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Preventing infection from reusable medical equipment: a systematic review

Sopwith, Will; Hart, Tony and Garner, Paul (2002) Preventing infection from reusable medical equipment: a systematic review. BMC Infectious Diseases, 2 . Article Number: 4. ISSN 1471-2334

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Abstract

Background: In 2000, the World Health Organization (WHO) had eight sets of conflicting recommendations for decontaminating medical equipment. We conducted a systematic review of observational studies to assist WHO in reconciling the various guidelines. This paper summarises the methods developed and illustrates the results for three procedures – alcohol, bleach and povidone iodine. Methods: We developed a Medline search strategy and applied inclusion criteria specifying the decontamination procedures of interest and an outcome of microbial destruction for a set of marker organisms. We developed protocols to assess the quality of studies and categorised them according to the reliability of the methods used. Through an iterative process we identified best practice for the decontamination methods and key additional factors required to ensure their effectiveness. We identified 88 published papers for inclusion, describing 135 separate studies of decontamination. Results: For disinfection with alcohol, best practice was identified from 23 studies as an exposure to 70–80% ethanol or isopropanol for at least 5 minutes. Bleach was effective for sterilization at a concentration of 5000 ppm for 5 minutes and for disinfection at 1000 ppm for 10 minutes (33 studies). Povidone iodine was only partially effective for disinfection at a concentration of 1% for 15 minutes (15 studies). Conclusions: Our findings provide an evidence base for WHO guidelines on decontaminating medical equipment. The results support the recommended use of bleach and show that alcohol could be used more widely than current guidelines suggest, provided best practice is followed. The effectiveness of povidone iodine is uncertain.

Item Type:Article
Additional Information:Published: 27 March 2002. 10 pages (page numbers not for citation purposes).
Uncontrolled Keywords:STAPHYLOCOCCUS-AUREUS; VIRUS TYPE-1; DISINFECTANTS; INACTIVATION; HIV; SUSCEPTIBILITY; ANTISEPTICS; EFFICACY
Subjects:R Medicine > R Medicine (General)
Departments, Research Centres and Related Units:Academic Faculties, Institutes and Research Centres > Liverpool School of Tropical Medicine
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DOI:10.1186/1471-2334-2-4
Publisher's Statement:© 2002 Sopwith et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
Related URLs:
Refereed:Yes
Status:Published
ID Code:717
Deposited On:26 Jun 2008 13:20
Last Modified:19 May 2011 21:10

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