Abstract
The U.S. Centers for Disease Control and Prevention (CDC) recommends that only heat sterilization be used for all reusable devices entering the oral cavity1. However, chemical disinfection is still employed for reprocessing dental devices in many areas of the world. In an analysis of a Florida dental practice responsible for nosocomial human immunodeficiency virus (HIV) transmissions, the possible role of contaminated devices was deemed unlikely in part because they were subjected to high–level disinfection with 2% glutaraldehyde2. Disease transmissions have, however, been documented for endoscopes used in diagnostic and surgical procedures even after this treatment3. In some dental devices, lubricants mix with potentially infectious patient materials, and organic debris has been observed in endoscopes after cleaning4–6. We have investigated whether lubricants can render high–level chemical disinfection procedures ineffective and have addressed the role that some common devices may play in disease transmission. We report here that HIV in whole–blood samples and Pseudomonas aeruginosa in blood and plasma survived high–level disinfection when entrapped in lubricants used in dental handpieces and endoscopes. We also found that lubricated dental devices used to clean and polish teeth (prophylaxis angles) have the potential to transfer sufficient amounts of blood to infect human lymphocyte cultures with HIV. These results emphasize the need to subject reusable dental devices to a heat–sterilization protocol that penetrates the lubricant7.
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References
Recommended infection-control practices for dentistry. Morbid. Mortal. Wkly Rep. 42, 1–12 (1993).
Gooch, B. et al. Lack of evidence for patient-to-patient transmission of HIV in a dental practice. J. Am. dent. Assoc. 123, 38–44 (1993).
Spach, D.H., Silverstein, F.E. & Stamm, W.E. Transmission of infection by gastrointestinal endoscopy and bronchoscopy. Ann. intern. Med. 118, 117–128 (1993).
Martin, E.J. Good vibrations. Acad. Gen. Dentistry, AGD Impact 23, 6–16 (1995).
Bond, W.W., Ott, B.J., Franke, K.A. & McCracken, J.E. Effective use of liquid chemical germicides on medical devices: instrument design problems. in Disinfection, Sterilization, and Preservation 4th edn (ed. Block, S.S.) 1097–1106 (Lea & Febiger, Philadelphia, Pennsylvania, 1991).
Favero, M.S. Strategies for disinfection and sterilization of endoscopes: The gap between basic principles and actual practice. Infect. Control Hosp. Epidemiol. 12, 279–281 (1991).
Barnes, C.M., Anderson, N.A., Li, Y. & Caufield, P.W. Effectiveness of steam sterilization in killing spores of Bacillus stearothermophilus in prophylaxis angles. Gen. Dent. 42, 456–458 (1994).
Lewis, D.L., Arens, M., Harllee, R. & Michaels, G.E. Risks of infection with blood- and saliva-borne pathogens from internally contaminated impressions and models. National Association of Dental Laboratories. Trends & Techniques 12, 30–34 (1995).
Vesley, D., Norlien, K.G., Nelson, B., Ott, B. & Streifel, A.J. Significant factors in the disinfection and sterilization of flexible endoscopes. Am. J. Infect. Control. 20, 291–300 (1992).
Gerberding, J.L. Reducing occupational risk of HIV infection. Hosp. Pract. 26, 103–118 (1991).
Lewis, D.L. et al. Cross-infection potential with dental equipment. Lancet 340, 1252–1256 (1992).
Lewis, D.L. Lack of HIV transmission in a dental practice (letter.) Ann intern. Med. 122, 960 (1995).
Lewis, D.L. & Boe, R.E. Cross-infection risks associated with current procedures for using high-speed dental handpieces. J. clin. Microbiol. 30, 401–406 (1992).
Erice, A.K., Sannerud, J., Leske, V.L., Aeppli, D. & Balfour, H.H. Jr., Sensitive microculture method for isolation of human immunodeficiency virus type 1 from blood leucocytes. J. clin. Microbiol. 30, 444–448 (1992).
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Lewis, D., Arens, M. Resistance of microorganisms to disinfection in dental and medical devices. Nat Med 1, 956–958 (1995). https://doi.org/10.1038/nm0995-956
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DOI: https://doi.org/10.1038/nm0995-956
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