McDonnell Gerald
STERIS Limited, Jay's Close, Viables, Basingstoke, Hampshire, UK.
J Perioper Pract. 2008 Jul;18(7):298-304. doi: 10.1177/175045890801800706.
Prion diseases present unique challenges to healthcare facilities, both in the care and treatment of patients. A significant cause for concern is in the routine reprocessing of medical devices used on patients and how disease transmission can be prevented on the reuse of devices. Investigations have shown that prion disease can be transmitted on medical devices, which can be a concern given the long incubation times associated with these diseases and that guidelines to control transmission only really apply in a small number of known or at risk cases. It is only recently that medical device-associated cleaning, disinfection and sterilization technologies have been investigated and the results of these studies are summarized in this report. The evidence would suggest that many simple decontamination steps can be applied to dramatically reduce the risks to patients, but the research has also given some surprises. Overall, it is reasonable to expect that standard precautions will be able to be applied both today as well as in the future to reduce the risk of prion disease transmission as well as the many other human pathogen concerns, although this may mean changes in some of our practices.
朊病毒疾病给医疗机构在患者护理和治疗方面带来了独特挑战。一个令人担忧的重要原因在于对患者使用过的医疗设备进行常规再处理，以及如何在设备重复使用时预防疾病传播。调查表明，朊病毒疾病可通过医疗设备传播，鉴于这些疾病的潜伏期较长，且控制传播的指南仅真正适用于少数已知或有风险的病例，这可能令人担忧。直到最近才对与医疗设备相关的清洁、消毒和灭菌技术进行了研究，本报告总结了这些研究结果。证据表明，许多简单的去污步骤可用于大幅降低对患者的风险，但研究也带来了一些意外发现。总体而言，可以合理预期，无论是现在还是将来，标准预防措施都能够用于降低朊病毒疾病传播风险以及许多其他人类病原体相关问题的风险，尽管这可能意味着我们的一些做法需要改变。
