Elimination of prion infectivity from surgical instruments
Research type
Research Study
Full title
Combined ultrasonically activated water stream (UAS) and novel disinfectant for variant Creutzfeldt Jakob (vCJD) disease decontamination of re-usable medical instruments.
IRAS ID
263743
Contact name
Charles W. Keevil
Contact email
Sponsor organisation
University of Southampton
Duration of Study in the UK
0 years, 6 months, 22 days
Research summary
Current reprocessing methods for reusable surgical instruments and endoscopes are not 100% efficient. The different forms of Creutzfeldt-Jakob disease can be potentially transmitted through instruments which come in contact with infectious tissues in a patient who unknowingly carried the disease prior to surgery. As a result some patients need to be informed and registered as "at increased risk" of developing a form of CJD, with all that implies in terms of personal distress and subsequent healthcare management.
Flexible endoscopes can't be heat-sterilised as they are partly made of plastic, and various bacterial infections through endoscopy have been reported. These are becoming more critical as endoscopic interventions are increasingly common and at the same time antimicrobial resistance is developing.
In most cases affected instruments are quarantined or disposed of, leading to delays and extra costs.
To try eliminating potential residual prion infectivity on reusable stainless steel instruments and flexible endoscopes we are testing a new ultrasound-activated stream UAS) device and a new chemical solution (SQ53) which demonstrated excellent antimicrobial capability in preliminary experiments.
In this project we will use CJD and vCJD brain tissue to spike surgical steel surfaces and test the capability of UAS and SQ53 to remove and/or inactivate CJD and vCJD infectivity in a Containment Level 3 laboratory. We will test residual prion infectivity on spike stainless steel wires using an in vitro cell assay we developed, as well as PMCA in collaboration with a specialist laboratory.REC name
East of Scotland Research Ethics Service REC 1
REC reference
20/ES/0030
Date of REC Opinion
27 Feb 2020
REC opinion
Favourable Opinion