EFHSS Questions and Answers - Question Q00211

Hi my name Cristina. My answer now is about CJD. Please inform me about the precautions against CJD specialy for cleaning in washer disinfectors. Is there any special product for this treatment of surgical instruments. Please inform me also for detergents for this reason. (detergents for CJD in washer disinfectors).

Dear Christina

The infectious agents of Prion diseases like CJD and vCJD are proteins which firstly are very difficult to destroy and secondly are very sticky. The longer Prion-containing organic residues are left on a surface e.g. stainless steel, the more difficult it gets to remove the Prion proteins from these surfaces again. Taking these characteristic of Prions into account I would recommend two things:

1. Process instruments immediately after use. If this is not possible, immerse instruments immediately in a non-corrosive cleaning agent or in a non-protein-fixing disinfectant. Rinse instruments well with water before putting them into the washer-disinfector (prevention of foam which would hinder cleaning).
2. For cleaning in the washer-disinfector, use an alkaline cleaner at high temperature (the higher the better, you can go up to 90°C). High alkalinity (diluted solution with pH in DI water of around 12) at high temperature hydrolyses (destroys) proteins. Although I have no direct proof, this is certainly true for Prions too. It may be possible that milder procedures (required for delicate instruments e.g. optics, anodized aluminum etc.) could destabilize and/or remove Prion proteins as well, however I have not seen proofs for that. In this case, the pretreatment described in point 1, preferable with a cleaner, should always be done.

Kind regards
Urs Rosenberg

Dear,

The Hospital "Klinikum Grosshadern" in Munich/Germany uses a special reprocessing washing program in washer disinfectors. During this special washing program detergents based on caustic soda and detergents based on active chlorine are used but this machine washing program is only one part of the whole reprocessing of surgical instruments, which includes pre-soaking with an alkaline detergent and sterilization at 134°C for one hour.

Please contact the leader of this CSSD department in Munich - Grosshadern, Mr Ludwig Fesenmeier, address:
Klinikum der Universitat Munchen - Grosshadern
Marchioninistr. 15
D - 81377 Munchen
Telephon: +49 89 7095 0
Telefax: +49 89 7004418
eMail:

Best regards,

Dr. Jürgen Staffeldt
Chemische Fabrik DR. WEIGERT GmbH, www.drweigert.de
Anwendungstechnik neodisher
Muhlenhagen 85
D - 20539 Hamburg
Tel: 49 40/ 789 60 - 165
Fax: 49 40/ 789 60 - 123
email: