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Métodos novedosos para la desinfección de dispositivos médicos contaminados con priones
Guillaume Fichet1, Emmanuel Comoy, Christelle Duval
1CEA/DSV/DRM/GIDTIP, Route du Panorama, 92265 Fontenay-aux-Roses, France.
Lancet (London, England)
|August 11, 2004
Resumen
Nuevos métodos inactivan eficazmente los priones en los dispositivos médicos, incluido el peróxido de hidrógeno vaporizado (VHP). Estos hallazgos ofrecen una descontaminación más segura para instrumentos y superficies contra enfermedades priónicas como la variante de la enfermedad de Creutzfeldt-Jakob.
Área de la Ciencia:
- Control y Control de Enfermedades Infecciosas
- La bioquímica es la bioquímica.
- Ciencia de los materiales Ciencia de los materiales.
Sus antecedentes:
- Los priones resisten la descontaminación estándar, lo que plantea riesgos de infección a través de los dispositivos médicos.
- La amplia distribución del agente variante de la enfermedad de Creutzfeldt-Jakob (vCJD) requiere mejores métodos de inactivación de priones.
- Las instalaciones sanitarias se enfrentan a desafíos en la descontaminación de instrumentos y superficies contra enfermedades priónicas.
Objetivo del estudio:
- Evaluar métodos innovadores de descontaminación física y química para la inactivación de priones.
- Desarrollar y utilizar modelos in vivo e in vitro para probar la eficacia de la descontaminación de priones.
- Identificar procedimientos prácticos para garantizar la seguridad de los instrumentos médicos y quirúrgicos.
Principales métodos:
- Adaptó un modelo de hamster in vivo adaptado a la cepa de scrapie 263K utilizando alambres de acero inoxidable contaminados.
- Desarrolló un protocolo de contaminación superficial in vitro para la detección bioquímica de la proteína priónica resistente a la proteasa (PrP(res)).
- Investigó la efectividad de varios métodos de descontaminación físicos (autoclave) y químicos (desinfectantes, VHP) para la descontaminación.
Principales resultados:
- Los métodos estándar (NaOH, NaOCl, autoclave en agua) lograron >5.6 log10 reducción en la infectividad.
- La autoclave sin inmersión redujo la infectividad en 4-4,5 log.
- Los tratamientos más suaves, que incluyen desinfectante fenólico, limpiador alcalino y limpiador enzimático con VHP, fueron efectivos. Solo VHP logró una reducción de 4,5 log.
Conclusiones:
- El peróxido de hidrógeno vaporizado (VHP) ofrece un método eficaz de inactivación de priones compatible con los componentes electrónicos.
- Se proponen nuevos procedimientos de descontaminación para los instrumentos médicos y las superficies que no pueden soportar los actuales métodos de inactivación de alto nivel.
- Estos avances tienen como objetivo mejorar la seguridad y prevenir la transmisión iatrogénica de enfermedades priónicas en entornos de atención médica.
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