Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-28T07:59:09.575Z Has data issue: false hasContentIssue false

Cleaning of Blood-Contaminated Reprocessed Angiographic Catheters and Spinal Needles

Published online by Cambridge University Press:  02 January 2015

Thereza Christina Vessoni Penna*
Affiliation:
Department of Biochemical and Pharmaceutical Technology, School of Pharmaceutical Science, University of São Paulo, São Paulo, Brasil
Carlos Augusto M. Ferraz
Affiliation:
Johnson & Johnson Produtos Profissionais LTDA Rodovia Presidente Dutra, São José dos compos, São Paulo., Brasil
*
Rua Antonio de Macedo Soares, 452, São Paulo, SP 04607-000, Brasil

Abstract

Objectives:

To evaluate the efficacy of a multistep cleaning method using a cleaner and a chemical disinfectant on blood-contaminated angiographic catheters and spinal needles intended to be sterilized by hydrogen peroxide gas plasma.

Method:

A mixture of radiopaque iodine contrast, bovine blood (plus ethylenediaminetetraacetic acid), and a suspension of Bacillus subtilis spores was used to simulate catheterization and needle use. The mixture was a 1:1 proportion of contrast and blood, inoculated so that there was a final concentration of B subtilis spores of 1.0×106 colony-forming units (CFU)/mL. The inoculated devices were cleaned using a hydrogen peroxide solution at a concentration of 1.5±0.5 percent by weight, followed by distilled water with enzymatic detergent. After drying, the devices were sterilized with hydrogen peroxide gas plasma.

Results:

The initial B subtilis spore concentration inoculated into catheters and needles varied from 2.12×104 to 2.74×107 CFU/mL. The residual load of B subtilis spores after cleaning varied from zero (no count) to a maximum of 200 CFU/device. The multistep cleaning procedure was responsible for an average 5-log10 reduction of B subtilis spores in the catheter and needle lumens.

Conclusions:

The hydrogen peroxide and enzymatic detergent aqueous solutions were shown to be efficacious when used as part of a multistep cleaning method. The low level of microbial contamination prior to sterilization with hydrogen peroxide gas plasma assured that the intended sterility assurance level was reached.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Association for the Advancement of Medical Instrumentation (US). Design, Testing, and Labeling Reusable Medical Devices for Reprocessing in Health Care Facilities: A Guide for Device Manufacturers. Report no. 12. Arlington, VA: AAMI; 1995.Google Scholar
2.Rutala, WA. Disinfection and sterilization of patient-care items. Infect Control Hosp Epidemiol 1996;17:377384.Google Scholar
3.Russel, D, Furr, JR, Maillard, JY. Microbial susceptibility and resistance to biocides. ASM News 1997;63:481487.Google Scholar
4.Alfa, MJ, DeGagne, P, Olson, N, Puchalski, T. Comparison of ion plasma, vaporized hydrogen peroxide, and 100% ethylene oxide sterilizers to the 12/88 ethylene oxide gas sterilizer. Infect Control Hosp Epidemiol 1996;17:92100.Google Scholar
5.Bentolita, P, Jacob, R, Roberge, F. Effects of re-use on the physical characteristics of angiographic catheters. J Med Eng Technol 1990;4:254259.Google Scholar
6.Jacobson, JA, Schwartz, CE, Marshall, HW, Conti, M, Burke, JP. Fever, chills, and hypotension following cardiac catheterization with single- and multiple-use disposable catheters. Cathet Cardiovasc Diagn 1983;9:3946.Google Scholar
7.American Public Health Association. Standard Methods for the Examination of Water and Wastewater. 19th ed. Washington, DC: APHA; 1995:938.Google Scholar
8.Penna, TCV, Ferraz, CAM, Cassola, MA. Presterilization microbial load on reused medical devices and STERRAD 100 effectiveness on reduction of inoculated Bacillus subtilis spores. Infect Control Hosp Epidemiol 1999;20:465472.Google Scholar
9.Cassola, MA, Ishisaki, E, Ferraz, CA, Penna, TCV. Hydrogen peroxide gas plasma sterilization of medical devices in Brazilian hospitals. Laes & Haes 1997;19:88100.Google Scholar
10.United States Pharmacopeia. 23rd ed. Rockville, MD: United States Pharmacopeial Convention; 1995:1847-1849,19761981.Google Scholar
11.Myers, HC, McAlister, D, Antonoplos, P. Natural bioburden levels detected on rigid lumened medical devices before and after cleaning. Am J Infect Control 1997;25:471476.Google Scholar
12.Chu, NS, Myers, HC, Ghazanfari, N, Antonoplos, P. Levels of naturally occurring microorganisms on surgical instruments after use and after washing. Am J Infect Control 1999;27:315319.Google Scholar
13.Rutala, WA, Gerden, MF, Jones, JF, Weber, DJ. Levels of microbial contamination on surgical instruments. Am J Infect Control 1998;26:143145.Google Scholar
14.Alfa, MJ, Degagne, P, Olson, N. Worst-case soiling levels for patient-used flexible endoscopes before and after cleaning. Am J Infect Control 1999;27:392401.Google Scholar