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Disinfection of endoscopes contaminated with Cryptosporidium parvum oocysts
Journal of Hospital Infection (2000) 44: 151–154
Letters to the Editor doi: 10.1053/jhin.1999.0684, available online at http://www.idealibrary.com on
Disinfection of endoscopes contaminated with Cryptosporidium parvum oocysts Sir, We read with interest the article of J.A. Wilson and A.B. Margolin ‘The efficacy of three common hospital liquid germicides to inactivate Cryptosporidium parvum oocysts’1 Their study used a cell culture assay to determine infectivity of C. parvum oocysts and confirms our previous results obtained using an animal model.2 Our studies emphasise the limits of current endoscope disinfection procedures since after a 90 min exposure to glutaraldehyde, C. parvum oocysts remained viable. We have previously shown, however, that low temperature hydrogen peroxide gas plasma sterilization, a procedure found suitable for sterilizing fragile medical materials, is effective in disinfecting endoscopes contaminated by C. parvum oocysts.3 We think that this procedure, which is not mentioned in Wilson’s paper, provides an efficient sterilization system for medical instruments.
S. Vassal L. Favennec J. J. Ballet P. Brasseur
Laboratoire d’Hygiène Hospitalière, Centre HospitaloUniversitaire de Rouen, Laboratoire de Parasitologie Expérimentale, Centre HospitaloUniversitaire de Rouen Laboratoire d’Immunologie et d’Immunopathologie, Centre Hospitalo-Universitaire de Caen.
References 1. Wilson JA, Margolin AB. The efficacy of three common hospital liquid germicides to inactivate Cryptosporidium parvum oocysts. J Hosp Infect 1999; 42: 231–237.
Address Correspondence to: S. Vassal, Laboratoire d’Hygiene, Hospitalière CHU de Rouen, 76031 Rouen Cedex France.
0195–6701/00/020151 + 05 $35.00
2. Vassal S, Favennec L, Ballet JJ, Brasseur P. Lack of activity of an association of detergent and germicidal agents on the infectivity of Cryptosporidium parvum oocysts. J Infect 1998; 36: 245–247. 3. Vassal S, Favennec L, Ballet JJ, Brasseur P. Hydrogen peroxide gas plasma sterilization is effective against Cryptosporidium parvum oocysts. Am J Infect Control 1998; 26: 136–138. doi: 10.1053/jhin.1999.0689, available online at http://www.idealibrary.com on
Control of MRSA Sir, We feel the Working Party may have misunderstood our views.1 Our comment was not so much on the need to control MRSA, as on the wisdom of devoting major effort and considerable NHS resources towards the attempted control of spread of one particular organism which appears resistant to such efforts. The revised guidelines certainly received wide consultation within the UK as we acknowledged. However this does not necessarily imply approval of the issuing societies’ ordinary members whose opinion was sought only when a sizeable draft document was circulated, beyond the stage where its very existence might be questioned. The extent to which infection control workers actually support the guidelines is therefore unknown. Nevertheless, we do recognize the achievement in categorizing the evidence, particularly when the interventions are not amenable to judgement by the usual rigorous standards of clinical trials. The correspondence columns did not invite comments on the evidence as the Working Party suggested, but we did cite what we felt were important references. Moreover, it should be noted that the Working Party itself placed most evidence within Category II – i.e., supported by experts but generally falling short of proof – we suggest not all experts would have reached the same conclusions. We are unconvinced by claims that MRSA control programmes in a few countries have succeeded. The references cited in the guidelines refer to outbreak control in a single Dutch hospital, and to Denmark where the authors could not explain declining MRSA.
© 2000 The Hospital Infection Society
Letters to the Editor doi: 10.1053/jhin.1999.0684, available online at http://www.idealibrary.com on
Disinfection of endoscopes contaminated with Cryptosporidium parvum oocysts Sir, We read with interest the article of J.A. Wilson and A.B. Margolin ‘The efficacy of three common hospital liquid germicides to inactivate Cryptosporidium parvum oocysts’1 Their study used a cell culture assay to determine infectivity of C. parvum oocysts and confirms our previous results obtained using an animal model.2 Our studies emphasise the limits of current endoscope disinfection procedures since after a 90 min exposure to glutaraldehyde, C. parvum oocysts remained viable. We have previously shown, however, that low temperature hydrogen peroxide gas plasma sterilization, a procedure found suitable for sterilizing fragile medical materials, is effective in disinfecting endoscopes contaminated by C. parvum oocysts.3 We think that this procedure, which is not mentioned in Wilson’s paper, provides an efficient sterilization system for medical instruments.
S. Vassal L. Favennec J. J. Ballet P. Brasseur
Laboratoire d’Hygiène Hospitalière, Centre HospitaloUniversitaire de Rouen, Laboratoire de Parasitologie Expérimentale, Centre HospitaloUniversitaire de Rouen Laboratoire d’Immunologie et d’Immunopathologie, Centre Hospitalo-Universitaire de Caen.
References 1. Wilson JA, Margolin AB. The efficacy of three common hospital liquid germicides to inactivate Cryptosporidium parvum oocysts. J Hosp Infect 1999; 42: 231–237.
Address Correspondence to: S. Vassal, Laboratoire d’Hygiene, Hospitalière CHU de Rouen, 76031 Rouen Cedex France.
0195–6701/00/020151 + 05 $35.00
2. Vassal S, Favennec L, Ballet JJ, Brasseur P. Lack of activity of an association of detergent and germicidal agents on the infectivity of Cryptosporidium parvum oocysts. J Infect 1998; 36: 245–247. 3. Vassal S, Favennec L, Ballet JJ, Brasseur P. Hydrogen peroxide gas plasma sterilization is effective against Cryptosporidium parvum oocysts. Am J Infect Control 1998; 26: 136–138. doi: 10.1053/jhin.1999.0689, available online at http://www.idealibrary.com on
Control of MRSA Sir, We feel the Working Party may have misunderstood our views.1 Our comment was not so much on the need to control MRSA, as on the wisdom of devoting major effort and considerable NHS resources towards the attempted control of spread of one particular organism which appears resistant to such efforts. The revised guidelines certainly received wide consultation within the UK as we acknowledged. However this does not necessarily imply approval of the issuing societies’ ordinary members whose opinion was sought only when a sizeable draft document was circulated, beyond the stage where its very existence might be questioned. The extent to which infection control workers actually support the guidelines is therefore unknown. Nevertheless, we do recognize the achievement in categorizing the evidence, particularly when the interventions are not amenable to judgement by the usual rigorous standards of clinical trials. The correspondence columns did not invite comments on the evidence as the Working Party suggested, but we did cite what we felt were important references. Moreover, it should be noted that the Working Party itself placed most evidence within Category II – i.e., supported by experts but generally falling short of proof – we suggest not all experts would have reached the same conclusions. We are unconvinced by claims that MRSA control programmes in a few countries have succeeded. The references cited in the guidelines refer to outbreak control in a single Dutch hospital, and to Denmark where the authors could not explain declining MRSA.
© 2000 The Hospital Infection Society