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We analyzed the effectiveness of manual cleaning protocols performed on high-speed dental handpieces, using protein identification by fluorescence. Although one protocol was able to able to lower the amount of protein, >40% of the handpieces showed amounts of residual protein at unacceptable levels.

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Abstract Introduction Currently, there is no safe, affordable, and ecologically-sustainable guideline that helps prevent contamination through endoscopy. We evaluated the safety of intermediate-level disinfection with 70% ethyl alcohol (w/v) based on biological-load recovery from rigid endoscopes after nasal endoscopy. Objective To demonstrate the efficacy of 70% ethanol in disinfecting rigid endoscopes (REs) to reduce microbial growth in microbiological cultures. Methods After a nasal endoscopy examination, the endoscope was swabbed with gauze; this served as the positive-control sample. The standard operating procedure for intermediate-level disinfection with 70% ethyl alcohol (w/v) following prior cleaning was applied. The endoscope was again swabbed; this served as the experimental sample. The collected material from the endoscope was extracted from gauze pieces, filtered through a 0.22-μm cellulose membrane, and cultivated in different means of culture. Results The results revealed a significant difference between the positive-control and experimental groups regarding the presence of Streptococcus coagulase (-) (p < 0.001), Bacillus spp. (p <0.001), and Staphylococcus aureus (p = 0.001). These microorganisms were detected in the control group, but not in the experimental group. Conclusions Microorganisms were not recovered from the samples of the experimental group, demonstrating the efficacy and the germicidal action of 70% ethyl alcohol (w/v) as a means of achieving intermediate-level disinfection.

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Introduction Currently, there is no safe, affordable, and ecologically-sustainable guideline that helps prevent contamination through endoscopy. We evaluated the safety of intermediate-level disinfection with 70% ethyl alcohol (w/v) based on biological-load recovery from rigid endoscopes after nasal endoscopy. Objective To demonstrate the efficacy of 70% ethanol in disinfecting rigid endoscopes (REs) to reduce microbial growth in microbiological cultures. Methods After a nasal endoscopy examination, the endoscope was swabbed with gauze; this served as the positive-control sample. The standard operating procedure for intermediate-level disinfection with 70% ethyl alcohol (w/v) following prior cleaning was applied. The endoscope was again swabbed; this served as the experimental sample. The collected material from the endoscope was extracted from gauze pieces, filtered through a 0.22-µm cellulose membrane, and cultivated in different means of culture. Results The results revealed a significant difference between the positive-control and experimental groups regarding the presence of Streptococcus coagulase (-) ( p < 0.001), Bacillus spp. ( p < 0.001), and Staphylococcus aureus ( p = 0.001). These microorganisms were detected in the control group, but not in the experimental group. Conclusions Microorganisms were not recovered from the samples of the experimental group, demonstrating the efficacy and the germicidal action of 70% ethyl alcohol (w/v) as a means of achieving intermediate-level disinfection.

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This review sought to provide an overview of proposed methods and protocols for processing surgical instruments contaminated with prions. A search of PubMed was conducted to identify studies published between January 1, 2012, and January 2, 2019, with no language restrictions and using varying combinations of the following terms: prions (Medical Subject Heading [MeSH]) OR decontamination (MeSH) OR cleaning OR disinfection OR sterilization. Articles were excluded if they did not involve medical device surfaces or describe the processing protocol. At least two reviewers independently selected articles, extracted data, and assessed data. A total of 627 articles published in peer-reviewed journals were identified. Of the 55 articles assessed for full-text eligibility, eight met the inclusion criteria. Only a few studies investigated protocols and methods for processing prion-contaminated medical devices; therefore, determining the best way to sterilize device surfaces and preserve the integrity of surgical instruments remains challenging. Moreover, the perspective of sterile processing department staff continues to be overlooked when designing studies.

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Chemical indicators are commonly used in hospitals to monitor steam sterilization conditions, indicating that medical devices are safe to be used. The results are stored for future evidence in the event of an infection incident root cause analysis. This type of indicator is also becoming an option for cycle monitoring in pharmaceutical steam sterilizers, improving cycle control. They are constructed and tested according to published standards, but contradictory results between chemical indicators and cycle printouts have a critical impact on process control. We found that type 6 chemical indicators used in steam sterilizer cycles did not perform according to their intended use, showing an ″approved″ result in a ″failed″ cycle (a false positive). This study demonstrated that type 6 chemical indicator specifications are not adequate for monitoring steam sterilizers. A change in standards is therefore needed.

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OBJECTIVE: To evaluate the efficacy of detergent and friction on removal of traditional biofilm and cyclic-buildup biofilm (CBB) from polytetrafluoroethylene (PTFE) channels and to evaluate the efficacy of glutaraldehyde to kill residual bacteria after cleaning. METHODS: PTFE channels were exposed to artificial test soil containing 108 CFU/mL of Pseudomonas aeruginosa and Enterococcus faecalis, followed by full cleaning and high-level disinfection (HLD) for five repeated rounds to establish CBB. For traditional biofilm, the HLD step was omitted. Cleaning with enzymatic and alkaline detergents, bristle brush, and Pull Thru channel cleaner were compared to a water flush only. Carbohydrate, protein, viable count, adenosine triphosphate (ATP) levels were analyzed and atomic force microscopy (AFM) was performed. RESULTS: In the absence of friction, cleaning of traditional biofilm and CBB was not effective compared to the positive control (Dunn-Bonferroni tests; P > .05) regardless of the detergent used. ATP, protein, and carbohydrate analyses were unable to detect traditional biofilm or CBB. The AFM analysis showed that fixation resulted in CBB being smoother and more compact than traditional biofilm. CONCLUSION: Friction during the cleaning process was a critical parameter regardless of the detergent used for removal of either traditional biofilm or CBB. Glutaraldehyde effectively killed the remaining microorganisms regardless of the cleaning method used.

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Currently, there are two orthopedic implant types: (1) Sterile implants (e.g., joint prostheses) are distributed in a ready-for-use sterile fashion, and (2) nonsterile implants (e.g., plates, screws, Schanz pins, intramedullary rods) are processed by a healthcare facility's central sterile service department (CSSD). The current study evaluated processed implants for presence of coagulase-negative staphylococci, which was observed in 30% of the cortical screws, spongy screws, and Schanz pins (37 total samples) processed by a CSSD. Some samples were resistant to antimicrobial agents, thereby demonstrating that risk exists in the current methods used in the processing of nonsterile implants. Also of important note, nonsterile implants are commonly loaned worldwide. Loaned implantable materials should not be processed in the same manner as materials routinely prepared in the CSSD, as it is not possible to know the quality of the cleaning performed before the materials are returned to the loaning company. It is not uncommon for hospitals to receive loaned materials with organic residues.

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PURPOSE: To evaluate the cytotoxicity of reusable cannulas for ophthalmic surgery after the cannulas were filled with an ophthalmic viscosurgical device (OVD) and cleaned with an enzymatic detergent. SETTING: Microbiological Testing Laboratory, Department of Medical-Surgical Nursing, University of São Paulo School of Nursing, and Cell Culture Section, Adolfo Lutz Institute, São Paulo, Brazil. DESIGN: Experimental study. METHODS: The sample consisted of 30 reusable 25-gauge injection cannulas, 20.0 mm in length, whose lumens were filled with an OVD solution for 50 minutes. The following steps were used to process the cannulas: (1) presoaking, (2) washing the lumen using a high-pressure water jet, (3) backwashing with enzymatic detergent in ultrasonic cleaner, (4) preliminary rinsing with tap water, (5) final rinsing with sterile distilled water, (6) drying with compressed filtered air, (7) wrapping in surgical-grade paper, and (8) steam sterilization at 134°C for 4 minutes. The cannulas were then tested for cytotoxicity according to the United States Pharmacopeia 32. RESULTS: The cleaning protocol used in this study removed residues of OVD solution and enzymatic detergent as shown by the lack of cytotoxicity of all sample extracts. CONCLUSION: This cleaning protocol has the potential to minimize the occurrence of toxic anterior segment syndrome associated with residues of OVD solutions and enzymatic detergents. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

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O controle da contaminaçäo ambiental, na sala de operaçäo, é uma das medidas de prevençäo da infecçäo do sítio cirúrgico. Assim, o presente estudo teve como objetivo identificar se os padrões mínimos para o controle da contaminaçäo ambiental estäo sendo considerados pelos profissionais de saúde que atuam na unidade de Centro Cirúrgico. A investigaçäo foi desenvolvida em um hospital geral, público; a coleta de dados realizou-se através de observaçäo das cirurgias, utilizando instrumentos previamente elaborados, na especialidade de ginecologia e obstetrícia, no mês de janeiro de 2000, perfazendo um total de 23 procedimentos anestésico-cirúrgicos observados. Realizamos uma análise descritiva e matemático-estatística, utilizando freqüência absoluta e porcentagem. Ao analisarmos o conjunto de itens do Padräo 1, que retrata a limpeza e montagem da sala de operaçäo, e do Padräo 2, relativo aos princípios de assepsia cirúrgica, constatamos que a maioria dos procedimentos foi realizada pelos profissionais que atuavam na unidade, da forma preconizada pela literatura, entretanto, alguns itens avaliados evidenciaram a necessidade de reavaliaçäo das práticas desenvolvidas pela equipe de saúde em relaçäo ao controle da contaminaçäo ambiental, bem como a atualizaçäo sobre os avanços técnico-científicos para o controle da infecçäo do sítio cirúrgico

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