potassium-permanganate and Creutzfeldt-Jakob-Syndrome

In this three-stage study, we test the hypothesis that supplementary cleaning with potassium permanganate > or =4 mg.l(-1) eliminates protein and particle contamination from the reusable Classic laryngeal mask airway. The first stage involved supplementary cleaning of 70 1 x 1 cm segments from deliberately contaminated laryngeal mask airways using potassium permanganate at 0, 2, 4, 8, 16, 32 and 64 mg.l(-1) and testing for protein staining. This showed that the lowest concentration required to eliminate protein contamination was 8 mg.l(-1). The second stage involved supplementary cleaning of 50 used laryngeal mask airways with either potassium permanganate 8 mg.l(-1) or saline and testing for protein staining. This showed that protein contamination was lower in the potassium permanganate group (p < 0.00001): all laryngeal mask airways in the control group and none in the potassium permanganate group were contaminated. The third stage involved scanning electron microscopic examination of 1 x 1 cm segments from three laryngeal mask airways used in the control group, three from the potassium permanganate group, plus three brand new laryngeal mask airways. The mean density of > or =1 mum surface particles was lower in the potassium permanganate 8 mg.l(-1) than the control group (21 vs. 121 .cm(-2), p < 0.0001) and was similar to brand new laryngeal mask airways (24 .cm(-2)). We conclude that supplementary cleaning with potassium permanganate 8 mg.l(-1) eliminates protein deposits from reusable laryngeal mask airways and reduces particle contamination to similar levels to brand new laryngeal mask airways.

Topics: Creutzfeldt-Jakob Syndrome; Cross Infection; Disinfectants; Disinfection; Dose-Response Relationship, Drug; Equipment Contamination; Equipment Reuse; Humans; Laryngeal Masks; Microscopy, Electron, Scanning; Potassium Permanganate; Proteins

A variety of disinfection procedures were tested on two strains of scrapie agent, treated either as brain macerates (autoclaving) or as 10% homogenates (chemical treatments). It is suggested that a given treatment should produce a titre loss, of both strains of scrapie, of at least 10(4) units before it be regarded as useful for the disinfection of the agents of scrapie and Creutzfeldt-Jakob disease (CJD). By this criterion, treatment at room temperature with about 4% Hycolin (0.6% chlorinated phenols), 0.2% permanganate, 5% Tego (dodecyl-di(aminoethyl)-glycine) or 5% sodium dodecyl sulphate (SDS) are unsuitable. However, data indicate that SDS might be used to reduce the heat stability of scrapie agent. Hypochlorite (Sterilex) was the only satisfactory chemical reagent tested. At least 10(4)-10(5) units of infectivity were lost by treatment with hypochlorite containing 1,000 ppm available chlorine after a 4-16 h exposure, or containing 10,000 ppm available chlorine after a half-hour exposure. The latter result points to the use of concentrated hypochlorite (about 2% available chlorine; approximately 20% Sterilex) to decontaminate surfaces. We suggest that the cleaning action of SDS, or other strong detergents, might also help to decontaminate surfaces, but studies on this are needed. Autoclaving at 126 degrees C for 1-2 h reduced titres by 10(3)-10(7) units, depending on the strain of agent. However, total disinfection of brain containing high titres of infectivity was approached only at 136 degrees C when titre losses of about 10(6) units were obtained by autoclaving for 4-32 min. Further studies are needed before we can make simple, general recommendations for the disinfection of CJD agents in hospital practice.

Topics: Animals; Creutzfeldt-Jakob Syndrome; Disinfection; Glycine; Humans; Hypochlorous Acid; Mice; Mice, Inbred Strains; Phenols; Potassium Permanganate; Prions; Scrapie; Sheep; Sodium Dodecyl Sulfate; Sterilization