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

• Published in: The Journal of hospital infection 2009-08, Vol.72 (4), p.342-350
• Main Authors: Lehmann, S, Pastore, M, Rogez-Kreuz, C, Richard, M, Belondrade, M, Rauwel, G, Durand, F, Yousfi, R, Criquelion, J, Clayette, P, Perret-Liaudet, A
• Format: Article
• Language: English
• Subjects: Animals; Bacteria - drug effects; Biological and medical sciences; Copper; Copper - pharmacology; Creutzfeldt–Jakob disease; Cricetinae; Cross Infection - prevention & control; Decontamination; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disinfectants - pharmacology; Disinfection - methods; Epidemiology. Vaccinations; Equipment and Supplies, Hospital; Fungi - drug effects; General aspects; Genetics; Human genetics; Humans; Hydrogen Peroxide - pharmacology; Infectious Disease; Infectious diseases; Life Sciences; Medical sciences; Mesocricetus; Mice; Neurology; Prion Diseases - prevention & control; Prion protein; Prions - drug effects; Viruses - drug effects
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2009.03.024

Summary 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 (H2 O2 ) 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 H2 O2 /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 H2 O2 /Cu alone or in combination with detergents (reduction factor ≥5.25 log10 ). 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.