Deactivation of Prions in the Healthcare Setting Prions are infectious agents composed entirely of a protein material which is transmissible to other prion proteins leading to disease in a manner that is epidemiologically comparable to the spread of viral infection. Prions composed of the prion protein are believed to be the cause of transmissible spongiform encephalopathies among other diseases. All known prion diseases are untreatable and fatal.
. Prions, however, are infectious by their effect on normal versions of the protein. Sterilizing prions, therefore, requires the denaturation of the protein to a state in which the molecule is no longer able to induce the abnormal folding of normal proteins. In general, prions are quite
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Chemical disinfectants and common thermal or ionizing treatments do not effectively denature the prion particles. Traditional means of instrument decontamination is not practical for prion-infected utensils. The recommended prion decontamination protocols for reusable surgical instruments and surfaces recommended by The World Health Organization and The Center for Disease Control and Prevention have been published and are readily available on CDC's website (http://www.cdc.gov/prions/cjd/infection-control.html) and are detailed below.
The three most stringent sterilization methods for heat-resistant instruments described in Annex III of the WHO guidelines are listed below; the methods are listed in order of more to less severe treatments. Sodium hypochlorite may be corrosive to some instruments, such as gold-plated instruments. Before instruments are immersed in sodium hypochlorite, the instrument manufacturer should be consulted about the instrument's tolerance of exposure to sodium hypochlorite. Instruments should be decontaminated by a combination of the chemical and recommended autoclaving methods before subjecting them to cleaning in a washer cycle and routine sterilization.
1. Immerse in a pan containing 1N sodium hydroxide (NaOH) and heat in a gravity displacement autoclave at 121°C for 30 min; clean; rinse in water; and subject to routine sterilization.[CDC NOTE: The pan containing
Wipe the gel off the transducer with a soft towel and clean under running water with nonabrasive liquid soap while wearing gloves. After washing the transducer, make sure that it is clean, then use a disposable paper towel and submerge the transducer into the disinfectant depending of the classifications mentioned earlier.
It is also important to keep learning about the new disinfectants that come out; there are constant upgrades and improvements being made with these products. There are so many different types of disinfectants so it’s important for you to choose the one that’s best suited for you. When looking for a disinfectant it’s also important to pick one that has an efficacy claim on the label. Efficacy means that it is able to produce and effect, it is also the effectiveness of the products ability to kill organisms when used correctly. Disinfectants also require upkeep; you have to be sure to change after the period of time recommended by the manufacturer. It is important to always wear gloves and safety glasses when handling disinfectant solutions. You should always keep an MSDS for the disinfectant, and always use tongs when removing items from disinfectant. You never want to let a disinfectant come in contact with your skin, if you ever do you should immediately wash with soap and warm water, rinse, and dry thourghly. Always dilute products as specified of the instructions on the label. The most common disinfectant in spas is Quaternary ammonium compounds, or “Quats”. Quats usually disinfects in ten minutes, some contain antirust ingredients so if you leave tools in the solution for too long it can cause dulling or damage. After they are in the solution for the specified time you should rinse, dry, then store in a clean, covered
| UNIT 4222- 264 THE PRINCIPLES OF INFECTION PREVENTION AND CONTROL | | | |
6. The disks in the 0.00% solution were transferred to an agar plate held next to the blue flame using the sterilized tweezers. Excess disinfectant was removed from the disks by wiping on the side of the well of the spotting tile. When the 5 disks were positioned (refer to Figure 1 below) the lid was replaced and sticky taped down. A label was added indicating the concentration of disinfectant.
Humans have to deal with many different diseases and the ones most disliked are the ones with no cures. Like cancer, transmissible spongiform encephalopathies have no cure, but they are more rare. These diseases are prion diseases which cause the brain to deteriorate. Prions are proteins that sometimes behave like viruses, which mean that they should have some form of nucleic acid, but since they don’t, they cause abnormalities. The nervous system contains many normal prions, but when an abnormal prion comes along, it transforms all the normal prions into abnormal ones. Bovine spongiform encephalopathy is found in cattle, but it can be transmitted to humans.
Cleaning removes organic matter, and most micro-organisms it does not destroy all micro-organisms, this method also can be used prior to the sterilisation or disinfection of equipment Cleaning is a low grade form of decontamination, when a piece of equipment has not been in contact with a patient or a patient who has healthy unbroken skin. Cleaning is accomplished by using hot water with a detergent using a disposal cloth. I use this process as a social clean prior to the three-step wipe method for the flexible endoscopes we use in the department. When I have finished with the cloth it is disposed of in the yellow clinical waste along with the gloves. When cleaning equipment I ensure they are dried properly to prevent contamination.
Contact precautions include: the patients being placed in private rooms, performing proper hand hygiene with antimicrobial soap and water, using friction for 15 seconds, and using gloves and gowns during patient care (Keske and Letizia 332). “One should also ensure adequate cleaning and disinfection of environmental surfaces and reusable devices. The uses of both buffered and buffered phosphate hypochlite solutions (bleach) have been shown to decrease the rate of C. difficile contamination and helps in reducing Clostridium Difficile associated disease (CDAD) rates” (Patel 104).
All areas that are being used for healthcare activities should be cleaned with either disinfectant wipes each morning and in between patients/procedures. Equipment should be all new out of the packets and clean. For things more major such as vasectomy’s, minor surgery or family planning clinics, areas should be cleaned everywhere with a disinfectant fluid and also with wipes, gloves should always be worn as well as other PPE such as aprons and hats. All equipment should be new from the packet and only touched by the person who is using
Sterile Processing compromises a service of which the medical and surgical supplies of any medical facility’s equipment and instrumentation- sterile or non-sterile are cleaned, prepared, processed, stored, and distributed throughout the healthcare facility. There are several functions of this highly skilled team perform on a daily basis from decontamination to the sterilization of high risk medical implant devices. They are the first line of defense in infection prevention for any patient receiving medical treatment in healthcare facilities. Japp (2014) affirmed the importance of properly processing medical devices performed by Sterile Processing technicians for patient safety by stating a critical point “Not following the correct process can be detrimental to the patient as the device that we are assuming is safe for the patient may all actually cause severe illness or death” (p.
The last form of sterilization I am going to talk about is cold sterile. The reason for cold sterile is not all items can go into heat sterilization. Liquid sterilant, such as 2% to 3.4% glutataldehyde, must be used for this type of sterilization. In order for the cold sterile to work the items must be fully submerged for no less than 10 hours, anything less than that would only be disinfection. This form of sterilization also requires a material safety data sheet due to it being a chemical.
Proteinaceous Infectious Particles, commonly known as Prions, are extremely rare misfolds of the protein PrPc, which cause fatally neurodegenerative diseases, and are theorized to be infectious only by the protein itself (U.S National Library of Medicine, 1998). This “protein-only theory” is still heavily debated today, as some scientists deny the theory, and there isn’t a significant amount of evidence on each side to qualify the theory or disprove it (Soto, C. 2011). The base “Prion” protein is encoded in the gene PRNP, while being non-infectious. Prions are most commonly found in human prion diseases, but they can also be in other animals in the form of Mad Cow Disease and Chronic Wasting Disease, classified as Bovine Spongiform Encephalopathies
While dysfunction of prion proteins remains the most widely accepted etiology of BSE, the USDA suggests there may be two other possible theories that could better explain the manifestation of BSE: the virino theory and the virus theory. However, both theories pale in comparison to the robust evidence in support of the prions theory. A major argument that works against both the virino theory and virus theory is that throughout several studies, the use of various treatments known to damage or inhibit nucleic acids have had no effect on the transmissibility of BSE. Interestingly, prion proteins lack nucleic acids – making them an excellent candidate as the infectious agent responsible for the development of bovine spongiform encephalopathy.
Prions are a type of protein found naturally in the brain and other regions of the central nervous system. The diseases associated with
These potentially infectious items need to be dealt with as soon as possible to reduce the risk of cross contamination and infection (HSE 2011). Standard precautions and principles must be adhered to, not only to protect the patient but also to protect members of the team who care for them.
The aggregation of prion proteins and their transmissibility from one cell to another has been shown to be evident (Cushman et al.; Goedert et al. 2010), therefore strongly suggesting that these events may play a role in pathogenesis for many diseases, including both AD and PD. While none of these diseases is infectious in an identical way as