Tonometers and infectious risk: myth or reality? Efficacy of different disinfection regimens on tonometer tips.
OBJECTIVE
To evaluate the adequacy of common disinfection regimens for disposable tonometer tips and assess if disinfection of reusable prisms or the use of disposable tips is preferable.


METHODS
We used disposable tonometer tips, using the same material and tip diameter of standard Goldmann tonometer prism. Strains of Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus subtilisand Candida albicanswere tested according to the European standard guidelines for disinfectants test. Antimicrobial effectiveness of the following disinfection practices has been assessed: dry wipe, Minuten wipes (Alpro), soaking in 3% hydrogen peroxide, 0.5% benzalkonium chloride, and 0.5% Pantasept for 1, 5, and 15 min. All tests have been performed three times and all conditions tested in duplicate.


RESULTS
Dry wiping and 1 min soak in 3% hydrogen peroxide were ineffective on all microrganisms. Minuten wipes, 1 min soak in 0.5% benzalkonium chloride or 3% hydrogen peroxide were ineffective on B. subtilis. 0.5% Pantasept soak was effective in 1 min for all microrganisms tested, whereas 3% hydrogen peroxide and 0.5% benzalkonium chloride soaks were effective when performed for at least 5 min. B. subtiliswas the most resistant organism to disinfectant regimes at 1 min time.


CONCLUSIONS
Results of our study demonstrate a relative disinfection efficacy for the different evaluated regimens, provided that correct exposure times are adopted for the chosen disinfectants, a condition difficult to ensure in a busy clinic setting. We conclude that disposable prism tonometry provides a safe alternative to Goldmann tonometry.
Cillino
S
S
Dipartimento di Neurologia, Oftalmologia, Otorinolaringoiatria e Psichiatria, Sezione di Oftalmologia, Università degli Studi di Palermo, Palermo, Italy. cillino@iol.it
Casuccio
A
A
Giammanco
G M
GM
Mammina
C
C
Morreale
D
D
Di Pace
F
F
Lodato
G
G
D000891:Anti-Infective Agents, Local / Q000494:pharmacology; D016863:Bacillaceae Infections / Q000635:transmission; D001412:Bacillus subtilis / Q000187:drug effects; D001548:Benzalkonium Compounds / Q000494:pharmacology; D002177:Candidiasis / Q000635:transmission; D003141:Communicable Diseases / Q000635:transmission*; D004202:Disinfectants / Q000494:pharmacology; D004203:Disinfection / Q000379:methods*; D004209:Disposable Equipment; D006801:Humans; D006861:Hydrogen Peroxide / Q000494:pharmacology; D009930:Organic Chemicals / Q000494:pharmacology; D011552:Pseudomonas Infections / Q000635:transmission; D018570:Risk Assessment / Q000379:methods; D013203:Staphylococcal Infections / Q000635:transmission; D014065:Tonometry, Ocular / Q000009:adverse effects / Q000295:instrumentation*
D000891:Anti-Infective Agents, Local; D001548:Benzalkonium Compounds; D004202:Disinfectants; D009930:Organic Chemicals; C050189:Pantasept; D006861:Hydrogen Peroxide