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Analysis of the sporicidal activity of chlorine dioxide disinfectant
against Bacillus anthracis (Sterne strain)
B.A. Chatuev and J.W. Peterson*
Galveston National Laboratory, Galveston, Texas, USA
Summary
Routine surface decontamination is an essential hospital and laboratory procedure, but the list of
effective, noncorrosive disinfectants that kill spores is limited. We investigated the sporicidal
potential of an aqueous chlorine dioxide solution and encountered some unanticipated problems.
Quantitative bacteriological culture methods were used to determine the log10 reduction of Bacillus
anthracis (Sterne strain) spores following 3 min exposure to various concentrations of aqueous
chlorine dioxide solutions at room temperature in sealed tubes, as well as spraying onto plastic and
stainless steel surfaces in a biological safety cabinet. Serial 10-fold dilutions of the treated spores
were then plated on 5% sheep blood agar plates, and the survivor colonies were enumerated.
Disinfection of spore suspensions with aqueous chlorine dioxide solution in sealed microfuge tubes
was highly effective, reducing the viable spore counts by 8 log10 in only 3 min. By contrast, the
process of spraying or spreading the disinfectant onto surfaces resulted in only a 1 log10 kill because
the chlorine dioxide gas was rapidly vaporised from the solutions. Full potency of the sprayed
aqueous chlorine dioxide solution was restored by preparing the chlorine dioxide solution in 5%
bleach (0.3% sodium hypochlorite). The volatility of chlorine dioxide can cause treatment failures
that constitute a serious hazard for unsuspecting users. Supplementation of the chlorine dioxide
solution with 5% bleach (0.3% sodium hypochlorite) restored full potency and increased stability
for one week.
Keywords
Bacillus anthracis; Chlorine dioxide; Disinfectant; Sodium hypochlorite; Spores
Introduction
Many disinfectants are available for use in hospital and laboratory settings; however, their
potency against many infectious agents is more often presumed than proven. Likewise, the
effective concentrations are often based on mixing dilutions with selected bacteria with little
focus on contact time, stability, or corrosive effects on metal surfaces (e.g. biosafety cabinets,
© 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.
*Corresponding author. Address: Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston
National Laboratory, 301 University Blvd., Galveston, TX 77555-0610, USA. Tel.: +1 (409) 266-6917; fax: +1 (409) 266-6810.
johnny.peterson@utmb.edu
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Conflict of interest statement
None declared.
NIH Public Access
Author Manuscript
J Hosp Infect. Author manuscript; available in PMC 2011 February 1.
Published in final edited form as:
J Hosp Infect. 2010 February ; 74(2): 178. doi:10.1016/j.jhin.2009.09.017.
NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript
autoclaves, and other expensive equipment). Most studies do not include viruses due the
inherent technical degree of difficulty in separating the virions from the disinfectant solution
before assay in mammalian host cells, which are even more susceptible to the toxic effects of
the disinfectant than the viruses. Consequently, assumptions are often based on minimal data
with bacteria.
This report describes our search for a relatively non-corrosive disinfectant that could be used
to decontaminate stainless steel biosafety cabinet surfaces and have maximum killing capacity
against the spores of Bacillus anthracis. An avirulent B. anthracis (Sterne) strain was selected
as an assay system to evaluate the efficacy of a commercially available disinfectant, Vimoba™
(Quip Laboratories, Wilmington, DE, USA) containing chlorine dioxide as the principal active
ingredient. Chlorine dioxide gas has been used to kill B. anthracis spores, as reviewed by Spotts
Whitney et al. following the 2001 bioterrorism attack in the USA.1
Many laboratories working with B. anthracis spores use various concentrations (5-50%) of
household bleach (sodium hypochlorite); however, this is corrosive and causes pitting of
stainless steel. An alternative to bleach is to use solutions of chlorine dioxide, a gas dissolved
in water. Chlorine dioxide is approximately ten times more soluble than chlorine, extremely
volatile, and can be easily removed from dilute aqueous solutions with minimal aeration.3 It
is also a potent oxidiser, accepting a maximum of five electrons during its reduction to form
the Cl- ion.4 In this study, we sought to determine whether Vimoba would have biocidal activity
against B. anthracis spores and reduce the need for high concentrations of bleach in
decontaminating laboratory surfaces.
Methods
Bacteria
Bacillus anthracis Sterne was acquired from T.M. Koehler in the Department of Microbiology
and Molecular Genetics, University of Texas - Houston Health Science Center Medical School,
Houston, Texas.
Preparation of B. anthracis spores
Spores were prepared from B. anthracis Sterne by growing the bacteria at 37°C on blood agar
plates and scraping the growth from the plates into 2× Schaeffer’s sporulation medium (pH
7.0) [16 g/L Difco Nutrient Broth, 0.5 g/L MgSO4 ·7H2O, 2.0 g/L KCl, and 16.7 g/L 4-
morpholinepropanesulphonic acid, 0.1% glucose, 1 mM Ca(NO3)2, 0.1 mM MnSO4, and 1
μM FeSO4]. Cultures were grown at 37°C with gentle shaking (80-90 rpm) for 24 h, after which
the suspension was diluted five-fold with sterile distilled water. After 10-11 days of continuous
shaking, sporulation was confirmed at >99% via phase contrast microscopy, and the spores
were centrifuged at 587 g in a sealed-carrier centrifuge (Beckman Coulter, Inc., Fullerton, CA,
USA) at 4°C for 15 min. Spore pellets were then washed four times in sterile phosphate-
buffered saline (PBS) and purified by centrifugation through 58% Ficoll Paque (GE Healthcare,
Piscataway, NJ, USA).
Preparation of disinfectant
Vimoba tablets (1.5 g) were purchased from Quip Laboratories, Inc. (Wilmington, DE, USA)
and pulverised inside their sealed envelopes with a mortar and pestle immediately before use.
Chlorine dioxide was generated by adding indicated milligram amounts of powder from the
effervescent Vimoba tablets to water. Disinfectant solutions were prepared fresh for every
experiment, unless stated otherwise in the text. For some experiments, the Vimoba powder was
added to 2-5% household bleach diluted in water. The latter disinfectant was referred to as
Vimoba-bleach cocktail.
Chatuev and Peterson Page 2
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Disinfectant assay
All experiments were performed inside a Class II biosafety cabinet. Initial experiments to test
the potency of Vimoba in killing B. anthracis Sterne were performed by mixing 50 μL of spores
(1 × 108 cfu) with an equal volume of the disinfectant solution diluted as indicated in capped
microfuge tubes for 3 min. The spores were quickly separated from the disinfectant by diluting
and washing with 1 mL of water and centrifugation (14 000 rpm). Subsequently, the viability
of the spores was assessed by serial dilution and plating on to 5% sheep blood agar plates. In
later experiments, the spore suspension (1 × 108 cfu) was spread on to 13 mm diameter circular
areas on the sterile surface of either stainless steel or polystyrene sheets before spraying with
or pipetting 500 μL of disinfectant on to the spots. After 3 min incubation at room temperature,
1 mL of water was added and the entire suspension was aspirated from the surface and spread
on to the surface of four or five blood agar plates. The total number of surviving spores was
estimated by plate counts. In some experiments, the disinfectant alone was first sprayed on to
surfaces to evaluate the effect of chlorine dioxide vaporisation on the potency of the
disinfectant. Samples of the spore suspension (50 μL; 1 × 108 cfu) were added to the spot for
3 min, the mixture was recovered from the surface and the survivors were determined by serial
dilution and plating on 5% sheep blood agar plates.
Results
Initial tube dilution experiments were performed to assess the potency of freshly prepared
Vimoba in killing B. anthracis Sterne spores. Table I represents a typical experiment in which
50 μL aliquots of the disinfectant, prepared from 0, 2.5, 5.0, and 10.0 mg/mL Vimoba tablets,
were distributed into microfuge tubes. After adding an equal volume of B. anthracis Sterne
spores (1 × 108 cfu) and incubating at room temperature for 3 min, the microfuge tubes were
diluted, centrifuged, and washed twice with 1 mL PBS. Subsequently, the suspensions were
diluted and plated on 5% sheep blood agar.
Table I shows the disinfectant potency when mixed in a closed tube with B. anthracis Sterne
spores for 3 min. Vimoba was highly effective in killing B. anthracis Sterne spores in a very
short period (3 min), and complete inactivation of 8 log10 of spores occurred with 10 mg/mL.
The potency was proportionately less with lower concentrations. This dose-response
experiment was very reproducible and was also observed with B. anthracis Ames spores (data
not shown). Consequently, Vimoba was considered as a potential sporicidal disinfectant for
routine contact disinfection of biosafety cabinets, carts, animal cages, and other surfaces
contaminated with B. anthracis Ames spores.
As a further test, we assessed its capacity to kill B. anthracis Sterne spores on contaminated
surfaces. We spotted 1 × 108 cfu B. anthracis spores on to 13 mm diameter circular areas on
the sterilised stainless steel work surface within a biosafety cabinet. Without allowing the areas
to dry, we sprayed or pipetted various concentrations (10-100 mg/mL) of Vimoba on to the
spots, waited 3 min, and then diluted and cultured the areas by transferring the suspension to
sectors of blood agar plates with sterile plastic ‘L’ rods. Qualitative culture of the spots revealed
many survivors even at the higher concentrations of the disinfectant with little difference
whether the Vimoba was sprayed or pipetted on to the surface (data not shown).
Since the disinfectant would usually be applied by spraying onto surfaces of equipment to
decontaminate them, we developed a quantitative experimental approach for testing the effect
of spraying or pipetting the disinfectant onto a work surface. Briefly, we sprayed or pipetted
~500 μL Vimoba onto 13 mm circular areas on each surface (sterilised 304 stainless steel work
surface and sterile polystyrene Petri dish lids) and allowed them to remain as a thin film for 3
min. Fifty microlitres of 1 × 108 B. anthracis Sterne spores were added to the spots and allowed
Chatuev and Peterson Page 3
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to remain for another 3 min. After dilution, quantitative plate counts were performed using
blood agar plates incubated at 37°C.
The effect of spraying or pipetting Vimoba onto stainless steel or plastic surfaces for 3 min
prior to mixing with 1 × 108 cfu B. anthracis spores is summarised in Table II. The negative
control is shown in the top row, which shows the number of spores added (1 × 108 cfu). The
second row shows the results of a positive control (8 log10 kill) performed by mixing 20 mg/
mL Vimoba with a 50 μL spore suspension (1 × 108 cfu). The third and fourth rows show that
the Vimoba in contact with a stainless steel surface reduced its killing efficiency to <1 log10
of B. anthracis spores. By comparison, spraying or pipetting Vimoba on to a polystyrene plastic
surface resulted in a 1 log10 reduction in spore viability.
In order to compensate for the loss of potency of Vimoba when it was sprayed or pipetted onto
a surface, an experiment was performed in which various concentrations (2-5%) of household
bleach were used to prepare the Vimoba solution, instead of water. Using the disinfectant assay
spray method developed for the previous experiment (Table II), four 1 L spray bottles were
filled completely with Vimoba solution prepared in 0%, 2%, 4%, or 5% bleach. Each solution
was sprayed on to a sterile stainless steel surface and after 3 min, 50 μL aliquots were aspirated
and pipetted into microfuge tubes containing 50 μL of 1 × 108 cfu B. anthracis Sterne spores.
Table III shows that freshly prepared full bottles of Vimoba alone (5 mg/mL) reduced spore
viability by 3.1 log10, but 24 h later it retained little if any potency against B. anthracis Sterne
spores. When the Vimoba was supplemented with as little as 2% bleach, full potency was
restored enabling it to kill 8 log10 of B. anthracis Sterne spores with stability for a period of
24 h. Clearly, the optimum concentration of bleach was 5%, because it allowed the disinfectant
to be used for at least one week. However, in situations where corrosion-sensitive equipment
is being decontaminated, it might be advisable to use a low concentration of bleach (e.g. 1-2%)
and prepare it fresh daily. It should also be noted in these experiments that the Vimoba
concentration was reduced from 10 to 5 mg/mL, striving to take advantage of the enhanced
effect of Vimoba and bleach.
Considering the volatility of chlorine dioxide in solution, a final experiment was designed to
determine the effect of residual volume of Vimoba solution remaining in 1 L plastic spray
bottles on stability. Reasoning that the surface:air ratio likely is important in the rate with which
chlorine dioxide vaporises from the solution. Therefore, using the same assay spray method
used in earlier experiments, several 1 L plastic spray bottles containing various volumes
(50-1000 mL) of Vimoba (5 mg/mL) were prepared with 5% bleach. We noted that on the day
of preparation, there was no difference in potency among the various bottles, with each reducing
the viability of B. anthracis Sterne spores by 8 log10 (Table IV). It became clear that bottles
containing lower volumes of disinfectant were stable for shorter periods of time. For example,
a 1 L bottle nearly empty (50 mL) could kill only 4.3 log10 of the 1 × 108 cfu of the B.
anthracis Sterne spores by 24 h, while by the second day had lost all disinfectant capacity.
When the 1 L bottles were filled with 250-500 mL, the disinfectant retained full potency for
four days and proportionately lesser kill capacity by the end of seven days. As long as the 1 L
bottles were three-quarters full or greater, the disinfectant retained full potency for seven days,
that is, the capacity to kill 8 log10 of B. anthracis Sterne spores.
Discussion
Chlorine dioxide gas has been used previously to decontaminate indoor materials and sanitise
water supplies and equipment; however, we report for the first time that chlorine dioxide in
solution rapidly kills B. anthracis spores.1,4 The disinfectant assay parameters that we
established employed chemically resistant B. anthracis spores as a target and 3 min as the
Chatuev and Peterson Page 4
J Hosp Infect. Author manuscript; available in PMC 2011 February 1.
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maximum period of exposure. We demonstrated by tube dilution that Vimoba had a potent
biocidal effect on B. anthracis Sterne spores in a closed tube assay system, reducing spore
viability by 8 log10 to an undetectable number in 3 min contact time. This was achieved by
preparing the chlorine dioxide solution by dissolving various amounts of the crushed
effervescent tablet (2.5-10.0 mg/mL) in water. All experiments, except where indicated, were
performed with freshly prepared disinfectant solutions. A 10 mg/mL solution produced
sufficient chlorine dioxide to completely kill 1 × 108 cfu of B. anthracis Sterne spores in a 3
min period. A 50% decrease in chlorine dioxide concentration to 5 mg/mL resulted in a 4.34
log10 reduction in spore viability. Further, by reducing the amount of chlorine-dioxide-
generating powder from 10 to 2.5 mg/mL, the disinfectant potency was reduced proportionately
to 1.57 log10.
It was noted that the disinfectant exerted a potent sporicidal effect in closed tubes. Typically
such observations should be sufficient to justify using the disinfectant in a laboratory or hospital
setting; however, additional experiments were performed to mimic the ‘real world’ scenario
of how the disinfectant would be used. Thus, we contaminated a sterile stainless steel work
surface with 13 mm spots of a suspension of B. anthracis Sterne spores (1 × 108 cfu), and then
sprayed or pipetted Vimoba onto them for 3 min. Spraying or pipetting Vimoba onto the
stainless steel work surface and spreading it out into a thin film resulted in a significant
reduction in disinfectant potential, limiting the kill capacity to approximately 1 log10 in 3 min.
Having already demonstrated that chlorine dioxide had a potent sporicidal effect in closed
microfuge tubes, we determined why the disinfectant lost so much capacity to kill the spores
when it was sprayed onto contaminated surfaces. It was thought that some loss of disinfectant
potential may have been due to oxidation of iron from the stainless steel surface, since chlorine
dioxide scavenged electrons and was known to be reduced to chlorite, chlorate, and chloride
ions. In Table II, we observed that the stainless steel surface played a minimal role, compared
with plastic, in reducing the potency of the disinfectant. Additionally, it made no difference
whether the disinfectant was sprayed or pipetted onto the work surface; both resulted in the
formation of a thin film with poor sporicidal results.
The majority of the loss in potency of Vimoba during application was postulated to result from
the rapid vaporisation of chlorine dioxide gas from the disinfectant solution at the work surface.
The flow of air within the biosafety cabinet could have promoted evaporation of the chlorine
dioxide; however, spreading the disinfectant out into a thin film seemed to be important in
diminishing potency. It is only logical that the application process would increase vaporisation
of the gaseous chlorine dioxide from the solution. Rather than discarding a potentially excellent
disinfectant from further use, we sought to improve its stability and killing capacity by
supplementing Vimoba with various concentrations of household bleach to improve its
disinfectant action and increase its stability. It was observed upon assay of the Vimoba-bleach
cocktail that addition of bleach to Vimoba restored it to full potency and extended its storage
life even when sprayed on to surfaces. In doing so, we were able to reduce the Vimoba
concentration by 50% (5 mg/mL instead of 10 mg/mL) and prepare it in 2-5% bleach. While
2% bleach supplement worked well when used immediately or within one day, 5% bleach was
considered much more reliable in killing B. anthracis spores for a period of seven days. The
combination of Vimoba and bleach was synergistic in killing B. anthracis spores (Table III),
resulting in greater combined potency than the anticipated additive effect of the two
components.
A disinfectant capable of reducing B. anthracis spore viability by 8 log10 in 3 min contact time
must be considered an excellent and reliable reagent. Few investigators would argue with the
presumption that such a disinfectant would likely exert an equal or greater effect on viruses or
vegetative cells of bacteria. The latter are considerably more susceptible to other disinfectants
than are spores, which tend to be very resistant to chemicals. As an example, B. anthracis
Chatuev and Peterson Page 5
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spores are often stored in 1% phenol without loss of viability.5 Further, the criteria posed are
actually similar to those used as criteria for sterilisers based on steam, vaporised hydrogen
peroxide, or ethylene oxide. It is routine practice to expect a 6 log10 reduction in viability of
spores from B. atropheus or B. stearothermophilus as an indicator of sterility. Only one other
property that might be expected from an excellent disinfectant is for it to be totally non-
corrosive. Vimoba contains corrosion inhibitors, although chlorine dioxide gas is only weakly
corrosive.6 Corrosion testing is in progress to determine whether the Vimoba-bleach cocktail
will be corrosive for metals such as stainless steel.
The Vimoba-bleach cocktail (5 mg/mL; 5%) was shown to be stable for at least seven days
when stored virtually full in sealed plastic spray bottles. As summarised in Table IV, we
examined the disinfectant potency when bottles were only partially filled. It became apparent
that 1 L plastic spray bottles that were at least three-quarters full maintained maximum killing
potential for B. anthracis Sterne spores for seven days; however, bottles that were one-quarter
to one-half full maintained maximum potency in killing B. anthracis Sterne spores for four
days. An essentially empty bottle (50 mL) was fully potent only when made up fresh.
It was concluded that Vimoba was a potent disinfectant in closed containers; however,
substantial reduction in potency occurred when it was sprayed or pipetted on to contaminated
surfaces as a thin film. In order to compensate for the loss of chlorine dioxide, Vimoba was
prepared in 5% bleach (0.3% sodium hypochlorite) and found to be a potent formulation,
remaining stable for at least seven days. Thus, when applied as a spray to decontaminate
surfaces, Vimoba should be supplemented with dilute bleach in order to have maximum
potency.
Acknowledgments
Funding sources
This study was performed with support from contract N01-AI-30065 from the National Institute of Allergy and
Infectious Diseases. No financial support was requested or provided by the manufacturer of Vimoba™ (Quip
Laboratories, Wilmington, DE, USA).
References
1. Spotts Whitney EA, Beatty ME, Taylor TH, et al. Inactivation of Bacillus anthracis spores. Emerg
Infect Dis 2003;9:623–627. [PubMed: 12780999]
2. Davis CP, Shirtliff ME, Trieff NM, Hoskins SL, Warren MM. Quantification, qualification, and
microbial killing efficiencies of antimicrobial chlorine-based substances produced by iontophoresis.
Antimicrob Agents Chemother 1994;38:2768–2774. [PubMed: 7695260]
3. US Environmental Protection Agency. Chlorine dioxide. Alternative disinfectants and oxidants. EPA
guidance manual; Apr. 1999 p. 4-1.p. 4-28.to
4. Hubbard H, Poppendieck D, Corsi RL. Chlorine dioxide reactions with indoor materials during building
disinfection: surface uptake. Environ Sci Technol 2009;43:1329–1335. [PubMed: 19350899]
5. Ivins BE, Pitt MLM, Fellows PF, et al. Comparative efficacy of experimental anthrax vaccine
candidates against inhalation anthrax in rhesus macaques. Vaccine 1998;16:1141–1148. [PubMed:
9682372]
6. Bohner HF, Bradley RL. Corrosivity of chlorine dioxide used as sanitizer in ultrafiltration systems. J
Dairy Sci 1991;74:3348–3352.
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Chatuev and Peterson Page 7
TableI
ExposureofB.anthracisSternesporestoVimoba™inmicrofugetubes
Vimobatablet
concentration(mg/mL)
Exposuretime
(min)
No.of
survivors(cfu)
Log10
reduction
%
kill
%
survival
031.0×010800100
2.532.7×1061.5797.32.7
5.034.6×1034.3499.990.01
10.030.081000
J Hosp Infect. Author manuscript; available in PMC 2011 February 1.
NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript
Chatuev and Peterson Page 8
TableII
ExposureofB.anthracisSternesporestoVimoba™aftercontactwithstainlesssteelorplastic
Vimoba
concentration
(mg/mL)
Disinfectant
treatment
Exposure
time(min)
No.of
survivors
(cfu)
Log10
reduction
%
kill
%
survival
0None31×10800100
10Plastictube
control
3081000
10Sprayedonto
SS
32×1070.78020
10Pipettedonto
SS
32.3×1070.647723
10Sprayedonto
plastic
39×1061.05919.0
10Pipettedonto
plastic
38×1061.1928.0
SS,stainlesssteel.
J Hosp Infect. Author manuscript; available in PMC 2011 February 1.
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Chatuev and Peterson Page 9
TableIII
StabilityofVimoba™-bleachcocktailstoredinfullsealedplasticspraybottlesa
Ageof
disinfectant
Control(no
disinfectant)
BacillusanthracisSternesporesurvival(cfu)
(log10reductioninviability)
(days)(cfu)
Vimoba
(5mg/mL)
Bleach
(5%)
Vimoba
(5mg/mL+
5%bleach)
Vimoba
(5mg/mL+
4%bleach)
Vimoba
(5mg/mL+
2%bleach)
0(fresh)1×1086×104(3.2)1×103
(5)
0(8)0(8)0(8)
11×1081×107(1.0)1.2×103
(4.9)
0(8)0(8)0(8)
21×1081.5×107
(0.8)
1.4×103
(4.9)
0(8)0(8)4×101(6.4)
31×1087.3×107
(0.14)
2.0×103
(4.7)
0(8)0(8)2×103(4.7)
41×1086.3×107
(0.2)
2.1×103
(4.7)
0(8)2×102(5.7)1×105(3.0)
51×1087.2×107
(0.14)
1.0×104
(4)
0(8)5×102(5.3)6×105(2.2)
61×1081.0×108(0)3.1×104
(3.5)
0(8)1×103(5.0)1×106(2.0)
71×108--0(8)4×103(4.4)3×106(1.5)
a
DisinfectantsprayedontostainlesssteelsurfacebeforeexposureofB.anthracisSternespores.
J Hosp Infect. Author manuscript; available in PMC 2011 February 1.
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Chatuev and Peterson Page 10
TableIV
StabilityofVimoba™bleachcocktailstoredinvariousvolumesinsealed1Lplasticspraybottlesa
Storagetime
(days)
Exposuretime
(min)
Log10reductioninviability
50mLb250mLb500mLb750mLb1000mLb
0(fresh)388888
134.38888
230.058888
33-8888
43-8888
53-5.55.888
63-5.05.888
73-3.75.188
a
DisinfectantsprayedontostainlesssteelsurfacebeforeexposureofB.anthracisSternespores.
b
Disinfectantstoragevolume.
J Hosp Infect. Author manuscript; available in PMC 2011 February 1.

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Dióxido de Cloro desinfectant against bacillus anthracis

  • 1. Analysis of the sporicidal activity of chlorine dioxide disinfectant against Bacillus anthracis (Sterne strain) B.A. Chatuev and J.W. Peterson* Galveston National Laboratory, Galveston, Texas, USA Summary Routine surface decontamination is an essential hospital and laboratory procedure, but the list of effective, noncorrosive disinfectants that kill spores is limited. We investigated the sporicidal potential of an aqueous chlorine dioxide solution and encountered some unanticipated problems. Quantitative bacteriological culture methods were used to determine the log10 reduction of Bacillus anthracis (Sterne strain) spores following 3 min exposure to various concentrations of aqueous chlorine dioxide solutions at room temperature in sealed tubes, as well as spraying onto plastic and stainless steel surfaces in a biological safety cabinet. Serial 10-fold dilutions of the treated spores were then plated on 5% sheep blood agar plates, and the survivor colonies were enumerated. Disinfection of spore suspensions with aqueous chlorine dioxide solution in sealed microfuge tubes was highly effective, reducing the viable spore counts by 8 log10 in only 3 min. By contrast, the process of spraying or spreading the disinfectant onto surfaces resulted in only a 1 log10 kill because the chlorine dioxide gas was rapidly vaporised from the solutions. Full potency of the sprayed aqueous chlorine dioxide solution was restored by preparing the chlorine dioxide solution in 5% bleach (0.3% sodium hypochlorite). The volatility of chlorine dioxide can cause treatment failures that constitute a serious hazard for unsuspecting users. Supplementation of the chlorine dioxide solution with 5% bleach (0.3% sodium hypochlorite) restored full potency and increased stability for one week. Keywords Bacillus anthracis; Chlorine dioxide; Disinfectant; Sodium hypochlorite; Spores Introduction Many disinfectants are available for use in hospital and laboratory settings; however, their potency against many infectious agents is more often presumed than proven. Likewise, the effective concentrations are often based on mixing dilutions with selected bacteria with little focus on contact time, stability, or corrosive effects on metal surfaces (e.g. biosafety cabinets, © 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved. *Corresponding author. Address: Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston National Laboratory, 301 University Blvd., Galveston, TX 77555-0610, USA. Tel.: +1 (409) 266-6917; fax: +1 (409) 266-6810. johnny.peterson@utmb.edu Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conflict of interest statement None declared. NIH Public Access Author Manuscript J Hosp Infect. Author manuscript; available in PMC 2011 February 1. Published in final edited form as: J Hosp Infect. 2010 February ; 74(2): 178. doi:10.1016/j.jhin.2009.09.017. NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript
  • 2. autoclaves, and other expensive equipment). Most studies do not include viruses due the inherent technical degree of difficulty in separating the virions from the disinfectant solution before assay in mammalian host cells, which are even more susceptible to the toxic effects of the disinfectant than the viruses. Consequently, assumptions are often based on minimal data with bacteria. This report describes our search for a relatively non-corrosive disinfectant that could be used to decontaminate stainless steel biosafety cabinet surfaces and have maximum killing capacity against the spores of Bacillus anthracis. An avirulent B. anthracis (Sterne) strain was selected as an assay system to evaluate the efficacy of a commercially available disinfectant, Vimoba™ (Quip Laboratories, Wilmington, DE, USA) containing chlorine dioxide as the principal active ingredient. Chlorine dioxide gas has been used to kill B. anthracis spores, as reviewed by Spotts Whitney et al. following the 2001 bioterrorism attack in the USA.1 Many laboratories working with B. anthracis spores use various concentrations (5-50%) of household bleach (sodium hypochlorite); however, this is corrosive and causes pitting of stainless steel. An alternative to bleach is to use solutions of chlorine dioxide, a gas dissolved in water. Chlorine dioxide is approximately ten times more soluble than chlorine, extremely volatile, and can be easily removed from dilute aqueous solutions with minimal aeration.3 It is also a potent oxidiser, accepting a maximum of five electrons during its reduction to form the Cl- ion.4 In this study, we sought to determine whether Vimoba would have biocidal activity against B. anthracis spores and reduce the need for high concentrations of bleach in decontaminating laboratory surfaces. Methods Bacteria Bacillus anthracis Sterne was acquired from T.M. Koehler in the Department of Microbiology and Molecular Genetics, University of Texas - Houston Health Science Center Medical School, Houston, Texas. Preparation of B. anthracis spores Spores were prepared from B. anthracis Sterne by growing the bacteria at 37°C on blood agar plates and scraping the growth from the plates into 2× Schaeffer’s sporulation medium (pH 7.0) [16 g/L Difco Nutrient Broth, 0.5 g/L MgSO4 ·7H2O, 2.0 g/L KCl, and 16.7 g/L 4- morpholinepropanesulphonic acid, 0.1% glucose, 1 mM Ca(NO3)2, 0.1 mM MnSO4, and 1 μM FeSO4]. Cultures were grown at 37°C with gentle shaking (80-90 rpm) for 24 h, after which the suspension was diluted five-fold with sterile distilled water. After 10-11 days of continuous shaking, sporulation was confirmed at >99% via phase contrast microscopy, and the spores were centrifuged at 587 g in a sealed-carrier centrifuge (Beckman Coulter, Inc., Fullerton, CA, USA) at 4°C for 15 min. Spore pellets were then washed four times in sterile phosphate- buffered saline (PBS) and purified by centrifugation through 58% Ficoll Paque (GE Healthcare, Piscataway, NJ, USA). Preparation of disinfectant Vimoba tablets (1.5 g) were purchased from Quip Laboratories, Inc. (Wilmington, DE, USA) and pulverised inside their sealed envelopes with a mortar and pestle immediately before use. Chlorine dioxide was generated by adding indicated milligram amounts of powder from the effervescent Vimoba tablets to water. Disinfectant solutions were prepared fresh for every experiment, unless stated otherwise in the text. For some experiments, the Vimoba powder was added to 2-5% household bleach diluted in water. The latter disinfectant was referred to as Vimoba-bleach cocktail. Chatuev and Peterson Page 2 J Hosp Infect. Author manuscript; available in PMC 2011 February 1. NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript
  • 3. Disinfectant assay All experiments were performed inside a Class II biosafety cabinet. Initial experiments to test the potency of Vimoba in killing B. anthracis Sterne were performed by mixing 50 μL of spores (1 × 108 cfu) with an equal volume of the disinfectant solution diluted as indicated in capped microfuge tubes for 3 min. The spores were quickly separated from the disinfectant by diluting and washing with 1 mL of water and centrifugation (14 000 rpm). Subsequently, the viability of the spores was assessed by serial dilution and plating on to 5% sheep blood agar plates. In later experiments, the spore suspension (1 × 108 cfu) was spread on to 13 mm diameter circular areas on the sterile surface of either stainless steel or polystyrene sheets before spraying with or pipetting 500 μL of disinfectant on to the spots. After 3 min incubation at room temperature, 1 mL of water was added and the entire suspension was aspirated from the surface and spread on to the surface of four or five blood agar plates. The total number of surviving spores was estimated by plate counts. In some experiments, the disinfectant alone was first sprayed on to surfaces to evaluate the effect of chlorine dioxide vaporisation on the potency of the disinfectant. Samples of the spore suspension (50 μL; 1 × 108 cfu) were added to the spot for 3 min, the mixture was recovered from the surface and the survivors were determined by serial dilution and plating on 5% sheep blood agar plates. Results Initial tube dilution experiments were performed to assess the potency of freshly prepared Vimoba in killing B. anthracis Sterne spores. Table I represents a typical experiment in which 50 μL aliquots of the disinfectant, prepared from 0, 2.5, 5.0, and 10.0 mg/mL Vimoba tablets, were distributed into microfuge tubes. After adding an equal volume of B. anthracis Sterne spores (1 × 108 cfu) and incubating at room temperature for 3 min, the microfuge tubes were diluted, centrifuged, and washed twice with 1 mL PBS. Subsequently, the suspensions were diluted and plated on 5% sheep blood agar. Table I shows the disinfectant potency when mixed in a closed tube with B. anthracis Sterne spores for 3 min. Vimoba was highly effective in killing B. anthracis Sterne spores in a very short period (3 min), and complete inactivation of 8 log10 of spores occurred with 10 mg/mL. The potency was proportionately less with lower concentrations. This dose-response experiment was very reproducible and was also observed with B. anthracis Ames spores (data not shown). Consequently, Vimoba was considered as a potential sporicidal disinfectant for routine contact disinfection of biosafety cabinets, carts, animal cages, and other surfaces contaminated with B. anthracis Ames spores. As a further test, we assessed its capacity to kill B. anthracis Sterne spores on contaminated surfaces. We spotted 1 × 108 cfu B. anthracis spores on to 13 mm diameter circular areas on the sterilised stainless steel work surface within a biosafety cabinet. Without allowing the areas to dry, we sprayed or pipetted various concentrations (10-100 mg/mL) of Vimoba on to the spots, waited 3 min, and then diluted and cultured the areas by transferring the suspension to sectors of blood agar plates with sterile plastic ‘L’ rods. Qualitative culture of the spots revealed many survivors even at the higher concentrations of the disinfectant with little difference whether the Vimoba was sprayed or pipetted on to the surface (data not shown). Since the disinfectant would usually be applied by spraying onto surfaces of equipment to decontaminate them, we developed a quantitative experimental approach for testing the effect of spraying or pipetting the disinfectant onto a work surface. Briefly, we sprayed or pipetted ~500 μL Vimoba onto 13 mm circular areas on each surface (sterilised 304 stainless steel work surface and sterile polystyrene Petri dish lids) and allowed them to remain as a thin film for 3 min. Fifty microlitres of 1 × 108 B. anthracis Sterne spores were added to the spots and allowed Chatuev and Peterson Page 3 J Hosp Infect. Author manuscript; available in PMC 2011 February 1. NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript
  • 4. to remain for another 3 min. After dilution, quantitative plate counts were performed using blood agar plates incubated at 37°C. The effect of spraying or pipetting Vimoba onto stainless steel or plastic surfaces for 3 min prior to mixing with 1 × 108 cfu B. anthracis spores is summarised in Table II. The negative control is shown in the top row, which shows the number of spores added (1 × 108 cfu). The second row shows the results of a positive control (8 log10 kill) performed by mixing 20 mg/ mL Vimoba with a 50 μL spore suspension (1 × 108 cfu). The third and fourth rows show that the Vimoba in contact with a stainless steel surface reduced its killing efficiency to <1 log10 of B. anthracis spores. By comparison, spraying or pipetting Vimoba on to a polystyrene plastic surface resulted in a 1 log10 reduction in spore viability. In order to compensate for the loss of potency of Vimoba when it was sprayed or pipetted onto a surface, an experiment was performed in which various concentrations (2-5%) of household bleach were used to prepare the Vimoba solution, instead of water. Using the disinfectant assay spray method developed for the previous experiment (Table II), four 1 L spray bottles were filled completely with Vimoba solution prepared in 0%, 2%, 4%, or 5% bleach. Each solution was sprayed on to a sterile stainless steel surface and after 3 min, 50 μL aliquots were aspirated and pipetted into microfuge tubes containing 50 μL of 1 × 108 cfu B. anthracis Sterne spores. Table III shows that freshly prepared full bottles of Vimoba alone (5 mg/mL) reduced spore viability by 3.1 log10, but 24 h later it retained little if any potency against B. anthracis Sterne spores. When the Vimoba was supplemented with as little as 2% bleach, full potency was restored enabling it to kill 8 log10 of B. anthracis Sterne spores with stability for a period of 24 h. Clearly, the optimum concentration of bleach was 5%, because it allowed the disinfectant to be used for at least one week. However, in situations where corrosion-sensitive equipment is being decontaminated, it might be advisable to use a low concentration of bleach (e.g. 1-2%) and prepare it fresh daily. It should also be noted in these experiments that the Vimoba concentration was reduced from 10 to 5 mg/mL, striving to take advantage of the enhanced effect of Vimoba and bleach. Considering the volatility of chlorine dioxide in solution, a final experiment was designed to determine the effect of residual volume of Vimoba solution remaining in 1 L plastic spray bottles on stability. Reasoning that the surface:air ratio likely is important in the rate with which chlorine dioxide vaporises from the solution. Therefore, using the same assay spray method used in earlier experiments, several 1 L plastic spray bottles containing various volumes (50-1000 mL) of Vimoba (5 mg/mL) were prepared with 5% bleach. We noted that on the day of preparation, there was no difference in potency among the various bottles, with each reducing the viability of B. anthracis Sterne spores by 8 log10 (Table IV). It became clear that bottles containing lower volumes of disinfectant were stable for shorter periods of time. For example, a 1 L bottle nearly empty (50 mL) could kill only 4.3 log10 of the 1 × 108 cfu of the B. anthracis Sterne spores by 24 h, while by the second day had lost all disinfectant capacity. When the 1 L bottles were filled with 250-500 mL, the disinfectant retained full potency for four days and proportionately lesser kill capacity by the end of seven days. As long as the 1 L bottles were three-quarters full or greater, the disinfectant retained full potency for seven days, that is, the capacity to kill 8 log10 of B. anthracis Sterne spores. Discussion Chlorine dioxide gas has been used previously to decontaminate indoor materials and sanitise water supplies and equipment; however, we report for the first time that chlorine dioxide in solution rapidly kills B. anthracis spores.1,4 The disinfectant assay parameters that we established employed chemically resistant B. anthracis spores as a target and 3 min as the Chatuev and Peterson Page 4 J Hosp Infect. Author manuscript; available in PMC 2011 February 1. NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript
  • 5. maximum period of exposure. We demonstrated by tube dilution that Vimoba had a potent biocidal effect on B. anthracis Sterne spores in a closed tube assay system, reducing spore viability by 8 log10 to an undetectable number in 3 min contact time. This was achieved by preparing the chlorine dioxide solution by dissolving various amounts of the crushed effervescent tablet (2.5-10.0 mg/mL) in water. All experiments, except where indicated, were performed with freshly prepared disinfectant solutions. A 10 mg/mL solution produced sufficient chlorine dioxide to completely kill 1 × 108 cfu of B. anthracis Sterne spores in a 3 min period. A 50% decrease in chlorine dioxide concentration to 5 mg/mL resulted in a 4.34 log10 reduction in spore viability. Further, by reducing the amount of chlorine-dioxide- generating powder from 10 to 2.5 mg/mL, the disinfectant potency was reduced proportionately to 1.57 log10. It was noted that the disinfectant exerted a potent sporicidal effect in closed tubes. Typically such observations should be sufficient to justify using the disinfectant in a laboratory or hospital setting; however, additional experiments were performed to mimic the ‘real world’ scenario of how the disinfectant would be used. Thus, we contaminated a sterile stainless steel work surface with 13 mm spots of a suspension of B. anthracis Sterne spores (1 × 108 cfu), and then sprayed or pipetted Vimoba onto them for 3 min. Spraying or pipetting Vimoba onto the stainless steel work surface and spreading it out into a thin film resulted in a significant reduction in disinfectant potential, limiting the kill capacity to approximately 1 log10 in 3 min. Having already demonstrated that chlorine dioxide had a potent sporicidal effect in closed microfuge tubes, we determined why the disinfectant lost so much capacity to kill the spores when it was sprayed onto contaminated surfaces. It was thought that some loss of disinfectant potential may have been due to oxidation of iron from the stainless steel surface, since chlorine dioxide scavenged electrons and was known to be reduced to chlorite, chlorate, and chloride ions. In Table II, we observed that the stainless steel surface played a minimal role, compared with plastic, in reducing the potency of the disinfectant. Additionally, it made no difference whether the disinfectant was sprayed or pipetted onto the work surface; both resulted in the formation of a thin film with poor sporicidal results. The majority of the loss in potency of Vimoba during application was postulated to result from the rapid vaporisation of chlorine dioxide gas from the disinfectant solution at the work surface. The flow of air within the biosafety cabinet could have promoted evaporation of the chlorine dioxide; however, spreading the disinfectant out into a thin film seemed to be important in diminishing potency. It is only logical that the application process would increase vaporisation of the gaseous chlorine dioxide from the solution. Rather than discarding a potentially excellent disinfectant from further use, we sought to improve its stability and killing capacity by supplementing Vimoba with various concentrations of household bleach to improve its disinfectant action and increase its stability. It was observed upon assay of the Vimoba-bleach cocktail that addition of bleach to Vimoba restored it to full potency and extended its storage life even when sprayed on to surfaces. In doing so, we were able to reduce the Vimoba concentration by 50% (5 mg/mL instead of 10 mg/mL) and prepare it in 2-5% bleach. While 2% bleach supplement worked well when used immediately or within one day, 5% bleach was considered much more reliable in killing B. anthracis spores for a period of seven days. The combination of Vimoba and bleach was synergistic in killing B. anthracis spores (Table III), resulting in greater combined potency than the anticipated additive effect of the two components. A disinfectant capable of reducing B. anthracis spore viability by 8 log10 in 3 min contact time must be considered an excellent and reliable reagent. Few investigators would argue with the presumption that such a disinfectant would likely exert an equal or greater effect on viruses or vegetative cells of bacteria. The latter are considerably more susceptible to other disinfectants than are spores, which tend to be very resistant to chemicals. As an example, B. anthracis Chatuev and Peterson Page 5 J Hosp Infect. Author manuscript; available in PMC 2011 February 1. NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript
  • 6. spores are often stored in 1% phenol without loss of viability.5 Further, the criteria posed are actually similar to those used as criteria for sterilisers based on steam, vaporised hydrogen peroxide, or ethylene oxide. It is routine practice to expect a 6 log10 reduction in viability of spores from B. atropheus or B. stearothermophilus as an indicator of sterility. Only one other property that might be expected from an excellent disinfectant is for it to be totally non- corrosive. Vimoba contains corrosion inhibitors, although chlorine dioxide gas is only weakly corrosive.6 Corrosion testing is in progress to determine whether the Vimoba-bleach cocktail will be corrosive for metals such as stainless steel. The Vimoba-bleach cocktail (5 mg/mL; 5%) was shown to be stable for at least seven days when stored virtually full in sealed plastic spray bottles. As summarised in Table IV, we examined the disinfectant potency when bottles were only partially filled. It became apparent that 1 L plastic spray bottles that were at least three-quarters full maintained maximum killing potential for B. anthracis Sterne spores for seven days; however, bottles that were one-quarter to one-half full maintained maximum potency in killing B. anthracis Sterne spores for four days. An essentially empty bottle (50 mL) was fully potent only when made up fresh. It was concluded that Vimoba was a potent disinfectant in closed containers; however, substantial reduction in potency occurred when it was sprayed or pipetted on to contaminated surfaces as a thin film. In order to compensate for the loss of chlorine dioxide, Vimoba was prepared in 5% bleach (0.3% sodium hypochlorite) and found to be a potent formulation, remaining stable for at least seven days. Thus, when applied as a spray to decontaminate surfaces, Vimoba should be supplemented with dilute bleach in order to have maximum potency. Acknowledgments Funding sources This study was performed with support from contract N01-AI-30065 from the National Institute of Allergy and Infectious Diseases. No financial support was requested or provided by the manufacturer of Vimoba™ (Quip Laboratories, Wilmington, DE, USA). References 1. Spotts Whitney EA, Beatty ME, Taylor TH, et al. Inactivation of Bacillus anthracis spores. Emerg Infect Dis 2003;9:623–627. [PubMed: 12780999] 2. Davis CP, Shirtliff ME, Trieff NM, Hoskins SL, Warren MM. Quantification, qualification, and microbial killing efficiencies of antimicrobial chlorine-based substances produced by iontophoresis. Antimicrob Agents Chemother 1994;38:2768–2774. [PubMed: 7695260] 3. US Environmental Protection Agency. Chlorine dioxide. Alternative disinfectants and oxidants. EPA guidance manual; Apr. 1999 p. 4-1.p. 4-28.to 4. Hubbard H, Poppendieck D, Corsi RL. Chlorine dioxide reactions with indoor materials during building disinfection: surface uptake. Environ Sci Technol 2009;43:1329–1335. [PubMed: 19350899] 5. Ivins BE, Pitt MLM, Fellows PF, et al. Comparative efficacy of experimental anthrax vaccine candidates against inhalation anthrax in rhesus macaques. Vaccine 1998;16:1141–1148. [PubMed: 9682372] 6. Bohner HF, Bradley RL. Corrosivity of chlorine dioxide used as sanitizer in ultrafiltration systems. J Dairy Sci 1991;74:3348–3352. Chatuev and Peterson Page 6 J Hosp Infect. Author manuscript; available in PMC 2011 February 1. NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript
  • 7. NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript Chatuev and Peterson Page 7 TableI ExposureofB.anthracisSternesporestoVimoba™inmicrofugetubes Vimobatablet concentration(mg/mL) Exposuretime (min) No.of survivors(cfu) Log10 reduction % kill % survival 031.0×010800100 2.532.7×1061.5797.32.7 5.034.6×1034.3499.990.01 10.030.081000 J Hosp Infect. Author manuscript; available in PMC 2011 February 1.
  • 8. NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript Chatuev and Peterson Page 8 TableII ExposureofB.anthracisSternesporestoVimoba™aftercontactwithstainlesssteelorplastic Vimoba concentration (mg/mL) Disinfectant treatment Exposure time(min) No.of survivors (cfu) Log10 reduction % kill % survival 0None31×10800100 10Plastictube control 3081000 10Sprayedonto SS 32×1070.78020 10Pipettedonto SS 32.3×1070.647723 10Sprayedonto plastic 39×1061.05919.0 10Pipettedonto plastic 38×1061.1928.0 SS,stainlesssteel. J Hosp Infect. Author manuscript; available in PMC 2011 February 1.
  • 9. NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript Chatuev and Peterson Page 9 TableIII StabilityofVimoba™-bleachcocktailstoredinfullsealedplasticspraybottlesa Ageof disinfectant Control(no disinfectant) BacillusanthracisSternesporesurvival(cfu) (log10reductioninviability) (days)(cfu) Vimoba (5mg/mL) Bleach (5%) Vimoba (5mg/mL+ 5%bleach) Vimoba (5mg/mL+ 4%bleach) Vimoba (5mg/mL+ 2%bleach) 0(fresh)1×1086×104(3.2)1×103 (5) 0(8)0(8)0(8) 11×1081×107(1.0)1.2×103 (4.9) 0(8)0(8)0(8) 21×1081.5×107 (0.8) 1.4×103 (4.9) 0(8)0(8)4×101(6.4) 31×1087.3×107 (0.14) 2.0×103 (4.7) 0(8)0(8)2×103(4.7) 41×1086.3×107 (0.2) 2.1×103 (4.7) 0(8)2×102(5.7)1×105(3.0) 51×1087.2×107 (0.14) 1.0×104 (4) 0(8)5×102(5.3)6×105(2.2) 61×1081.0×108(0)3.1×104 (3.5) 0(8)1×103(5.0)1×106(2.0) 71×108--0(8)4×103(4.4)3×106(1.5) a DisinfectantsprayedontostainlesssteelsurfacebeforeexposureofB.anthracisSternespores. J Hosp Infect. Author manuscript; available in PMC 2011 February 1.
  • 10. NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptNIH-PAAuthorManuscript Chatuev and Peterson Page 10 TableIV StabilityofVimoba™bleachcocktailstoredinvariousvolumesinsealed1Lplasticspraybottlesa Storagetime (days) Exposuretime (min) Log10reductioninviability 50mLb250mLb500mLb750mLb1000mLb 0(fresh)388888 134.38888 230.058888 33-8888 43-8888 53-5.55.888 63-5.05.888 73-3.75.188 a DisinfectantsprayedontostainlesssteelsurfacebeforeexposureofB.anthracisSternespores. b Disinfectantstoragevolume. J Hosp Infect. Author manuscript; available in PMC 2011 February 1.