Modifications to the AOAC use-dilution test for quaternary ammonium compound-based disinfectants that significantly improve method reliability

The AOAC use-dilution test (UDT) for bactericidal disinfectant efficacy (Method 964.02) has often been criticized for its extreme variability in test results, particularly for quaternary ammonium compound (QAC)-based disinfectants against Pseudomonas aeruginosa. While efforts are under way to develop a new and better test method for hospital disinfectant products that is globally acceptable, U.S. manufacturers and formulators of QAC products must continue in the interim to measure their product performance against the current UDT method. Therefore, continued variability in the UDT places an unnecessary and unfair burden on U.S. QAC product manufacturers to ensure that their products perform against an, at best, unreliable test method. This article reports on evaluations that were conducted to attempt to identify key sources of UDT method variability and to find ways to mitigate their impact on test outcomes for the method. The results of testing across 4 laboratories, involving over 6015 carriers, determined that operator error was a key factor in test variability. This variability was found to be significantly minimized by the inclusion of a simple culture dilution step. The findings from this study suggest possible refinements to the current AOAC UDT method that would serve to improve the overall ruggedness and reliability of the method and to optimize recovery of cells from the carrier surface, thereby further improving the accuracy and reproducibility of counts and test outcomes until such time as a replacement method is implemented.