Monitoring dental sterilizers' effectiveness using biological indicators.

The purpose of this study was to evaluate the effectiveness of dental office sterilizers as measured by their ability to kill bacterial spores present on biological indicator strips. The biological indicators used in this study contained two different spores, Bacillus stearothermophilus and Bacillus subtilis (Spordi, AMSCO/Medical Products). Ten spore test strips were sent to 87 dental offices; 51 sterilizers were tested. Office personnel were instructed to place four strips in the center of a normal sterilization load and process the load. The procedure was repeated on a second day. The processed strips, along with two unprocessed control strips, were returned by mail for laboratory culturing. The results indicated the overall failure rate (positive test) of sterlizers tested for both days was 51% at the culturing temperature of 37 degrees C and 33.3% at 55 degrees C. McNemar's test indicated a significant difference (p less than .03) in sterilization failures associated with the type and number of microorganisms present on the test strips. This study also showed that the more times a sterilizer was tested, the more likely a failure would occur. Overall, an alarming number of sterilizers (64.7%) were not effective in killing all the spores present on the indicator strips. When office personnel were given information for improving sterilizer performance, there was a noticeable reduction in sterilization failures following retesting.