Journal Article

Novel methods for disinfection of prion-contaminated medical devices

Dehen, Capucine, Duval, Christelle, Fichet, Guillaume, Comoy, Emmanuel, Antloga, Kathleen, McDonnell, Gerald, Ida Lasmézas, Corinne, Charbonnier, Aurore, Deslys, Jean-Philippe, Brown, Paul

2004

Overview

The unique resistance of prions to classic methods of decontamination, and evidence that prion diseases can be transmitted iatrogenically by medical devices pose a serious infection control challenge to health-care facilities. In view of the widespread tissue distribution of the variant Creutzfeldt-Jakob disease agent in human beings, new practicable decontamination procedures are urgently needed. We adapted an in-vivo method using stainless steel wires contaminated with prions to the hamster-adapted scrapie strain 263K. A new in-vitro protocol of surface contamination compatible with subsequent biochemical detection of PrP res (protease-resistant form of the prion protein) from the treated surface was developed to explore the mechanisms of action of methods of decontamination under test. These models were used to investigate the effectiveness of innovative physical and chemical methods of prion inactivation. Standard chemical decontamination methods (NaOH 1N, NaOCl 20 000 ppm) and autoclaving in water at 134°C reduced infectivity by>5·6 log 10 lethal doses; autoclaving without immersion was somewhat less effective (4–4·5 log reduction). Three milder treatments, including a phenolic disinfectant, an alkaline cleaner, and the combination of an enzymatic cleaner and vaporised hydrogen peroxide (VHP) were also effective. VHP alone, which can be compatible with electronic components, achieved an approximately 4·5 log reduction in infectivity (equivalent to autoclaving without water immersion). New decontamination procedures are proposed to ensure the safety of medical and surgical instruments as well as surfaces that cannot withstand the currently recommended prion inactivation procedures.

• Publisher: Elsevier Ltd,Elsevier Limited
• Subject: Animals / Blood Transfusion / Brain - microbiology / Creutzfeldt-Jakob disease / Cricetinae / Decontamination / Disease transmission / Disinfection - methods / Equipment Contamination / Female / Hydrogen peroxide / Implants, Experimental - microbiology / Inactivation / Medical equipment / Medical instruments / Medical procedures / Mesocricetus / Neurological disorders / Phenols / Prevention / Prion Diseases - microbiology / Prion Diseases - prevention & control / Prions / Scrapie - prevention & control / Scrapie - transmission / Sodium hydroxide / Sterilization / Surgical Instruments