A preliminary evaluation of a reusable digital sterilization indicator prototype

BACKGROUND

Sterilization of critical and semicritical instruments used in patient care must undergo a terminal process of sterilization. Use of chemical and physical indicators are important in providing information on the sterilizer's performance during each cycle. Regular and periodic monitoring of sterilizers using biological indicators is necessary in periodically validating performance of sterilizers. Data loggers or independent digital parametric indicators are innovative devices that provide more information than various classes chemical indicators. In this study we evaluated a prototype of an independent digital parametric indicator's use in autoclaves.

AIM

The purpose of this study was to evaluate the performance of an independent digital indicator/data logger prototype (DS1922F) that could be used for multiple cycles within an autoclave.MG Materials and methods: Three batches of the DS1922F (150 samples) were used in this study that was conducted in a series. The first batch was challenged with 300 sterilization cycles within an autoclave and the data loggers evaluated to study failures and the reason for failure, make corrections and improve the prototype design. After changes made based on studying the first batch, the second batch of the prototype (150 samples) were challenged once again with 300 sterilization cycles within an autoclave and failure studied again in further improvement of the prototype. The final batch (3rd batch) of the prototype (150 samples) was challenged again but with 600 cycles to see how long they would last. Kaplan-Meier survival analysis analyses of all three batches was conducted (α = 0.05) and failed samples qualitatively studied in understanding the variables involved in the failure of the prototype, and in improving quality.

RESULTS

Each tested batch provided crucial information on device failure and helped in improvement of the prototype. Mean lifetime survival of the final batch (Batch 3) of prototype was 498 (480, 516) sterilization cycles in an autoclave.

CONCLUSION

In this study, the final batch of the DS1922F prototype data logger was found to be robust in withstanding the challenge of 600 autoclave cycles, with a mean lifetime of more than 450 cycles, multiple times more than prescribed number of cycles.

CLINICAL SIGNIFICANCE

Instrument reprocessing is among the important aspects of infection control. While stringent procedures are followed in instrument reprocessing within the clinic in assuring patient safety, regular use of sterilization process indicators and periodic biological validation of the sterilizer's performance is necessary. Chemical indicators for use in Autoclaves provide information on whether the particular cycle's parameters were achieved but do not provide at what specific point in time or temperature the failure occurred. Data loggers and associated reader software as the tested prototype in this evaluation (DS1922F), are designed to provide continuous information on time and temperature of the prescribed cycle. Data loggers provide immediate information on the process as opposed to Biological Indicators that take from days to a week in obtaining a confirmatory result. Further, many countries do not have the sterilization monitoring service infrastructure to meet the demands of the end users. In the absence of sterilization monitoring services, use of digital data loggers for each sterilization cycle is more pragmatic.

A pilot study of 2 methods for control of dental unit biofilms

OBJECTIVE

This pilot study was conducted to clinically evaluate 2 different concentrations of sodium hypochlorite for the control of dental unit biofilms and to evaluate the efficacy of pasteurizing dental treatment water for patient care.

METHOD AND MATERIALS

Two dental units with no prior chemical treatment were retrofitted with self-contained water systems for this study. One dental unit was treated with 5,000 ppm of sodium hypochlorite and the other with 1,500 ppm. Treatment consisted of a 10-minute contact with the dental unit water lines, followed by a flush with a buffer solution. A pasteurizer was equipped with autoclavable spigots to provide dental treatment water. Heterotrophic Plate Count Samplers (Millipore) water sampler kits were used to quantify microbial contamination as absolute colony-forming units per millimeter. Scanning electron micrographs were taken of water line lumens to compare pretreatment and posttreatment biofilms.

RESULTS

Pasteurized water was significantly less contaminated than was tap water. No significant difference in contamination was found between the 5,000 ppm and 1,500 ppm treatment chairs, either in the reservoir water or effluent water. Scanning electron micrographs demonstrated removal of the biofilms after sodium hypochlorite treatments, regardless of the concentration used.

CONCLUSION

There was no significant difference between the abilities of 5,000- and 1,500-ppm concentrations of sodium hypochlorite to control contamination of dental treatment water and biofilms. Pasteurization of tap water can reduce contamination; this water can be used as acceptable dental treatment water (< 200 CFU/mL).

Rationale for using single-use disposable air/water syringe tips

The research discussed in this article was conducted to study the inaccessible lumen surfaces of used and unused metal tips of air/water syringes using a light and a scanning electron microscope. Factors affecting the selection of air/water syringe tips were enumerated and compared. Patient and dentist acceptance of reusable and single-use air/water syringe tips for use in the oral cavity was evaluated. Although heat sterilization may destroy microbial organisms, the internal surfaces of metal tips were found to be rough, making them the focus of mineral and bioburden deposits. With regard to cleaning and sterilization, disposable tips were found to be more acceptable in clinical use than metal tips.

Hepatitis B virus infection. Current status in dentistry

HBV is a serious threat to members of the dental team. Dental personnel who are carriers of HBV, many of whom may not be aware of their status, are also at risk for hepatitis delta infection. In 1991, the Occupational Safety and Health Administration issued an instruction (in the Federal Register Part II, 29 CFR Part 1910.1030, 56-235)64175-64182) on Occupational Exposure to Bloodborne Pathogens--Final Rule, mandating that HBV vaccine be offered by employers free of charge to all at-risk employees. From a public and professional health perspective, such a mandate was a significant step forward. It is hoped that this update will assist employers to understand better their role in providing HBV vaccine and will assist employees in understanding why acceptance of vaccination is of prime importance to practitioners and staff, their families, and their patients.

Infection control in dental radiology

Although exposure to blood is rare in oral and maxillofacial radiology, contact with saliva occurs. Thus the spread of infectious diseases is possible through cross-contamination, and specific infection control protocols and unit dosing of items are needed. This article outlines rationale for implementing state-of-the-art infection control procedures; and explains federal standards and guidelines with an impact on infection control and occupational safety in dental radiology procedures.

Infection control in dental radiology

Although exposure to blood is rare in oral and maxillofacial radiology, contact with saliva occurs. Thus the spread of infectious diseases is possible through cross-contamination, and specific infection control protocols and unit dosing of items are needed. This article outlines rationale for implementing state-of-the-art infection procedures; and explains federal standards and guidelines with an impact on infection control and occupational safety in dental radiology procedures.

Diet and oral premalignancy in female south Indian tobacco and betel chewers: a case-control study

The diets of 158 tobacco/betel quid-chewing women diagnosed with oral premalignant lesions and 155 quid-chewing but lesion-free controls, frequency matched for age, tobacco/betel habits, and socioeconomic status, were assessed using a food frequency survey. Index scores generated from the food frequency survey indicated that the mean levels of consumption for foods of animal origin (p < 0.001), total vegetables and fruit (p = 0.001), vegetables alone (p = 0.006), fruits alone (p = 0.006), and green leafy vegetables (p = 0.015) were significantly lower in cases than in controls. The mean index score for cobalamin (vitamin B12) was lower in cases with a borderline significance (p = 0.05), whereas the indexes for folate and carotene were not significantly different. The analysis of index scores estimating the number of 100-g servings per week of foods of animal origin [meat, eggs, milk, curd (yogurt), fish] consumed revealed that women who ate fewer servings were more likely to have premalignant lesions than those who ate more animal foods [odds ratio (OR) 3.38, 95% confidence interval (CI) 2.07-5.54, p = 0.001]. The risk for low consumption of vegetables was not as significant as that for foods of animal origin. However, those eating low levels of vegetables and low levels of foods of animal origin were at the greatest risk for lesions (OR 5.38, 95% CI 1.72-22.17, p < 0.05). In South Indian female tobacco/betel chewers, a diet deficient in foods of animal origin appears to be a more significant risk factor for oral premalignancy than is a diet deficient in fruits and vegetables.