---
title: I'll take Kill Claims for $200
description: I'll take Kill Claims for $200
---

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## I'll take Kill Claims for $200

<http://static1.squarespace.com/static/595689fc9de4bbc892200518/t/59568acb5fd63b5f292877c6/1498845519435//img.png.com/static/595689fc9de4bbc892200518/t/59568acb5fd63b5f292877c6/1498843851079/1000w/>

From its inception, the intent of the Talk Clean to Me  
 blog has been to educate about the choice and use of disinfectants.  The content of our blogs are based on fact  
 drawing from a myriad of published sources and smattered with analogies or  
 stories of direct experiences and we hope a bit of humour. If we go back to the original blogs from the  
 Spring and Summer of 2011, we started off weaving a story of the desired traits  
 of a disinfectant targeting key areas to consider when choosing a product.

Understanding that some may think the blog a bit self  
 serving  as both Lee and I work for a  
 disinfectant manufacturer, it's rewarding to read Drs Rutala and Weber's  
 article published in ICHE this July titled "[Selection of the Ideal Disinfectant](http://www.ncbi.nlm.nih.gov/pubmed/24915214)"  
 as it highlights many of the same points we have been talking about since we  
 launched Talk Clean to Me.

Over the next several weeks, I will try to summarize the  
 article and invite everyone to read it as it is truly a landmark piece that  
 embodies the attributes that anyone who is choosing a disinfectant should  
 consider.  As hinted in my title, the  
 focus of this blog will be on the first section "Kill Claims For the Most  
 Prevalent Healthcare Pathogens" which closely resembles the idea behind  
 our "[Strength in Not Always Found in Numbers](http://talkcleantome.blogspot.ca/2011/08/strength-is-not-always-found-in-numbers.html)" blog.

As Rutala and Weber highlight, the disinfectant product  
 selected should be one that is effective against the pathogens that cause HAIs,  
 and vegetative bacteria such as *S. aureus*, *Enterococcus*, *E. coli*, *Klebsiella*,  
*Pseudomonas *and *Enterobacter *have been found to cause almost 80% of all  
 HAIs.  I hope you'll take a look at Table  
 3 from the article as it summarizes the most prevalent pathogens that cause  
 HAIs very nicely. Basically, the marketing ploy by some disinfectant manufacturers  
 focuses on who has the greatest NUMBER of claims, not who has the most  
 APPLICABLE claims....inferring that they are the most effective product is a  
 carefully crafted game of smoke and mirrors.

The next important area to understand is with respect to  
 antibiotic resistance.  Without a  
 doubt,  antibiotic resistance is a  
 concern from a treatment perspective.  As  
 we touched upon in our "[Doors, Keys and Sledgehammers](http://talkcleantome.blogspot.ca/2011/09/doors-keys-and-sledgehammers.html) " blog and  
 confirmed by Rutala and Weber, disinfectant testing for antibiotic-resistant  
 organisms is not necessary, as antibiotic resistant pathogens are not more  
 resistant to disinfectants than antibiotic sensitive pathogens.  There are however, some pathogens that are  
 intrinsically more resistant to disinfectants than others which leads me to the  
 third, and I think most important discussion of this section of the article -  
 the concept of the order of susceptibility of microorganisms to disinfectants.

When considering disinfectants, we also need to consider  
 the hierarchical scale of susceptibility.   
 The original hierarchy was developed by [Spaulding](http://webbertraining.com/files/library/docs/323.pdf) in 1957 and is still  
 widely cited in guidelines and policies, however, our understanding of  
 pathogens and their susceptibility to disinfectants has dramatically  
 improved.  Rutala and Weber have proposed  
 a new hierarchy which I completely concur with based on my experience of  
 conducting efficacy testing on a number of different disinfectant actives. Regardless of the hierarchical scale you  
 choose to follow it is imperative to understand that this is only a guide and  
 that the efficacy of disinfectants to pathogens will vary depending on the  
 disinfectant active as well as how the product is formulated (e.g. 2  
 Quat-Alcohol products with different formulations can have widely varied kill  
 claims and contact times).  As outlined  
 in the article, a non-sporicidal disinfectant with a TB claim which  
 traditionally was considered the most resistant vegetative bacteria does not  
 mean that the product will have the ability to kill small, non-enveloped  
 viruses such as Norovirus or Poliovirus.

Another area where the hierarchy should be considered is  
 with emerging pathogens such as [MERS-CoV](http://talkcleantome.blogspot.ca/2014/05/help-its-here-i-need-disinfectant.html) or[ Enterovirus D68](http://talkcleantome.blogspot.ca/2014/09/kids-colds-and-enterovirus-d68.html). Emerging pathogens generally mean that there  
 is not an approved test methodology for a disinfectant to obtain efficacy  
 claims by the EPA. In cases such as this  
 where the microbiologic class has been established, than an already approved  
 surrogate could be used.  For example,  
 claims against Human Coronavirus would be appropriate to ensure efficacy  
 against MERS-CoV or as in our "[H1N1, H5N1, H10N8, H7N9 - What Influenza strain will we see next? ](http://talkcleantome.blogspot.ca/2014/02/h1n1-h5n1-h10n8-h7n9-h5n8-what.html)" blog, proven efficacy against 1 strain of  
 Influenza A would be sufficient to assume efficacy against emerging strains of  
 influenza.

Lastly, for viruses where the microbiological class has  
 not yet been determined (e.g. when SARS first hit or [Ebola](https://info.virox.com/ebola-resources) where there is no  
 test method to determine efficacy) then we would look for efficacy against the  
 heartier non-enveloped viruses.   
 Typically in these situations efficacy against Poliovirus, Adenovirus,  
 Rhinovirus or Canine Parvovirus would be considered as this viruses are known  
 to be more resistant to disinfectants than others.

As Drs. Rutala and Weber so eloquently stated "*using  
 this accumulated knowledge of microbiological susceptibility should discourage  
 unnecessary testing, listing irrelevant organisms on labels and avoid  
 "bug-of-the-month" testing"*.

Stay tuned for next week's blog which will focus on the  
 second section "Fast Kill Times and Acceptable Wet-Contact Time To Ensure  
 Proper Disinfection of Non-Critical Surfaces and Patient Care Equipment".

*Bugging Off!*

Nicole

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