of microbicides against viruses 204
Other virucidal processes 210
Viral resistance to microbicides 210
Viral aggregation 210
Other mechanisms 212
Multiplicity reactivation 212
Conclusions 212
References 213
10: Transmissible Spongiform Encephalopathies and Decontamination 222
Introduction 222
Prion diseases 222
Agent characteristics 224
General considerations 226
Practical considerations in decontamination studies 227
General 227
Test methods 228
Inactivation methods 230
Physical inactivation methods 230
Chemical inactivation methods 233
Future perspectives in prion decontamination 237
Parallels with other protein-precipitating diseases 238
References 238
11: Microbicides – the Double-edged Sword: Environmental Toxicity and Emerging Resistance 243
Introduction 243
Applications of biocidal products and fate in the environment 244
Differences and similarities in antimicrobial actions 245
Microbicide concentration and bacterial susceptibility 245
Effects of Low Concentrations of a Microbicide 245
Concentrations of Microbicides in the Environment 246
Microbicides and antimicrobial resistance in bacteria 246
General Considerations 246
Expression and Overexpression of Efflux Pumps and Other Systems 247
Physiological and Metabolic Changes 247
Conclusions 247
References 248
SECTION 2: Practice 250
12: Evaluation of Antimicrobial Efficacy 250
Introduction 250
Classification of disinfectant tests 251
Primary and secondary testing methods: suspension 252
Suspension tests 252
Capacity tests 254
Surface (carrier) testing 255
Carrier test 255
Non-standard methods for investigating microbicidal activity 255
Biochemical methods 256
Physical methods 256
Discriminatory counting techniques 256
Flow cytometry 256
Bioluminescence 256
Quantitative optical density 257
Conclusions 257
Acknowledgments 257
References 257
13: Assessing the Efficacy of Professional Healthcare Antiseptics: a Regulatory Perspective 261
Introduction 261
North American regulatory process 261
Canada 261
United States of America 262
European Union regulatory process 262
Antiseptics in healthcare settings: why are they needed? 263
Scientific methods used by regulatory agencies to assess antiseptic effectiveness 263
Conclusions 267
References 268
14: Regulation of Microbicides 269
14.1: Legislation Affecting Disinfectant Products in Europe: the Biocidal Products Directive and the Registration, Evaluation and Authorization of Chemicals Regulations 269
Introduction 269
The biocidal products directive 269
Development of the legislation 269
Definitions and scope 269
How does the BPD work? 269
Legislation evolves 272
Registration, evaluation, authorization and restriction of chemicals (REACH) 273
Development of the legislation 273
Definitions and scope 273
How does REACH work? 273
Downstream users 274
Safety data sheets 275
Legislation evolves 275
References 275
14.2: Regulatory Authorization of Hard Surface Disinfectants in Canada 276
Introduction 276
Disinfectants versus sanitizers 276
Legislative and regulatory authority 278
The food and drugs act 278
The food and drug regulations 278
Premarket review process 278
Pre-submission meeting 279
DIN authorization 279
Regulatory decision 280
Reconsideration process 280
Post-DIN changes 280
Postmarket regulatory activities 281
Emerging pathogens 281
Additional sources of information 281
Acknowledgments and disclaimer 281
References 281
14.3: United States Regulation of Antimicrobial Pesticides 283
Introduction 283
Pesticide history 283
Environmental protection agency structure 284
Antimicrobial pesticides overview 284
Public health antimicrobial pesticide categories 284
Emerging pathogens 285
Determining whether a product is a pesticide 285
Obtaining a pesticide registration 286
File a registration 286
Supplemental registration process 286
Purchase an existing registration 286
The registration process 286
Fulfilling data requirements 287
EPA review process 287
Changes to registrations 288
Labels 288
Registrant obligations 288
Antimicrobial testing program 288
State pesticide registration 288
Treated articles 288
Devices 289
Minimum risk pesticides 289
Nanotechnology 289
OECD antimicrobial efficacy methods 289
Conclusions 289
References 289
15: Sterilization Processes 291
15.1: Heat Sterilization 291
Introduction 291
Kinetics of heat inactivation 291
Microbial susceptibility to heat 293
Moist heat 293
Parenteral products 294
Non-parenteral products 295
Dressings 296
Lumened devices 298
Thermal processing of foods 298
Combination treatments 299
Alternative means for heat delivery and control 300
Dry heat 301
Lyophilization 302
Mechanisms of microbial inactivation 302
Mechanisms of spore resistance to heat 303
Conclusions 303
Acknowledgments 303
References 303
15.2: Radiation Sterilization 308
Introduction 308
Radiation energy 309
Types of radiation 309
Units of nuclear radiation 309
Radiation sources 309
Sensitivity and resistance of microorganisms to radiation 310
Mechanisms of lethal action 311
Choice of radiation dose 312
Standards and control procedures 312
Uses of ionizing radiation 313
Ultraviolet radiation 313
Survival curves following ultraviolet radiation 314
Sensitivity to ultraviolet radiation 314
Target site and inactivation 314
Repair mechanisms 314
Effect of ultraviolet radiation on bacterial spores 315
Practical uses of ultraviolet radiation 316
Other forms of radiation used in disinfection and sterilization 316
Conclusions 316
References 316
15.3: Gaseous Sterilization 320
Introduction 320
General principles 321
Characteristics of an ideal low-temperature gaseous sterilizing agent 321
Types of gaseous sterilizing agent and mechanisms of action 321
Principal features of sterilizing equipment 322
Validation 322
Load release 322
Biological indicators 322
Residues of gas sterilants 322
Alkylating agents 322
Ethylene oxide 322
Formaldehyde 326
Oxidizing agents 329
Hydrogen peroxide gas 329
Peracetic acid 331
Gaseous ozone 333
Chlorine dioxide 336
Plasma sterilization 337
Conclusions 341
References 342
15.4: Gas Plasma Sterilization 347
Introduction 347
Applications of gas plasma for decontamination 348
Sterilization systems that use gas plasma 349
Hydrogen peroxide gas plasma sterilization 349
Other oxidizing agent-based plasma systems 352
Sterilization with gas plasma 352
Oxygen 352
Hydrogen peroxide and peracetic acid 353
Nitrogen 353
Other gases 354
Mechanisms of action 354
Future perspectives 355
References 355
15.5: Filtration Sterilization 357
Historical introduction 357
Filtration media 357
Filters of diatomaceous earth 357
Fibrous pad filters 358
Sintered or fritted ware 358
Membrane filters 358
Applications and limitations of filtration 371
Filtration “sterilization” 371
Non-sterilizing uses of membrane filtration 374
Testing of filters 375
Filters used in liquid sterilization 375
Filters used in gas “sterilization” 378
Designing a filtration system for the preparation of medicinal products 379
Acknowledgments 380
References 380
16: New and Emerging Technologies 385
Introduction 385
General considerations 386
Process optimization 386
Formulation optimization, including synergism 387
Ultrahigh pressure and supercritical fluids 387
High-voltage electric pulses 389
Other physical processes 390
High-intensity light 390
Magnetic fields 390
Sonication 391
Microwaves 391
Gas plasma 391
Vapor-phase oxidants 392
Nitric oxide and nitrogen dioxide 394
Bacteriophages and other biological substances 394
Glucoprotamines 395
Microbicidal surfaces 395
Copper and silver 395
N-halamines 396
Titanium dioxide 397
Conclusions 397
References 397
17: Preservation of Medicines and Cosmetics 402
Nature of medicines and cosmetics 402
Consequences of microbial contamination 404
Effect of formulation parameters on microbial contamination and spoilage 405
Formulation effects on microbial growth 405
Formulation effects on preservative efficacy 406
Use of preservatives in medicines and cosmetics 409
Medicines 410
Cosmetics 411
Potentiation and synergy 412
Regulatory aspects of the preservation of medicines and cosmetics 413
Prediction of preservative efficacy 414
Adverse reactions of users to preservatives 415
References 416
18: Sterility Assurance: Concepts, Methods and Problems 422
Introduction 422
Sterile, sterilized 422
Sterility and sterility assurance 423
Factors affecting sterility assurance 423
Sterility assurance in practice 424
Sterility testing 424
Process monitoring and parametric release 425
Equipment function tests 426
Performance verification tests 426
Process validation practices 428
Bioburden estimation 430
Parametric release of product in practice 430
Sterile barrier systems 431
References 431
19: Special Problems in Hospital Environments 432
19.1: Hand Hygiene 432
Transmission of healthcare-associated pathogens through hands 432
Products and methods for hand antisepsis and infrastructures required for optimal hand hygiene 433
Methods to monitor hand hygiene compliance and other hand hygiene indicators 436
Monitoring hand hygiene by direct observation methods 437
Indirect monitoring of hand hygiene 438
Automated monitoring of hand hygiene 438
Hand hygiene practices among healthcare workers 438
Strategies to improve hand hygiene compliance 439
Effectiveness of hand hygiene programs to reduce healthcare-associated infections, including cost-saving issues 441
The World Health Organization multimodal hand hygiene improvement strategy and toolkit 447
Adverse events related to hand hygiene and in particular to the use of alcohol-based handrubs 447
Appendix 19.1 World Health Organization recommendations on hand hygiene in health care 448
Consensus recommendations 448
Disclaimer 450
References 450
19.2: Decontamination of the Environment and Medical Equipment in Hospitals 459
Introduction 459
A rational approach to disinfection: a disinfectant policy 460
Objective 460
Categories of risk to patients and treatment of equipment and environment 461
Requirements of chemical disinfectants 461
Choice of a disinfection method 461
Implementation of the disinfectant policy 463
Problems with certain microorganisms 463
Bacterial spores 463
Bloodborne viruses, hepatitis A virus and prions 463
Mycobacteria 464
Prions 464
Contaminated disinfectant solutions 464
Treatment of the environment and equipment 465
Walls, ceilings and floors 465
Air 466
Baths, washbowls and toilets 466
Bedpans and urinals 466
Crockery and cutlery 466
Cleaning equipment 467
Babies’ incubators 467
Respiratory ventilators and associated equipment 467
Anesthetic equipment 467
Endoscopes 468
Miscellaneous items of medical equipment 468
Conclusions 468
Acknowledgment 469
References 469
19.3: Decontamination of Endoscopes 473
Introduction 473
Rigid endoscopes 474
Flexible endoscopes 475
Infections associated with flexible endoscopy 475
Risk assessment 475
Problems associated with flexible endoscopes 475
Decontamination procedure 475
Steps in the decontamination procedure 475
Selection of a chemical disinfectant for HLD 477
Automated endoscope reprocessors 478
Typical AER cycle including a validated cleaning cycle 478
Endoscope washer disinfectors: issues 478
Cleaning verification of reprocessed endoscopes 480
Staff training 482
Written procedures 482
Training 482
Acknowledgment 482
References 482
19.4: Issues Associated with the Decontamination of Laundry and Clinical Waste 485
Introduction 485
Healthcare laundry 485
Routine healthcare laundry 485
Categorization of healthcare laundry 486
Decontamination of laundry 487
Staff uniforms 487
Dry cleaning 488
Washing machines in acute clinical areas 488
Laundry quality assurance systems 488
Clinical waste 488
Segregation of clinical waste 488
Infectious waste 489
Offensive waste 489
Storage of clinical waste 489
Transfer documentation 489
Accidents and incidents 489
Final disposal method 489
Types of disposal 490
Conclusions 490
References 490
Further reading 491
19.5: Treated Recreational Water Venues 492
Introduction 492
Engineering design considerations 492
Swimming pools and water parks 493
Hot tubs and spas 494
Hot springs and natural pools 494
Whirlpool baths and birthing pools designed for a single user 494
Water chemistry 494
Disinfection 494
Efficacy testing disinfectants 495
Health effects 495
Skin, ear and eye irritation and infection 495
Gastrointestinal infections 496
Respiratory irritation and infections 496
Other infectious diseases 497
Management and reporting 497
References 497
20: Antimicrobial Surfaces and Devices 499
20.1: Antimicrobial Surfaces 499
Introduction 499
Passive surfaces 500
Diamond-like carbon 500
Polyethylene oxide brush coatings 500
Bacterial interference 500
Reactive surfaces 501
Challenges associated with the development of reactive surfaces: Urinary catheters 501
Other reactive surfaces that continuously release antimicrobial agents 502
Reactive surfaces that kill microorganisms on contact 503
Reactive surfaces that release antimicrobial agents on command 505
Reactive surfaces that release antimicrobial agents on demand 508
Conclusions 508
References 509
20.2: Antimicrobial Devices 514
Introduction 514
Definition of medical device 515
Biomaterials 515
Medical device applications of biomaterials 515
Biomaterials in medical device manufacture 515
Complications associated with indwelling medical devices 517
Mechanical complications 517
Biocompatibility 517
Infectious complications 517
Healthcare-associated infections 518
Device-associated infections: Events following device implantation 518
Deposition of conditioning film, colonization and biofilm formation 519
Clinical management of device-related infections 519
Development of antimicrobial biomaterials 520
Antiseptics 521
Silver 521
Antibiotics 521
Antimicrobial combinations 522
Antimicrobial devices 522
Antimicrobial urological devices 522
Antimicrobial central venous access devices/catheters 523
Antimicrobial endotracheal tubes 523
Antimicrobial orthopedic devices 524
Antimicrobial peritoneal catheters 524
Antimicrobial catheters for neurosurgery 524
Antimicrobial sutures 525
The future: Emerging strategies for anti-infective biomaterials 525
Conclusions 526
References 526
20.3: Antimicrobial Dressings 528
Introduction 528
Silver dressings 529
Iodine dressings 531
Chlorhexidine dressings 531
Polyhexamethylene biguanide dressings 531
Honey dressings 532
Evaluation and safety of wound dressings 532
References 532
20.4: Antimicrobial Textiles and Testing Techniques 534
Introduction 534
Benefits of antimicrobial agents on textiles 534
Microbiological growth on Textiles 535
Microbiological issues associated with manufacturing and raw materials 535
Natural and synthetic materials 535
Benefits in the hospital and home 535
Antimicrobial agents 536
Leaching and non-leaching agents 536
Mode of antimicrobial action 536
Global regulatory compliance 536
Objectives and principles of antimicrobial testing 537
Tiered antimicrobial testing 537
Testing via zone of inhibition studies 537
Antimicrobial test methods used to measure activity 538
Inherent “passive” microbial resistance and preservative testing 538
Measuring “active” microbial properties on textiles 538
Test methods specific for claim validation 540
Conclusions 541
References 542
21: Other Health Sectors 544
21.1: Use of Microbicides in Disinfection of Contact Lenses 544
Introduction 544
Lens care 545
Lens care solutions 545
Active ingredients 545
Other formulation constituents 546
Lens care alternatives 546
Complications 546
General 546
Qualification of lens care solutions 547
The ISO stand-alone test 547
The ISO regimen test 548
The ISO preservative efficacy/discard date test 548
Additional testing 549
Conclusions 550
References 550
21.2: Special Issues in Dentistry 551
Introduction 551
Cross-infection 552
Bloodborne viruses 552
Transmissible spongiform encephalopathy 554
Other potential pathogens 555
Contamination of the working environment 556
Aerosols and splatter 556
Dental unit water lines 556
Impressions, prosthetics and dental instruments 557
Clinical waste 557
Compliance with infection control measures 558
Training in infection control 558
Recent developments in dental hygiene 558
Ozonated liquids 558
Photodynamic therapy 559
References 559
22: Emerging Natural Technologies 564
22.1: Natural Products 564
Introduction 564
Host defense peptides (antimicrobial peptides) 564
Natural products of bacterial origin 565
Bacterial antimicrobial peptides 565
Enzymes 566
Natural products of plant origin 566
Garlic 567
Green tea 569
Essential oils 569
Natural products of animal origin 570
Hive products 570
Antimicrobial peptides of animal origin 573
Human defense peptides 573
Magainins 573
Lactoferrin 573
Maggot therapy or biosurgery 573
Conclusions 574
References 574
22.2: Applications of Bacteriophage Technology 579
Introduction 579
Characteristics of bacteriophages 579
Lytic and lysogenic cycles 580
Applications of bacteriophages 582
Phage-typing 582
Bacterial identification 582
Vaccine production 582
Phage display and the production of therapeutic antibodies 583
Bacteriophage therapy of human bacterial infections 583
Early experiences of bacteriophage therapy 583
Drivers for change 583
Recent clinical experiences with bacteriophages 584
Applications in agriculture and animal health 586
Bacteriophages for the control of bacteria on foods 586
Bacteriophages to treat infections in animals 586
Further applications of bacteriophages 587
Bacteriophage lysins 587
Toxin delivery 587
Conclusions 588
References 588
23: Control of Infectious Bioagents 590
Introduction 590
Bacillus anthracis 591
Foot-and-mouth disease 591
Containment approaches 592
Microbicide susceptibility of infectious agents 592
Prions 592
Bacterial spores 593
Vegetative bacteria 594
Botulinum toxin 595
Viruses 595
Summary 595
Decontamination principles 596
Containment requirements 596
Source reduction 596
Surface decontamination technologies 596
Large-area decontamination technologies 596
Summary 598
Determining the efficiency of the decontamination process 598
Summary 599
New and upcoming decontamination technologies 599
Green microbicides 599
Summary 600
Conclusions 600
References 601
Index 603