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Cleaning and Sterilization Protocol for Reused Cardiac Electrophysiology Catheters Inactivates Hepatitis and Coxsackie Viruses

Published online by Cambridge University Press:  21 June 2016

Julian D. Druce ,
Jessica S. Russell ,
Christopher J. Birch ,
Karen Vickery ,
Richard W. Harper  and
Joseph J. Smolich
Julian D. Druce
Affiliation:
Victorian Infectious Diseases Reference Laboratory, Melbourne Health, North Melbourne, Victoria, Australia
Jessica S. Russell
Affiliation:
Victorian Infectious Diseases Reference Laboratory, Melbourne Health, North Melbourne, Victoria, Australia
Christopher J. Birch
Affiliation:
Victorian Infectious Diseases Reference Laboratory, Melbourne Health, North Melbourne, Victoria, Australia
Karen Vickery
Affiliation:
Department of Infectious Diseases and Immunology, University of Sydney, Sydney, New South Wales, Australia
Richard W. Harper
Affiliation:
Harper and Smolich are from the Centre for Heart & Chest Research, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria, Australia
Joseph J. Smolich*
Affiliation:
Harper and Smolich are from the Centre for Heart & Chest Research, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria, Australia
*
Department of Cardiology, Royal Children's Hospital, Flemington Road, Parkville, 3052, Victoria, Australia
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Abstract

Objective:

To assess the efficacy of a standard cleaning and sterilization protocol employed during reuse of cardiac electrophysiology catheters on the infectivity of duck hepatitis B virus (DHBV; a surrogate for human hepatitis B virus), bovine viral diarrhea virus (BVDV; a surrogate for human hepatitis B virus), and human Coxsackie type B3 virus (CB3).

Setting:

Public health virology laboratory.

Methods:

Studies were performed on the distal, electrode-containing segments of 120 electrophysiology catheters previously used in up to 10 clinical procedures. Catheter segments were immersed for 1 hour in blood infected with high titers of DHBV, BVDV, or CB3. After air drying for 2 hours, subgroups of 8 catheters were subjected to no treatment, washing in general-purpose detergent, washing in enzyme cleaner, sterilization in ethylene oxide, or the full protocol of sequential detergent-enzyme cleaner-ethylene oxide exposure. Presence of residual virus was assessed by nucleic acid detection and infectivity studies.

Results:

DHBV nucleic acid was detected on catheters after individual steps and the full protocol, whereas BVDV and CB3 nucleic acids were detected after individual steps but not the full protocol. These findings were associated with the presence of infectious DHBV and CB3, but not BVDV, on catheters after washing in detergent or enzyme cleaner. However, ethylene oxide alone or the full protocol reduced infectivity of all three viruses to undetectable levels.

Conclusion:

These experimental studies provide strong evidence that appropriate cleaning and sterilization of reused electrophysiology catheters inactivates blood-borne viruses such as hepatitis B and C and Coxsackie type B3.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 8 , August 2005 , pp. 720 - 725
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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