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A Decontamination and Sterilization Protocol Employed During Reuse of Cardiac Electrophysiology Catheters Inactivates Human Immunodeficiency Virus

Published online by Cambridge University Press:  02 January 2015

Julian D. Druce ,
Jessica S. Russell ,
Christopher J. Birch ,
Lynette A. Yates ,
Richard W. Harper  and
Joseph J. Smolich
Julian D. Druce
Affiliation:
Victorian Infectious Diseases Reference Laboratory, North Melbourne
Jessica S. Russell
Affiliation:
Victorian Infectious Diseases Reference Laboratory, North Melbourne
Christopher J. Birch
Affiliation:
Victorian Infectious Diseases Reference Laboratory, North Melbourne
Lynette A. Yates
Affiliation:
Centre for Heart & Chest Research, Department of Medicine, Monash University and Monash Medical Centre, Clayton, Victoria, Australia
Richard W. Harper
Affiliation:
Centre for Heart & Chest Research, Department of Medicine, Monash University and Monash Medical Centre, Clayton, Victoria, Australia
Joseph J. Smolich*
Affiliation:
Centre for Heart & Chest Research, Department of Medicine, Monash University and Monash Medical Centre, Clayton, Victoria, Australia
*
Centre for Heart and Chest Research, Cardiology Unit, Monash Medical Centre, 246 Clayton Road, Clayton, 3168, Victoria, Australia
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Abstract

Objective:

To assess the effect of a standard decontamination and sterilization protocol employed during reuse of cardiac electrophysiology (EP) catheters on human immunodeficiency virus (HIV).

Setting:

Public health viral research laboratory.

Methods:

Studies were performed on distal, electrode-containing segments of 40 EP catheters previously used in up to 10 clinical EP procedures. EP catheter segments were immersed for 1 hour in blood contaminated with a high titer of HIV. After air drying for 2 hours, subgroups of 8 EP catheters were subjected to either (1) no treatment, (2) washing in general purpose detergent, (3) washing in enzyme cleaner, (4) sterilization in ethylene oxide, or (5) the full protocol of sequential detergent-enzyme cleaner-ethylene oxide exposure. HIV infectivity after treatment was determined by measuring HIV RNA and, in cell culture studies, assessing HIV-induced cytopathic effects (CPEs) and supernatant HIV-specific p24 antigen content.

Results:

With no treatment, all catheters had high HIV RNA levels associated with CPEs and high p24 antigen levels. After washing in detergent, 5 of 8 catheters had HIV RNA detected, but without CPEs or p24 antigen. HIV RNA was detected in all catheters after washing in enzyme cleaner, with CPEs and a high p24 antigen level in 1 of 8 catheters. HIV RNA, CPEs, and p24 antigen were absent after ethylene oxide. After the full protocol, HIV RNA levels were undetectable (n = 7) or low (n = 1), without evidence of CPEs or p24 antigen.

Conclusion:

Appropriate decontamination and sterilization of EP catheters during reuse is highly effective in inactivating HIV.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 3 , March 2003 , pp. 184 - 190
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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