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Improved surveillance of surgical instruments reprocessing following the variant Creutzfeldt-Jakob disease crisis in England: findings from a three-year survey.

التفاصيل البيبلوغرافية
العنوان: Improved surveillance of surgical instruments reprocessing following the variant Creutzfeldt-Jakob disease crisis in England: findings from a three-year survey.
المؤلفون: Hervé RC; Environmental Healthcare Unit, School of Biological Sciences, University of Southampton, Southampton, UK. Electronic address: R.Herve@soton.ac.uk., Hedges J; Sterile Services Department, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK., Keevil CW; Environmental Healthcare Unit, School of Biological Sciences, University of Southampton, Southampton, UK.
المصدر: The Journal of hospital infection [J Hosp Infect] 2021 Apr; Vol. 110, pp. 15-25. Date of Electronic Publication: 2021 Jan 19.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: W.B. Saunders For The Hospital Infection Society Country of Publication: England NLM ID: 8007166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2939 (Electronic) Linking ISSN: 01956701 NLM ISO Abbreviation: J Hosp Infect Subsets: MEDLINE
أسماء مطبوعة: Publication: London : W.B. Saunders For The Hospital Infection Society
Original Publication: New York, Academic Press.
مواضيع طبية MeSH: Creutzfeldt-Jakob Syndrome*/prevention & control , Decontamination*/standards , Equipment Contamination*/prevention & control , Surgical Instruments*, Animals ; England ; Humans ; Mice
مستخلص: Background: Sensitive, direct protein-detection methods are now recommended for the inspection of reprocessed reusable surgical instruments in England to reduce the risk of prion transmission.
Aim: To implement an established, highly sensitive method to quantify proteinaceous residues on reprocessed instruments in a Sterile Services Department (SSD) and evaluate its potential impact on service provision.
Methods: We introduced highly sensitive epifluorescence (EDIC/EF) microscopy in a large SSD. Over three years, we periodically tested two models of washer disinfector using stainless-steel tokens spiked with mouse brain homogenate or Browne test soil for comparison. We also obtained data and feedback from staff who had been using EDIC/EF to examine almost 3000 reprocessed instruments.
Findings: All reprocessed test surfaces harboured residual contamination (up to 258.4 ng from 1-μg spikes). Proximity between surfaces affected decontamination efficacy and allowed cross-contamination. Up to 50 ng de novo proteinaceous contamination was deposited on control surfaces after a single automated washer disinfector (AWD) cycle. The test soil behaved differently than real tissue contamination. SSD staff observed proteinaceous residues on most reprocessed instruments using EDIC/EF, which can detect far smaller amounts than the currently accepted national threshold of 5 μg per side.
Conclusions: Implementing recent national guidelines to address the prions concern proved an eye-opener. Microscopic levels of proteins remain on many reprocessed instruments. The impact most of these residues, potentially including prions, may have on subsequent patients after sterilization remains debatable. Improving surveillance capability in SSDs can support decision making and raise the standards of surgical instruments reprocessing.
(Copyright © 2021. Published by Elsevier Ltd.)
فهرسة مساهمة: Keywords: Prions; Proteins; Sterile service departments; Surgical instruments; Surveillance
تواريخ الأحداث: Date Created: 20210122 Date Completed: 20210804 Latest Revision: 20210804
رمز التحديث: 20231215
DOI: 10.1016/j.jhin.2021.01.005
PMID: 33482297
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-2939
DOI:10.1016/j.jhin.2021.01.005