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Journal of Clinical Microbiology, October 2006, p. 3728-3733, Vol. 44, No. 10
0095-1137/06/$08.00+0     doi:10.1128/JCM.01280-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Comparative Study of Surgical Instruments from Sterile-Service Departments for Presence of Residual Gram-Negative Endotoxin and Proteinaceous Deposits{triangledown}

I. P. Lipscomb,* A. K. Sihota, and C. W. Keevil

Environmental Healthcare Unit, School of Biological Sciences, University of Southampton, Southampton SO16 7PX, United Kingdom

Received 22 June 2006/ Returned for modification 31 July 2006/ Accepted 15 August 2006

The ineffective cleaning of surgical instruments may be a vector for the transmission of hospital-acquired infections. The aim of this research was to investigate whether further decontamination procedures need to be instigated in sterile-service departments (SSDs) to reduce the risk of nosocomial illnesses, such as endotoxemia, sepsis, or iatrogenic Creutzfeldt-Jakob disease (to date, 1,147 cases of confirmed Creutzfeldt-Jakob disease deaths in the United Kingdom since 1990 have been reported). Instrument sets were obtained from nine anonymous United Kingdom National Health Service (NHS) primary care trust SSDs. The investigation implemented an advanced light microscopy technique, episcopic differential interference contrast microscopy with the sensitive fluorescent reagents SYPRO Ruby and 4',6-diamidino-2-phenylindole dihydrochloride (DAPI), to detect proteinaceous and microbial contamination levels. Gram-negative lipopolysaccharide (LPS) endotoxin was monitored using a dansylated polymyxin B fluorochrome agent. None of the 260 instruments examined displayed signs of microbial colonization or LPS endotoxin contamination. However, over 60 percent of the instruments showed a high degree of protein soiling (0.4 to 4.2 µg protein/mm2). Some instruments appeared soiled with crystalline deposits that may consist of a potentially hazardous material contributing to inflammation and/or surgical shock. It is clear that the overall standard for cleaning must be raised in order to fulfill the imminent introduction of new European standards and to reduce the risk of cross-patient contamination and iatrogenic transmission.

* Corresponding author. Mailing address: Environmental Healthcare Unit, School of Biological Sciences, University of Southampton, Southampton SO16 7PX, United Kingdom. Phone: 023 80599280. Fax: 023 80594459. E-mail: i.lipscomb{at}soton.ac.uk.

{triangledown} Published ahead of print on 23 August 2006.

Journal of Clinical Microbiology, October 2006, p. 3728-3733, Vol. 44, No. 10
0095-1137/06/$08.00+0     doi:10.1128/JCM.01280-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Howlin, R., Harrison, J., Secker, T., Keevil, C. (2009). Acquisition of proteinaceous contamination through the handling of surgical instruments by hospital staff in sterile service departments. British Journal of Infection Control 10: 106-111 [Abstract]  
  • Lipscomb, I. P., Herve, R., Harris, K., Pinchin, H., Collin, R., Keevil, C. W. (2007). Amyloid-specific fluorophores for the rapid, sensitive in situ detection of prion contamination on surgical instruments. J. Gen. Virol. 88: 2619-2626 [Abstract] [Full Text]  


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