       Document 0755
 DOCN  M9620755
 TI    Resistance of microorganisms to disinfection in dental and medical
       devices.
 DT    9602
 AU    Lewis DL; Arens M; Department of Ecology, University of Georgia, Athens
       30602, USA.
 SO    Nat Med. 1995 Sep;1(9):956-8. Unique Identifier : AIDSLINE MED/96071605
 AB    The U.S. Centers for Disease Control and Prevention (CDC) recommends
       that only heat sterilization be used for all reusable devices entering
       the oral cavity. 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% glutaraldehyde. Disease
       transmissions have, however, been documented for endoscopes used in
       diagnostic and surgical procedures even after this treatment. In some
       dental devices, lubricants mix with potentially infectious patient
       materials, and organic debris has been observed in endoscopes after
       cleaning. 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 lubricant.
 DE    Bacterial Infections/BLOOD/*PREVENTION & CONTROL/TRANSMISSION
       Blood/MICROBIOLOGY/*VIROLOGY  *Dental Instruments
       Disinfectants/*PHARMACOLOGY  Disinfection/*METHODS
       Endoscopy/*INSTRUMENTATION  *Equipment Contamination  Equipment Design
       Gingiva/INJURIES  Glutaral/*PHARMACOLOGY  Heat  Human  HIV
       Infections/BLOOD/*PREVENTION & CONTROL/TRANSMISSION  HIV-1/*ISOLATION &
       PURIF/PHYSIOLOGY  Infection Control/*METHODS  *Lubrication  Petroleum
       Pseudomonas aeruginosa/*ISOLATION & PURIF/PHYSIOLOGY  Silicone Oils
       Sterilization  Support, Non-U.S. Gov't  T-Lymphocytes/VIROLOGY  Virus
       Cultivation  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

