scholarly journals Effectiveness of autoclaving in sterilizing reusable medical devices in healthcare facilities

2019 ◽  
Vol 13 (10) ◽  
pp. 858-864 ◽  
Author(s):  
Gopal Panta ◽  
Ann K Richardson ◽  
Ian C Shaw
Keyword(s):  
Developing Countries ◽  
Medical Devices ◽  
Cost Effective ◽  
Biological Indicators ◽  
Healthcare Associated Infections ◽  
Steam Sterilization ◽  
Healthcare Facilities ◽  
Clinical Procedures ◽  
Cost Effective Method ◽  
Healthcare Associated

Medical devices are sterilized before being used for invasive clinical procedures such as surgery, to prevent pathogen transfer. Failure to sterilize medical devices properly presents a risk of healthcare-associated infections. Studies and reports have indicated that inadequately sterilized medical devices are one of the causes of a higher rate of healthcare-associated infections in developing countries. Steam sterilization (autoclaving) is the most widely used method for sterilization and is considered the most robust and cost-effective method for sterilization of medical devices. The effectiveness of steam sterilization can be measured using biological indicators. A literature search was undertaken to understand the effectiveness of autoclaving in sterilizing reusable medical devices in healthcare facilities across the globe. Studies using biological indicators for measuring the effectiveness of autoclaving were obtained. Failures of steam sterilization practices were identified and discussed as a means of identifying factors that might be associated with the ineffectiveness of steam sterilization practices between different countries. The number of studies measuring the effectiveness of steam sterilization is small, and few evaluate the effectiveness of steam sterilization specifically in developing countries. There are fewer studies on higher level healthcare facilities than dental facilities. More evidence about the effectiveness of autoclaving in healthcare facilities is needed to draw firm conclusions, but the data suggest that there are inadequacies in autoclave procedures and operator education.

scholarly journals Detection of Possible Medical Product-Related Infection or Pathogen Transmission—United States, 2015–2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s30-s31
Author(s):  
Isaac Benowitz ◽  
Joseph Perz ◽  
Julia Marders
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Medical Devices ◽  
Medical Product ◽  
Pathogen Transmission ◽  
Healthcare Associated Infections ◽  
Healthcare Facilities ◽  
Biological Products ◽  
Medical Products ◽  
Healthcare Associated

Background: Medications, medical devices, biological products, and other medical products can cause healthcare-associated infections related to contamination in production or transportation (intrinsic contamination) or contamination at the point of use (extrinsic contamination). Rapid identification of contaminated medical products can lead to actions to decrease further patient harm. We sought to describe events that prompted public health investigations of contaminated medical products in healthcare facilities. Methods: We reviewed records of CDC consultations with health departments and healthcare facilities from January 2015 through August 2019 to identify public health investigations in which medical products were identified as a likely source of patient infection or pathogen transmission to at least 1 patient. We collected data on products, contamination type, pathogens, route of patient exposure, healthcare setting where exposure occurred, and resulting actions. Results: There were 34 investigations involving medications (n = 15, 44%), medical devices (n = 12, 35%), biological products (n = 3, 9%), and other medical products (n = 4, 12%). Intrinsic contamination was suspected in 15 investigations (44%), with 13 (87%) based on isolation of a pathogen from unopened products and 2 (13%) based on isolation of similar pathogens from patients in contact with a medical product at multiple facilities. Extrinsic contamination was suspected in 19 investigations (56%) based on evidence of pathogen transmission at a single healthcare facility and concurrent infection control gaps at that facility supporting a mechanism of contamination. The most common pathogens prompting investigation were nontuberculous mycobacteria (n = 9, 26%), Burkholderia spp (n = 7, 21%), Klebsiella spp (n = 3, 9%), Serratia spp (n = 2, 6%), and other environmental and commensal organisms. Patients were most commonly exposed in hospitals (n = 19, 56%) and outpatient settings (n = 9, 26%). The most common patient exposures that resulted in transmission of the pathogen were infusions and injections (n = 15, 44%), diagnostic and therapeutic procedures (n = 9, 26%), and surgery (n = 5, 15%). Patient were notified and offered testing in at least 6 investigations (18%) . Interventions included product removal, healthcare provider alerts, patient notification and testing, modification of injection safety practices and other general infection control practices, correction of improper storage and handling, and changes in product design, manufacturing processes, or instructions for use. Conclusions: Public health investigations identified intrinsic and extrinsic contamination of medications, devices, and other products as a cause of healthcare-associated infections. Healthcare facilities should consider contaminated products in investigations of healthcare-associated infections, take steps to identify local infection control concerns, and alert public health authorities to events that could suggest widespread contamination.Funding: NoneDisclosures: None

Managing Our Microbial Mark

2016 ◽  
Vol 42 (2-3) ◽  
pp. 393-428
Author(s):  
Ann Marie Marciarille
Keyword(s):  
United States ◽  
Infection Control ◽  
The United States ◽  
West African ◽  
Healthcare Associated Infections ◽  
Healthcare Facilities ◽  
Quality Reporting ◽  
Reporting Systems ◽  
Control Procedures ◽  
Healthcare Associated

The narrative of Ebola's arrival in the United States has been overwhelmed by our fear of a West African-style epidemic. The real story of Ebola's arrival is about our healthcare system's failure to identify, treat, and contain healthcare associated infections. Having long been willfully ignorant of the path of fatal infectious diseases through our healthcare facilities, this paper considers why our reimbursement and quality reporting systems made it easy for this to be so. West Africa's challenges in controlling Ebola resonate with our own struggles to standardize, centralize, and enforce infection control procedures in American healthcare facilities.

scholarly journals Impact of Healthcare-Associated Infections Connected to Medical Devices—An Update

2021 ◽  
Vol 9 (11) ◽  
pp. 2332
Author(s):  
Nitin Chandra Teja Dadi ◽  
Barbora Radochová ◽  
Jarmila Vargová ◽  
Helena Bujdáková
Keyword(s):  
Medical Devices ◽  
Surgical Site Infections ◽  
Central Line ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infections ◽  
Care Bundles ◽  
Planktonic Form ◽  
Novel Approaches ◽  
Healthcare Associated ◽  
The Impact

Healthcare-associated infections (HAIs) are caused by nosocomial pathogens. HAIs have an immense impact not only on developing countries but also on highly developed parts of world. They are predominantly device-associated infections that are caused by the planktonic form of microorganisms as well as those organized in biofilms. This review elucidates the impact of HAIs, focusing on device-associated infections such as central line-associated bloodstream infection including catheter infection, catheter-associated urinary tract infection, ventilator-associated pneumonia, and surgical site infections. The most relevant microorganisms are mentioned in terms of their frequency of infection on medical devices. Standard care bundles, conventional therapy, and novel approaches against device-associated infections are briefly mentioned as well. This review concisely summarizes relevant and up-to-date information on HAIs and HAI-associated microorganisms and also provides a description of several useful approaches for tackling HAIs.

Challenges to Validation Of a Complex Nonsterile Medical Device Tray

2014 ◽  
Vol 48 (4) ◽  
pp. 306-311
Author(s):  
Daniel Prince ◽  
Jozef Mastej ◽  
Isabel Hoverman ◽  
Raja Chatterjee ◽  
Diana Easton ◽  
...  
Keyword(s):  
Medical Device ◽  
Medical Devices ◽  
Biological Indicators ◽  
Careful Attention ◽  
Geobacillus Stearothermophilus ◽  
Steam Sterilization ◽  
Worst Case

Validation by steam sterilization of reusable medical devices requires careful attention to many parameters that directly influence whether or not complete sterilization occurs. Complex implant/instrument tray systems have a variety of configurations and components. Geobacillus stearothermophilus biological indicators (BIs) are used in overkill cycles to to simulate worst case conditions and are intended to provide substantial sterilization assurance. Survival of G. stearothermophilus spores was linked to steam access and size of load in the chamber. By a small and reproducible margin, it was determined that placement of the trays in a rigid container into minimally loaded chambers were more difficult to completely sterilize than maximally loaded chambers.

scholarly journals Enhanced antibacterial efficacy of nitric oxide releasing thermoplastic polyurethanes with antifouling hydrophilic topcoats

2017 ◽  
Vol 5 (7) ◽  
pp. 1246-1255 ◽  
Author(s):  
Priyadarshini Singha ◽  
Jitendra Pant ◽  
Marcus J. Goudie ◽  
Christina D. Workman ◽  
Hitesh Handa
Keyword(s):  
Nitric Oxide ◽  
Medical Devices ◽  
Antimicrobial Efficacy ◽  
Healthcare Associated Infections ◽  
Antibacterial Efficacy ◽  
Thermoplastic Polyurethanes ◽  
Nitric Oxide Releasing ◽  
Healthcare Associated

Hydrophilic antifouling topcoat combined with nitric oxide releasing polymer to enhance antimicrobial efficacy and combat healthcare-associated infections caused by medical devices.

scholarly journals Disinfectant Wipes Transfer Clostridioides difficile Spores from Contaminated Surfaces to Uncontaminated Surfaces during the Disinfection Process

2020 ◽  
Author(s):  
Carine A. Nkemngong ◽  
Gurpreet K. Chaggar ◽  
Xiaobao Li ◽  
Peter J. Teska ◽  
Haley F Oliver
Keyword(s):  
Hydrogen Peroxide ◽  
Quaternary Ammonium ◽  
Healthcare Associated Infections ◽  
Cross Contamination ◽  
Healthcare Facilities ◽  
Contamination Risk ◽  
Clostridioides Difficile ◽  
Disinfection Process ◽  
The Us ◽  
Healthcare Associated

Abstract Background: Pre-wetted disinfectant wipes are increasingly being used in healthcare facilities to help address the risk of healthcare associated infections (HAI). However, HAIs are still a major problem in the US with Clostridioides difficile being the most common cause, leading to approximately 12,800 deaths annually in the US. An underexplored risk when using disinfectant wipes is that they may cross-contaminate uncontaminated surfaces during the wiping process. The objective of this study was to determine the cross-contamination risk that pre-wetted disinfectant towelettes may pose when challenged with C. difficile spores. We hypothesized that although the tested disinfectant wipes had no sporicidal claims, they will reduce spore loads. We also hypothesized that hydrogen peroxide disinfectant towelettes would present a lower cross-contamination risk than quaternary ammonium products. Methods: We evaluated the risk of cross-contamination when disinfectant wipes are challenged with C. difficile ATCC 43598 spores on Formica surfaces. A disinfectant wipe was used to wipe a Formica sheet inoculated with C. difficile. After the wiping process, we determined log10 CFU on previously uncontaminated pre-determined distances from the inoculation point and on the used wipes. Results: We found that the disinfectant wipes transferred C. difficile spores from inoculated surfaces to previously uncontaminated surfaces. We also found that wipes physically removed C. difficile spores and that hydrogen peroxide disinfectants were more sporicidal than the quaternary ammonium disinfectants. Conclusion: Regardless of the product type, all disinfectant wipes had some sporicidal effect but transferred C. difficile spores from contaminated to otherwise previously uncontaminated surfaces. Disinfectant wipes retain C. difficile spores during and after the wiping process.

scholarly journals CouldHistoplasma capsulatumBe Related to Healthcare-Associated Infections?

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Laura Elena Carreto-Binaghi ◽  
Lisandra Serra Damasceno ◽  
Nayla de Souza Pitangui ◽  
Ana Marisa Fusco-Almeida ◽  
Maria José Soares Mendes-Giannini ◽  
...  
Keyword(s):  
Medical Devices ◽  
Histoplasma Capsulatum ◽  
Paracoccidioides Brasiliensis ◽  
Etiologic Agent ◽  
Hospital Environment ◽  
Healthcare Associated Infections ◽  
Filamentous Form ◽  
Etiologic Agents ◽  
Cross Transmission ◽  
Healthcare Associated

Healthcare-associated infections (HAI) are described in diverse settings. The main etiologic agents of HAI are bacteria (85%) and fungi (13%). Some factors increase the risk for HAI, particularly the use of medical devices; patients with severe cuts, wounds, and burns; stays in the intensive care unit, surgery, and hospital reconstruction works. Several fungal HAI are caused byCandidaspp., usually from an endogenous source; however, cross-transmission via the hands of healthcare workers or contaminated devices can occur. Although other medically important fungi, such asBlastomyces dermatitidis,Paracoccidioides brasiliensis, andHistoplasma capsulatum, have never been considered nosocomial pathogens, there are some factors that point out the pros and cons for this possibility. Among these fungi,H. capsulatuminfection has been linked to different medical devices and surgery implants. The filamentous form ofH. capsulatummay be present in hospital settings, as this fungus adapts to different types of climates and has great dispersion ability. Although conventional pathogen identification techniques have never identifiedH. capsulatumin the hospital environment, molecular biology procedures could be useful in this setting. More research onH. capsulatumas a HAI etiologic agent is needed, since it causes a severe and often fatal disease in immunocompromised patients.

Preventing Healthcare-Associated Infections by Monitoring the Cleanliness of Medical Devices and Other Critical Points in a Sterilization Service

2016 ◽  
Vol 50 (s3) ◽  
pp. 45-52 ◽  
Author(s):  
Isabel Veiga-Malta
Keyword(s):  
Medical Devices ◽  
Positive Impact ◽  
Good Practice ◽  
Surgical Instruments ◽  
Healthcare Associated Infections ◽  
Positive Contribution ◽  
Atp Bioluminescence ◽  
Sterilization Service ◽  
Healthcare Associated

Abstract It is well known that the common goal of all central sterile supply departments (CSSDs) is to prevent healthcare-associated infections. Such infections entail high costs to society, not only economic but also social. Therefore, delivering safe medical devices and guaranteeing a positive contribution to the control of healthcare-associated infections form the main responsibilities of a CSSD. The monitoring of the effectiveness of medical device cleaning processes is highly recommended. However, ensuring a flawless environment for the preparation, assembly, and packaging of medical devices and clean handling of sterilized items is crucial to achieving the goal of safe medical devices. This study analyzed not only the cleanliness of surgical instruments but also two critical aspects of the surrounding environment: the cleanliness of work surfaces and the cleanliness of workers' hands. To evaluate the cleanliness of surgical instruments, two methods were used: the adenosine triphosphate (ATP) detection method and a residual protein test. It was not the intention of this work to make an exhaustive comparison of these methods. The ATP bioluminescence method was also used for monitoring the cleanliness of work surfaces and workers' hands. The aims of this study were to establish the most suitable method of evaluating the cleanliness of reusable medical devices in the CSSD and to assess the quality of the environment. Assessing the surgical instruments, work surfaces, and staff hands for cleanliness allowed the identification of possible contamination sources and to correct them by improving cleaning/disinfection protocols. Furthermore, the use of ATP monitoring tests of workers' hands highlighted the importance of staff compliance with good practice guidelines. Thus, these results have a positive impact on the CSSD quality system and, consequently, on patient safety.

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