Abstract
Removal of pathogenic organisms from reprocessed surgical instruments is essential to prevent iatrogenic infections. Some bacteria can make persistent biofilms on medical devices. Contamination of non-disposable equipment with prions also represents a serious risk to surgical patients. Efficient disinfection of prions from endoscopes and other instruments such as high-resolution cameras remains problematic because these instruments do not tolerate aggressive chemical or heat treatments. Herein, we develop a new washing system that uses both the alkaline and acidic water produced by electrolysis. Electrolyzed acidic water, containing HCl and HOCl as active substances, has been reported to be an effective disinfectant. A 0.15% NaCl solution was electrolyzed and used immediately to wash bio-contaminated stainless steel model systems with alkaline water (pH 11.9) with sonication, and then with acidic water (pH 2.7) without sonication. Two bacterial species (Staphylococcus aureus and Pseudomonas aeruginosa) and a fungus (Candida albicans) were effectively removed or inactivated by the washing process. In addition, this process effectively removed or inactivated prions from the stainless steel surfaces. This washing system will be potentially useful for the disinfection of clinical devices such as neuroendoscopes because electrolyzed water is gentle to both patients and equipment and is environmentally sound.
Highlights
Performing surgical treatments under rigid endoscopy has been recommended and dramatically changes the approach to treating diseases because these interventions are less invasive than traditional methods and result in better overall outcomes [1, 2]
We evaluate the effects of sequential washing to remove or inactivate contamination by bacterial pathogens Staphylococcus aureus and Pseudomonas aeruginosa, the fungus Candida albicans, and human prions
We examined the effectiveness of our washing procedure to remove bacteria S. aureus and P. aeruginosa or fungus C. albicans
Summary
Performing surgical treatments under rigid endoscopy has been recommended and dramatically changes the approach to treating diseases because these interventions are less invasive than traditional methods and result in better overall outcomes [1, 2]. Thoracoscopic resection of esophageal and neuroendoscopic removal of pituitary tumors are recently developed and widely adopted examples of endoscopic surgeries [1, 3,4,5]. Some bacteria are capable of forming biofilms on the endoscope and cause iatrogenic infection [6, 7]. Usual decontamination procedures for endoscopes do not prevent iatrogenic transmission of prions, representing a serious problem in hospitals [8]. Endoscopes, and other instruments such as high-resolution cameras, are expensive and damaged by chemicals or heat because of their complex designs with multiple inner structures. A gentle disinfection process that is effective at removing or destroying pathogens is needed for these sorts of equipment [6, 9]
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