Residual protein levels on reprocessed dental instruments
Residual protein levels on reprocessed dental instruments
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DOI：
10.1016/j.jhin.2005.01.021
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发表时间：
2005-11-01
影响因子：
6.9
通讯作者：
Bagg, J
中科院分区：
文献类型：
--
作者：
Smith, A;Letters, S;Bagg, J
减少初始。灭菌前器械上的生物负载被认为可降低医源性克雅氏病的传播风险。根管锉用于根管预备，可能与来自上颌和下颌脑神经分支的神经物质密切接触并被其污染。本研究检查了22个牙科诊所清洁根管锉的方法，并对220个已使用、清洁、高压灭菌并被认为可重复使用的根管锉的可见碎屑和残留蛋白水平进行了评分。在解剖光学显微镜下检查后，对可见碎片进行评分。使用基于蛋白质与邻苯二甲醛/N-乙酰半胱氨酸反应的荧光测定法定量残留蛋白质。实践中使用的清洁根管锉的方法有很大的差异。清洁过程从用酒精浸渍的布擦拭到手工擦洗和/或使用超声波浴。在98%的文件上目视检测到表面碎片。所有样品均检测到残留蛋白。检查的文件（中位数：5.4微克;范围：0.5-63.2微克）。这些结果表明，在初级保健中常规再处理的一些手术工具的清洁是不完整的，不能排除这些手术工具是交叉感染的潜在来源。(c)2005年，医院感染协会。出版社：Elsevier Ltd. rights reserved.
Reduction of the initial. bioburden on instruments, prior to sterilization, is believed to reduce transmission risks of iatrogenic Creutzfeldt-Jakob disease. Endodontic files are used in the preparation of root canals and are likely to have close contact and become contaminated with neural material, from branches of the maxillary and mandibular cranial nerves. This study examined methods used by 22 dental practices to clean endodontic files, and scored visible debris and residual protein levels adhering to 220 dental endodontic files that had been used, cleaned, autoclaved and were deemed ready for re-use. Visible debris was scored after examination under a dissecting light microscope. Residual protein was quantified using a fluorescent assay based on reaction of proteins with o-phthaldialdehyde/N-acetyl cysteine. There was wide variation in the methods used by practices to clean endodontic files. The cleaning process varied from a wipe with an alcohol-impregnated cloth to hand scrubbing and/or use of an ultrasonic bath. Surface debris was visually detected on 98% of files. Residual protein was detected on all. the files examined (median amount: 5.4 mu g; range: 0.5-63.2 mu g). These results demonstrate that the cleaning of some instruments reprocessed routinely in primary care is incomplete, and such instruments cannot be excluded as a potential source of cross-infection. (c) 2005 The Hospital Infection Society. Published by Elsevier Ltd. All. rights reserved.