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适用于与热敏医疗设备兼容的传统病原体和朊病毒感染性病原体的新型医院消毒流程。

New hospital disinfection processes for both conventional and prion infectious agents compatible with thermosensitive medical equipment.

作者信息

Lehmann S, Pastore M, Rogez-Kreuz C, Richard M, Belondrade M, Rauwel G, Durand F, Yousfi R, Criquelion J, Clayette P, Perret-Liaudet A

机构信息

CNRS, Institut de Génétique Humaine UPR 1142, Université Montpellier 1, France.

出版信息

J Hosp Infect. 2009 Aug;72(4):342-50. doi: 10.1016/j.jhin.2009.03.024. Epub 2009 Jun 21.

Abstract

With the detection of prions in specific tissues in variant and sporadic Creutzfeldt-Jakob diseases, efficient decontamination for human transmissible spongiform encephalopathy (TSE) agents, that is compatible with medical equipment, has become a major issue. We previously described the cleavage of prions on exposure to copper (Cu) and hydrogen peroxide (H(2)O(2)) and have used this property to develop efficient prion decontamination processes. To validate this approach, in-vitro assays on genuine human and animal prions using both brain homogenates and steel wires to mimic contamination of medical equipment were conducted. In-vivo experiments using steel wire in the hamster 263 K model were then used to evaluate the effect on prion infectivity. Assays on classical pathogens following international norms completed these prion experiments. In-vitro data confirmed the full decontamination efficacy of H(2)O(2)/Cu on different TSE strains. Combination of Cu with peracetic acid, used for endoscope disinfection, also revealed improved prion decontamination. Animal assay demonstrated efficacy on TSE infectivity of H(2)O(2)/Cu alone or in combination with detergents (reduction factor > or =5.25 log(10)). Assays on classical pathogens confirmed the disinfection properties of the different processes. Taken together, these new disinfection processes are efficient for both conventional and prion infectious agents and are, compatible with thermosensitive medical equipment. They can be adapted to hospitals' and practitioners' routine use, and they present reduced risks for the environment and for healthcare professionals.

摘要

随着在变异型克雅氏病和散发性克雅氏病的特定组织中检测到朊病毒,针对与医疗设备兼容的人类可传播性海绵状脑病(TSE)病原体的高效去污已成为一个主要问题。我们之前描述了朊病毒在暴露于铜(Cu)和过氧化氢(H₂O₂)时的裂解,并利用这一特性开发了高效的朊病毒去污工艺。为了验证这种方法,我们使用脑匀浆和钢丝模拟医疗设备污染,对真正的人类和动物朊病毒进行了体外试验。然后,在仓鼠263K模型中使用钢丝进行体内实验,以评估对朊病毒传染性的影响。按照国际规范对经典病原体进行的试验完成了这些朊病毒实验。体外数据证实了H₂O₂/Cu对不同TSE毒株的完全去污效果。铜与用于内窥镜消毒的过氧乙酸的组合也显示出朊病毒去污效果的改善。动物试验证明了单独使用H₂O₂/Cu或与洗涤剂联合使用对TSE传染性的效果(降低因子≥5.25 log₁₀)。对经典病原体的试验证实了不同工艺的消毒特性。综上所述,这些新的消毒工艺对传统病原体和朊病毒感染性病原体均有效,并且与热敏医疗设备兼容。它们可以适应医院和从业者的日常使用,并且对环境和医护人员的风险降低。

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