DISINFECTION 229
the hypothesis that disinfectants in use shall be at least as
efficient as 5% phenol, and that a dilution of twenty times
the phenol coefficient should achieve this. Accordingly, this
dilution is tested against standardized cultures in order to
confirm this, or alternatively, in order to determine a correc-
tion factor.
Whereas the extinction methods discussed above evaluate
the extinction concentration corresponding to predetermined
exposure times, Berry and Bean (1954) devised a test for
evaluating extinction times for chosen disinfectant concentra-
tions. While the test is only applicable to phenolic and other
easily inactivated disinfectants, it has been claimed to be at
least as reproducible as other methods in common use (Cook
and Wills, 1954). The method of assessing the end-point of
the reaction has been further improved by Mathei (1949).
Methods other than extinction tests for standardizing dis-
infectants include various methods based on assessment of
cessation of vital enzyme activities. The enzymes involved
have generally been certain oxidases or dehydrogenases
(Sykes, 1939; Knox et al. , 1949). In a less specific manner,
inhibition of respiration has been used as a method of assess-
ment (Roberts and Rahn, 1946). The controversy surround-
ing these methods centers around the problem of correlating
enzyme activity with viability.
Other methods which have been proposed include mea-
surement of post-incubation opacity corresponding to stan-
dard survivor levels (Needham, 1947), and also measurement
of cell volume increase following post-exposure incubation
(Mandels and Darby, 1953).
The range of tests discussed above is by no means
exhaustive, and only covers general purpose tests appli-
cable to water-misible disinfectants. Any number of alter-
native tests could be devised by appropriate selection and
standardization of the various parameters. In addition, there
are numerous tests which can be, and have been, devised in
order to standardize disinfectants intended for specific uses
such as sporicidal or tuberculocidal duties (AOAC 1970).
Methods of standardizing disinfectants other than those
to which the above discussion applies are usually designed
more closely around the particular use envisaged. Thus, a
considerable element of actual, or simulated, in-use testing
is usually involved. For convenience, they are best discussed
in the following section.
A recent test is the Kelsey–Sykes test (Kelsey and Maurer,
1974), which is a form of capacity test. In this, incremental
additions of test organisms are made to appropriate dilutions
of test disinfectant and aliquots are removed for detecting
survival immediately prior to the next addition of organisms.
On the basis of this method, use-dilutions of the test dis-
infectant (which need not necessarily be a phenolic) under
clean and dirty conditions can be recommended to hospitals,
which should then check them during in-use tests (see also
Coates, 1977; Cowen, 1978).
In-Use Tests
The previous two sections have dealt with testing methods
applied in the laboratory, which yield information primarily
of value to the disinfectant manufacturer. The “consumer,”
however, is almost solely concerned with the performance
of disinfectant materials under the conditions of use which
are associated with the application envisaged. To this end,
he is more interested in testing methods which resemble, as
closely as possible, these practical conditions. However, the
foregoing remarks should not be taken to imply that labo-
ratory standardization methods are completely arbitrary. In
view of the greater difficulty experienced in killing organ-
isms which are present as dried surface films, as opposed to
those in fluid suspension, many standardization tests have
employed films on various surfaces as their inocula. Surfaces
used have included silk thread (Koch, 1881), garnets (Kronig
and Paul, 1887), glass cover-slips (Jensen and Jensen, 1933),
glass cylinders (Mallmann and Hanes, 1945), glass slides
(Johns, 1946), stainless steel cylinders (AOAC Use-Dilution
Confirmatory Test, 1960), and glass tablet tubes (Hare, Raik
and Gash, 1963). It should be noted that while these sur-
faces represent a step toward the practical situation, they
nevertheless comprise a collection of laboratory “artifacts”
when compared with real situations. A nearer approach was
achieved by use of surfaces such as rubber strips (Goetchins
and Botwright, 1950) and glazed, waxed, and rubber tiles
(Rogers, Mather and Kaplan, 1961).
Where the physical size of articles required to be disin-
fected is fairly small, it is quite feasible to carry out in-use
testing in the laboratory. Hence metal trays were used by
Neave and Hoy (1947), 10 gallon milk churns by Hoy and
Clegg (1953), and small drinking glasses by Gilcreas and
O’Brien (1941). Similarly, scalpels, syringes and similar
small items may conveniently be subjected to in-use testing
in the laboratory. Where the physical size of the system is
somewhat greater, then the laboratory must be forsaken in
order to carry out on-site testing. Typical examples of such
situations include hospital walls and floors, and industrial or
dairy processing machinery. The outstanding value of in-use
testing arises from the fact that results obtained are directly
applicable to the system without the need for interpreta-
tion and extrapolation, and that practical difficulties such as
short contact times or inaccessibility of certain areas can be
accounted for.
The choice of test organisms usually reflects either of
two main approaches. The simplest approach is to inoculate
the system artificially with organisms considered to be of
practical significance in the particular application. This sig-
nificance may be due to the resistance to disinfection of the
organism, or alternatively, to its practical effect on the system
should it survive the disinfection process. In order to simu-
late the practical system, the organisms may be suspended
in appropriate materials before inoculation. An example
would be the use of milk as a suspending fluid in tests on
dairy disinfection. A slight variation on this approach is to
inoculate with indeterminate mixtures of likely organisms
obtained from natural sources, such as low quality, raw milk.
The second approach involves the use of the normal, pre-
existing flora of the system which has arisen during normal
use. Investigations of this flora before and after the disin-
fection process would provide direct evidence as to whether
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