College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada.
BMC Oral Health. 2024 Nov 9;24(1):1361. doi: 10.1186/s12903-024-05152-2.
Quality assurance policies mitigate the risk of nosocomial infections from dental office instrument sterilization by assessing sterilizer performance through biological indicator (BIs) testing. This study aimed to evaluate the prevalence of failed sterilization cycles and their causes of failure for a period of eight years through database analysis of a quality assurance laboratory in the province of Saskatchewan, Canada.
A database of BIs (n = 198,771) performed by an independent quality assurance laboratory from 2015 to 2022 was analyzed. Dental offices (n = 362) inserted Sporview Biological Sterility Indicators strips in full sterilizer loads and mailed the processed BI tests to an external quality assurance laboratory for analysis. Samples were assessed based on a colorimetric method checking for changes in color and turbidity. Data was collected and statistical analyses were performed using IBM SPSS 28.0.
The overall failure rate throughout the study was 0.20%, and it decreased gradually from 0.51% (2015) to 0.15% (2022). On average, retests were conducted within 2 days of failure notification. The preferred method of processing was steam sterilization (98%), which had a steadily increasing utilization over time and displays a statistically lower failure rate (0.20%) as opposed to dry heat (1.30%) and chemical vapour (1.40%) sterilizers. Most BI failures were attributable to human error (91.80%), and equipment failures were significantly more likely to occur with dry heat or chemical vapour sterilizers (p < .001).
This study significantly contributes to the understanding of dental sterilizer performance in Canada. The low and decreasing sterilizer failure rates over the study period indicate safe dental office procedures and reduced potential for disease transmissions. The study highlights the effectiveness of steam sterilizers with remarkably low failure rates, while human error remains the primary cause of failures. Further research should focus on identifying factors leading to human error and interventions to minimize sterilization failures in dental settings.
质量保证政策通过通过生物指示剂 (BI) 测试评估消毒器性能，从而降低牙科器械消毒过程中医院感染的风险。本研究旨在通过对加拿大萨斯喀彻温省一个质量保证实验室的数据库进行分析，评估八年期间消毒循环失败的发生率及其失败原因。
分析了一个独立质量保证实验室在 2015 年至 2022 年期间进行的 BI（n=198771）数据库。362 家牙科诊所在满载消毒器中插入 Sporview 生物无菌指示剂条，将处理过的 BI 测试寄送到外部质量保证实验室进行分析。根据比色法检查颜色和浊度变化来评估样本。使用 IBM SPSS 28.0 收集和分析数据。
整个研究过程中总的失败率为 0.20%，且呈逐渐下降趋势，从 2015 年的 0.51%下降到 2022 年的 0.15%。平均而言，在接到失败通知后的 2 天内进行了重测。首选的处理方法是蒸汽消毒（98%），随着时间的推移，使用率稳步上升，且与干热（1.30%）和化学蒸汽（1.40%）消毒器相比，其失败率显著较低（0.20%）。大多数 BI 失败归因于人为错误（91.80%），且设备故障在干热或化学蒸汽消毒器中更有可能发生（p<0.001）。
本研究极大地促进了对加拿大牙科消毒器性能的理解。在研究期间，消毒器的低且呈下降趋势的失败率表明牙科诊室的程序安全，降低了疾病传播的可能性。该研究突出了蒸汽消毒器的有效性，其失败率极低，而人为错误仍是失败的主要原因。进一步的研究应侧重于确定导致人为错误的因素，并采取干预措施，以尽量减少牙科环境中的消毒失败。
