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Rapid method for the sensitive detection of protein contamination on surgical instruments
I P Lipscomb1, A K Sihota, M Botham
1Environmental Healthcare Unit, School of Biological Sciences, University of Southampton, Southampton, UK. i.lipscomb@soton.ac.uk
Abstract:
Hospital sterile service departments (SSDs) currently rely on simple visual confirmation of cleanliness as an assessment of the efficacy of cleaning surgical instruments. The inherent inability to monitor low levels of infectious or proteinaceous contamination on surgical instruments creates the possibility that highly dangerous and robust biological agents may remain infectious and undetected even after standard cleaning and sterilization procedures have been employed. This paper describes the development of a novel microscopy technique, episcopic differential interference contrast microscope, combined with the fluorescent reagent, SYPRO Ruby, to rapidly detect brain tissue protein to below 400 pg/mm(2) on an instrument surface. This technique has displayed a minimum level of detection observed by 50% of volunteers of 85 pg/mm(2) (95% confidence intervals 67-112 pg/mm(2)). Quantitative assessment of instruments supplied from various SSDs enabled the establishment of a 'contamination index' of both proteinaceous and non-proteinaceous deposits on the surface. This new methodology for the assessment of surface contamination is generally applicable and should facilitate future quantitative surveys of instrument contamination in hospitals and other healthcare environments.
Insights
A new microscopy technique using SYPRO Ruby reliably detects low levels of protein contamination on surgical instruments, improving sterile service department (SSD) safety. This method enhances the detection of infectious agents missed by visual inspection.
Area of Science:
- Biomedical Engineering
- Microscopy
- Healthcare Technology
Background:
- Sterile service departments (SSDs) use visual inspection for surgical instrument cleanliness.
- Current methods fail to detect low levels of infectious or proteinaceous contamination.
- Undetected contamination poses a risk of transmitting dangerous biological agents.
Purpose of the Study:
- To develop a novel microscopy technique for detecting low-level protein contamination on surgical instruments.
- To establish a quantitative method for assessing instrument cleanliness in SSDs.
- To improve the safety and efficacy of surgical instrument reprocessing.
Main Methods:
- Development of an episcopic differential interference contrast microscope.
- Utilized the fluorescent reagent SYPRO Ruby for protein detection.
- Quantitative assessment of protein contamination on instrument surfaces (pg/mm²).
Main Results:
- The technique detected brain tissue protein down to 400 pg/mm².
- Minimum detection level observed by 50% of volunteers was 85 pg/mm².
- Established a 'contamination index' for proteinaceous and non-proteinaceous deposits.
Conclusions:
- The novel microscopy technique offers rapid and sensitive detection of surface contamination.
- This method can significantly enhance the assessment of surgical instrument cleanliness.
- The technique is broadly applicable for quantitative surveys in healthcare environments.
