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Inactivation of prions in daily medical practice
1Paris V University, Faculté des Sciences Pharmaceutiques & Biologiques de Paris, France.
Abstract:
The danger of transmission of non conventional agents such as prions constitutes a risk that is difficult to evaluate as the actual understanding of the infectious mechanism is minimal. The efficacy of each procedure is evaluated via submitting infectious particles mixed with cellular products to inactivating treatments, and then by inoculating animals with fractions of the preparation. With these protocols, some ineffective treatments can be identified (for example, soaking in aldehyde), and three reference treatments are recommended by the WHO: soaking in 1 N sodium hydroxide (1 h, 20 degrees C), soaking in 12.5% bleach (1 h, 20 degrees C) and steam sterilization in autoclave (134 degrees C-138 degrees C, 18 min). Universal precautions of asepsis and hygiene must be applied, especially in anatomo-pathological laboratories and for the re-use of medical devices in neurosurgery or in ophthalmology.
Insights
Prion transmission poses a significant risk due to limited understanding of infectious mechanisms. Recommended prion inactivation methods include sodium hydroxide, bleach, and autoclaving for safe medical device reprocessing.
Area of Science:
- Infectious disease transmission
- Prion biology
- Sterilization and disinfection
Background:
- Non-conventional infectious agents like prions present unique transmission risks.
- The precise mechanisms of prion infection are not fully understood, complicating risk assessment.
- Effective inactivation protocols are crucial for preventing prion spread.
Purpose of the Study:
- To evaluate the efficacy of various treatments for inactivating prion particles.
- To identify ineffective prion decontamination methods.
- To recommend validated prion inactivation procedures.
Main Methods:
- Infectious particles were mixed with cellular products and subjected to inactivating treatments.
- Animal inoculation was used to assess the infectivity of treated preparations.
- Standardized laboratory protocols were employed to test decontamination efficacy.
Main Results:
- Certain treatments, such as aldehyde soaking, were found to be ineffective against prions.
- Three World Health Organization (WHO)-recommended treatments demonstrated efficacy: 1 N sodium hydroxide (1 hour), 12.5% bleach (1 hour), and steam sterilization (134-138°C for 18 minutes).
Conclusions:
- Rigorous decontamination protocols are essential for managing prion risks.
- Specific chemical and physical methods are validated for prion inactivation.
- Universal precautions and validated reprocessing are critical in healthcare settings, particularly for neurosurgery and ophthalmology.