Rutala W A, Weber D J
Division of Infectious Diseases, University of North Carolina (UNC) School of Medicine and the Department of Hospital Epidemiology, UNC Health Care System, Chapel Hill, NC 27599-7030, USA.
Clin Infect Dis. 2001 May 1;32(9):1348-56. doi: 10.1086/319997. Epub 2001 Apr 10.
Prion diseases constitute a unique infection control problem because prions exhibit unusual resistance to conventional chemical and physical decontamination methods. Recommendations to prevent cross-transmission of infection from medical devices contaminated by Creutzfeldt-Jakob disease (CJD) have been based primarily on prion inactivation studies. The recommendations in this article consider inactivation data but also use epidemiological studies of prion transmission, infectivity of human tissues, and efficacy of removing microbes by cleaning. On the basis of the scientific data, only critical (e.g., surgical instruments) and semicritical devices contaminated with high-risk tissue (i.e., brain, spinal cord, and eye tissue) from high-risk patients--those with known or suspected infection with CJD--require special treatment.
朊病毒疾病构成了一个独特的感染控制问题，因为朊病毒对传统的化学和物理去污方法表现出异常的抗性。关于预防克雅氏病（CJD）污染的医疗设备导致感染交叉传播的建议主要基于朊病毒灭活研究。本文中的建议不仅考虑了灭活数据，还运用了朊病毒传播的流行病学研究、人体组织的传染性以及清洁去除微生物的效果。基于科学数据，只有来自高危患者（即已知或疑似感染CJD的患者）且被高危组织（即脑、脊髓和眼组织）污染的关键设备（如手术器械）和半关键设备需要特殊处理。
