Author: Simone Harland
Hamburg, 22 February 2018
The 10th Hamburg Symposium organized by Chemische Fabrik Dr. Weigert GmbH dealt with topical issues related to hygienic aspects of medical device reprocessing. The main focus was on the prionicidal reprocessing of instruments and on increasing the safety of the reprocessing process. Following the welcome speech by Bernd Stranghöner, the some 100 delegates assembled in the Hamburg Kunsthalle (Hamburg Festival Hall) also learned about reprocessing design-critical instruments.
In the first lecture Prof. Dr. med. Walter J. Schulz-Schaeffer from the Institute of Neuropathology of the University of Homburg/Saarland reported on the latest insights into prions and decontamination measures. He explained that prions were proteins that occurred in both a physiological and pathogenic form. The pathogenic prion proteins transmissible to humans could enter the body via contaminated foodstuffs (e.g. bovine spongiform encephalitis [BSE] in cattle) or iatrogenic routes. Both these transmission pathways were implicated in variant Creutzfeldt-Jakob disease (vCJD) which was always fatal. Variant CJD belonged to the group of transmissible spongiform encephalopathies (TSEs) which resulted in spongiform changes to the brain tissue, giving rise, inter alia, to dementia.
The speaker continued by stating that prions were resistant to the reprocessing methods designed to inactivate nucleic acids, hence protein denaturation measures were needed to that effect. Therefore a good standard of hygiene was required for medical device reprocessing to prevent iatrogenic transmission. Schulz-Schaeffer pointed out that each instrument, and each device, had to be reprocessed as if it had come into contact with a patient infected with CJD – comparable to the measures taken for prophylaxis of hepatitis. Hence, alkaline cleaning or obligatory steam sterilization at 134 °C for 18 minutes or alternatively alkaline cleaning of instruments, combined with steam sterilization of medical devices at 134 °C with a holding time of 5 minutes, was needed. Schulz-Schaeffer stated that the latter was the better method of protection against prions.
Read more in Steri-World Issue 02/18.