Sterile Processing

With 2010 coming to a close quickly, ICT presents the top news items and articles relating to disinfection, sterilization and sterile processing, ranked in order of popularity based on Web clicks by ICT readers.

Manufacturers make claims about their products' efficacy in killing disease-causing pathogens, but what do infection preventionists really know about the validity of these claims? In a series of articles, we'll take a look at what practitioners in infection prevention should understand about the science behind label claims and marketing hype, including the FDA clearance and EPA registration processes, as well as testing protocols that preceded a product's appearance in the marketplace. In this first article, we talk to Wallace Puckett, PhD, vice president of science and technology for STERIS Corporation, about the knowledge gaps that currently exist relating to research and development of disinfectants, antibacterials, antimicrobials, microbicides and sporicides.

Patients fitted with long-term indwelling bladder catheters often face a serious complication: bacteria, most commonly Gram-negative Proteus mirabilis, can easily colonize and encrust the catheter. This eventually leads to the formation of a crystalline biofilm, consisting of mucopolysaccharide, that blocks the normal flow of urine from the bladder. Current methods for unblocking encrusted catheters by mechanical means, such as saline solution, replacing the catheter, or by using agents that try to dissolve the biofilm crystals, do not provide satisfactory results.

Some people enjoy evaluating new technologies and sometimes it is part of their job description and they are overwhelmed by all the possibilities of products to review. Often the first person to evaluate a new technology or solution for an infection control-related problem is the infection preventionist (IP).

In the continual challenge faced by infection preventionists to drive down healthcare-acquired infection (HAI) rates, the impact of the environment as a reservoir of pathogens is becoming increasingly clear. It has been demonstrated that not only do pathogens shed by prior occupants of a room remain viable for prolonged periods, but that these present a significantly increased risk of infection to subsequent room occupants. While routine cleaning can reduce the microbiological burden in a patient room it does not always eliminate the presence of bacteria and hence risk of infection. Even where very stringent cleaning regimens are in place, it is a constant challenge to maintain high-quality cleaning in a room.

Modern medicine has advanced to the point that it seems almost unconscionable that certain preventable or treatable causes of illness and death still pose an enormous threat. Thomas Frieden, MD, director of the Centers of Disease Control and Prevention (CDC), has named six public health problems that he feels can be reduced. Healthcare-acquired infection (HAI) is one of the priorities identified by the CDC, along with smoking, AIDS, obesity/nutrition, teen pregnancy and auto injuries. There is no magic bullet that will stop hospital infections dead in their tracks, but it is a "winnable battle" as Frieden put it.

Although it is one of the most potent antimicrobials available, silver, in particular ionic silver, is safe. A naturally occurring element, silver has long been used as an antimicrobial; as early as 79 AD in Egypt it was used in long-term water storage, and in the 900s, Chinese emperors would only use silver eating utensils "to prevent poisoning."