Cleaning of blood-contaminated reprocessed angiographic catheters and spinal needles

OBJECTIVES: To evaluate the efficacy of a multistep cleaning method using a cleaner and a chemical disinfectant on blood-contaminated angiographic cat heters and spinal needles intended to be sterilized by hydrogen peroxide ga s plasma. METHOD: A mixture of radiopaque iodine contrast, bovine blood (plus ethylen ediaminetetraacetic acid), and a suspension of Bacillus subtilis spores was used to simulate catheterization and needle use. The mixture was a 1:1 pro portion of con trast and blood, inoculated so that there was a final concen tration of B subtilis spores of 1.0 x 10(6) colony-forming units (CFU)/mL. The inoculated devices were cleaned using a hydrogen peroxide solution at a concentration of 1.5 +/- 0.5 percent by weight, followed by distilled wate r with enzymatic detergent. After drying, the devices were sterilized with hydrogen peroxide gas plasma. RESULTS: The initial B subtilis spore concentration inoculated into cathete rs and needles varied from 2.12 x 10(4) to 2.74 x 10(7) CFU/mL. The residua l load of B subtilis spores after cleaning varied from zero (no count) to a maximum of 200 CFU/device. The multistep cleaning procedure was responsibl e for an average 5-log(10) reduction of B subtilis spores in the catheter a nd needle lumens. CONCLUSIONS: The hydrogen peroxide and enzymatic detergent aqueous solution s were shown to be efficacious when used as part of a multistep cleaning me thod. The low level of microbial contamination prior to sterilization with hydrogen peroxide gas plasma assured that the intended sterility assurance level was reached (Infect Control Hosp Epidemiol 2000;21:499-504).