Comparison of ion plasma, vaporized hydrogen peroxide, and 100% ethylene oxide sterilizers to the 12/88 ethylene oxide gas sterilizer
Comparison of ion plasma, vaporized hydrogen peroxide, and 100% ethylene oxide sterilizers to the 12/88 ethylene oxide gas sterilizer
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DOI：
10.1086/647252
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发表时间：
1996-02-01
影响因子：
4.5
通讯作者：
Puchalski, T
中科院分区：
文献类型：
--
作者：
Alfa, MJ;DeGagne, P;Puchalski, T
目的：将使用12%环氧乙烷（EtO）和88%氯氟烃混合物作为灭菌气体（12/88）的标准气体灭菌器的性能与不使用氯氟烃的选定气体、离子等离子体和汽化过氧化氢（H2 O2）灭菌器进行了比较。对血清和食盐对灭菌器性能的影响进行了评价。测试载体（瓷和不锈钢的青霉素，或125-cm长的塑料管[内径3.2 mm]）接种大肠杆菌、粪肠球菌、铜绿假单胞菌、龟分枝杆菌、嗜热脂肪芽孢杆菌孢子、枯草芽孢杆菌孢子，和环状芽孢杆菌孢子，然后使用12/88、100%EtO、离子等离子体或蒸发的H2 O2进行灭菌。用和不用10%血清和0.65%盐制备细菌接种物，并且使用活菌计数确定灭菌后的残余细菌负荷。所有测试的灭菌器都能使青霉素上的细菌接种物减少6个对数（50），除非存在10%血清和0.65%盐，在这种情况下，使用100% EtO、蒸发的H2 O2，离子等离子体灭菌器不如12/88灭菌器有效。没有一种灭菌器可以根除10%血清和0.65%盐中10（6）CFU的所有细菌，当接种在狭窄的管腔内时。结论：100%EtO、汽化H2 O2和离子等离子灭菌器的安全裕度小于12/88灭菌器。当存在血清和盐时，所有灭菌器（包括12/88）都无法可靠地杀死狭窄管腔中的微生物，这引起了对软式内窥镜气体灭菌当前实践的担忧。
OBJECTIVE: The performance of a standard gas sterilizer, which uses a mixture of 12% ethylene oxide (EtO) and 88% chlorofluorocarbon as the sterilizing gas (12/88), was compared to selected gas, ion plasma, and vaporized hydrogen peroxide (H2O2) sterilizers that do not use chlorofluorocarbons. The effect of serum and salt an sterilizer performance was evaluated.DESIGN: Test carriers (porcelain and stainless steel penicylinders, or 125-cm lengths of plastic tubing [internal diameter of 3.2 mm]) were inoculated with Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, Mycobacterium chelonei, Bacillus stearothermophilus spores, Bacillus subtilis spores, and Bacillus circulans spores and then subjected to sterilization using 12/88, 100% EtO, ion plasma, or vaporized H2O2. The bacterial inoculum was prepared with and without 10% serum and 0.65% salt, and the residual bacterial load after sterilization as determined using viable counts.RESULT: All of the sterilizers tested effected a six-log(50) reduction of the bacterial inoculum on penicylinders, unless 10% serum and 0.65% salt were present, in which case the 100% EtO, vaporized H2O2, and ion plasma sterilizers were not as effective as the 12/88 sterilizer. None of the sterilizers could eradicate 10(6) CFU of all of the bacteria in 10% serum and 0.65% salt when inoculated inside a narrow lumen.CONCLUSIONS: The margin of safety for the 100% EtO, vaporized H2O2, and ion plasma sterilizers is less than that of the 12/88 sterilizer. The inability of all sterilizers, including the 12/88, to kill organisms in narrow lumens reliably when serum and salt were present raises concern about the current practice of gas sterilization of flexible endoscopes.