Quantitative evaluation of prion inactivation comparing steam sterilization and chemical sterilants: proposed method for test standardization

Vadrot, C.; Darbord, J. C.

doi:10.1016/j.jhin.2006.06.007

Cited by 29 publications

(21 citation statements)

References 22 publications

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“…Exposure of brain homogenate to peracetic acid (1500 ppm for 20 min) is associated with a very high protein fixation rate of 96%, which is much higher than with exposure to glutaraldehyde (19%) [201] . Mice inoculated with variant Creutzfeld-Jacob disease (vCJD)-infective brain homogenate previously exposed to peracetic acid survived on average 291 d, which was significantly shorter than mice inoculated with negative control homogenate (> 450 d).…”

Section: Special Case: Effect Of Peracetic Acid On Nerve Tissuementioning

confidence: 96%

“…Mice inoculated with variant Creutzfeld-Jacob disease (vCJD)-infective brain homogenate previously exposed to peracetic acid survived on average 291 d, which was significantly shorter than mice inoculated with negative control homogenate (> 450 d). Mice inoculated with vCJD-infective brain homogenate previously exposed to glutaraldehyde (2% for 20 min) survived longer compared with the peracetic acid group (mean: 324 d), demonstrating a clinical correlate of the almost complete fixation of brain homogenate protein by peracetic acid [201] .…”

Section: Special Case: Effect Of Peracetic Acid On Nerve Tissuementioning

confidence: 96%

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Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes?

Kampf

Fliss

Martiny

2014

WJGE

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The bioburden (blood, protein, pathogens and biofilm) on flexible endoscopes after use is often high and its removal is essential to allow effective disinfection, especially in the case of peracetic acid-based disinfectants, which are easily inactivated by organic material. Cleaning processes using conventional cleaners remove a variable but often sufficient amount of the bioburden. Some formulations based on peracetic acid are recommended by manufacturers for the cleaning step. We performed a systematic literature search and reviewed the available evidence to clarify the suitability of peracetic acid-based formulations for cleaning flexible endoscopes. A total of 243 studies were evaluated. No studies have yet demonstrated that peracetic acidbased cleaners are as effective as conventional cleaners. Some peracetic acid-based formulations have demonstrated some biofilm-cleaning effects and no biofilmfixation potential, while others have a limited cleaning effect and a clear biofilm-fixation potential. All published data demonstrated a limited blood cleaning effect and a substantial blood and nerve tissue fixation potential of peracetic acid. No evidence-based guidelines on reprocessing flexible endoscopes currently recommend using cleaners containing peracetic acid, but some guidelines clearly recommend not using them because of their fixation potential. Evidence from some outbreaks, especially those involving highly multidrug-resistant gram-negative pathogens, indicated that disinfection using peracetic acid may be insufficient if the preceding cleaning step is not performed adequately. Based on this review we conclude that peracetic acid-based formulations should not be used for cleaning flexible endoscopes. Key words: Peracetic acid; Cleaning; Flexible endoscope; Biofilm; Resistance; Bioburden; Blood; Disinfection; Reprocessing Core tip: Some formulations based on peracetic acid (PAA) are recommended by manufacturers for cleaning flexible endoscopes. We reviewed 243 studies to analyse the evidence for this recommendation. No study demonstrated that PAA-based cleaners were as effective as conventional cleaners, and some PAA-based formulations had clear biofilm-fixation potential. Dried blood and nerve tissue were substantially fixed by PAA. Some outbreaks, especially of highly multidrug-resistant gram-negative pathogens, indicated that insufficient cleaning could not be compensated for by using PAA in the disinfection step. PAA-based formulations should not be used for cleaning flexible endoscopes.

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Section: Special Case: Effect Of Peracetic Acid On Nerve Tissuementioning

confidence: 96%

Section: Special Case: Effect Of Peracetic Acid On Nerve Tissuementioning

confidence: 96%

Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes?

Kampf

Fliss

Martiny

2014

WJGE

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“…10 These chemical sterilants have not been shown to be effective in reducing potential prion transmission. 11 With this in mind, a junior staff member trained to use the flexible endoscope will not necessarily have been adequately trained in its safe decontamination. If junior staff are to take responsibility for flexible endoscope cleaning, it is an absolute requirement for patient safety that they receive adequate training.…”

Section: Discussionmentioning

confidence: 99%

Disinfection of flexible fibre-optic endoscopes out-of-hours: confidential telephone survey of ENT units in England – 10 years on

et al. 2013

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“…a transgenic mouse assay model). Alternative assay methods are becoming available for consideration, such as an in vivo mouse assay that does not use contaminated carriers, an ex vivo scrapie-cell assay developed from a mouse neuroblastoma cell line, or a method known as the standard steel binding assay (SSBA), but their use still requires validation studies to determine their sensitivity and limitations (Solassol et al ., 2004;Vadrot and Darbord, 2006;Edgeworth et al ., 2011).…”

Section: Research Developments Towards a Validated Reprocessing Strategymentioning

confidence: 99%

Prions and endotoxins: reprocessing strategies for reusable medical devices

Sehulster

2012

Sterilisation of Biomaterials and Medical Devices

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Quantitative evaluation of prion inactivation comparing steam sterilization and chemical sterilants: proposed method for test standardization

Cited by 29 publications

References 22 publications

Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes?

Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes?

Disinfection of flexible fibre-optic endoscopes out-of-hours: confidential telephone survey of ENT units in England – 10 years on

Prions and endotoxins: reprocessing strategies for reusable medical devices

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