Palenik C J, Burke F J, Bose M, Altweis M L
Department of Oral Biology, Indiana University School of Dentistry, USA.
J Indiana Dent Assoc. 1997 Spring;76(1):45-50; quiz 52.
The purpose of this study was to evaluate the effect that two steam autoclaves and an unsaturated chemical vapor sterilizer had on killing bacterial endospores present on commercial spore strips or applied to sterile anesthetic injection systems placed within sharps containers. Three types of sterilizers were used: a gravity steam autoclave, a high vacuum steam autoclave and an unsaturated chemical vapor sterilizer. The microbial challenge for the sterilizers were Bacillus stearothermophilus spores present on commercial spore strips or drawn into and applied onto sliding sheath anesthetic injection systems with anesthetic carpules attached. Spore-soiled items were placed into the middle of sharps containers three-quarters-filled with representative clinical waste and sterilized. If, after culturing, sterilization of all test items in a group was not achieved, additional sterilization time was applied. Spore strips were killed within a single cycle of each sterilizer. Spore-soiled injection systems and carpules could not be routinely sterilized in the gravity steam autoclave or unsaturated chemical vapor sterilizers, even after three consecutive sterilization cycles. These items, however, were sterilized by exposure to a single-treatment cycle in a high-vacuum steam autoclave. Results indicate that routine sterilization of spore contaminated anesthetic carpules or injection systems could not be accomplished in a reasonable amount of time using sterilizers commonly found in dental offices.
本研究的目的是评估两台蒸汽高压灭菌器和一台不饱和化学蒸汽灭菌器对杀灭商业芽孢条上或应用于置于锐器容器内的无菌麻醉注射系统上的细菌芽孢的效果。使用了三种类型的灭菌器:重力蒸汽高压灭菌器、高真空蒸汽高压灭菌器和不饱和化学蒸汽灭菌器。灭菌器面临的微生物挑战是商业芽孢条上存在的嗜热脂肪芽孢杆菌芽孢,或吸入并应用于附有麻醉药筒的滑动护套麻醉注射系统上的芽孢。将被芽孢污染的物品放置在装满代表性临床废物四分之三的锐器容器中间并进行灭菌。如果培养后一组中的所有测试物品未达到灭菌效果,则延长灭菌时间。每种灭菌器在一个单一周期内就能杀死芽孢条。即使经过连续三个灭菌周期,被芽孢污染的注射系统和药筒在重力蒸汽高压灭菌器或不饱和化学蒸汽灭菌器中也无法常规灭菌。然而,通过在高真空蒸汽高压灭菌器中进行单次处理周期,这些物品得以灭菌。结果表明,使用牙科诊所常见的灭菌器,无法在合理时间内对被芽孢污染的麻醉药筒或注射系统进行常规灭菌。