![]() ![]() MTF: First, look at your mechanical and chemical indicators. ICC: Now that we have a positive spore test (BI failure), now what? This means that something has gone wrong with your sterilization process. If both the test and control BI are alive, this is called a positive spore test or BI failure. If both the test and control BI are killed, this is an indication that something is wrong with the lot of spores and the test should be repeated with another lot. A passing spore test is called a negative spore test. In other words, the spores from the test BI should have been killed, whereas the spores from the control BI should be alive. The final results should show the control BI has positive results for bacterial growth, but the test BI should not. Both the test and control BI should be incubated at the same time. The control BI should be from the same manufacturer and lot as the test BI, yet not processed through the sterilizer. A second control BI also has an important role in spore testing. The IFU will determine the placement and location of the test BI within the autoclave. First and foremost, always follow manufacturer’s instructions for use (IFU). ICC: Can you walk me through how to perform a spore test? This is an added step that requires diligence and compliance. With mail-in services, the record keeping is done by the monitoring service, whereas recordkeeping for in-office systems must be done by dental personnel. With either method, sterilization monitoring records (mechanical, chemical, and biological) must be maintained in accordance with state and local regulations. For in-office spore testing, it is important to use the proper incubation temperature and time specified by the manufacturer. So, there is no need to worry about inaccurate results due to delays in snail mail. There have been some concerns that postal delays may cause spore tests to arrive at the monitoring service days after the sterilization process, however, they do not influence spore incubation or final test results. Neither choice is better than the other, however, there are several considerations to keep in mind as you select whether to perform an in-office or mail-in monitoring service. MTF: Spore testing may be incubated using in-office incubation systems, or by mail-in monitoring services provided by medical companies, universities, and dental schools. ICC: I have seen in-office incubation systems for spore testing and mail-in monitoring services. In other words, if Geobacillus and Bacillus spores are killed, all other pathogens should be killed in the sterilization cycle as well. Inactivation of the BI strongly implies that other potential pathogens in the load have been killed. This monitoring process assesses the killing of highly resistant microorganisms (e.g., Geobacillus stearothermophilus for autoclaves and chemical vapor units, or Bacillus atrophaeus for dry heat autoclaves). BIs and spore tests remain the best assurance that sterilization equipment is functioning, and instrument processing procedures are being performed correctly. MTF: Yes, BIs and spore tests refer to the same monitoring procedure. ICC: I have heard of “biological indicators” and “spore tests.” Are these the same? Using mechanical and chemical monitoring, dental personnel can rest assured that unsterilized instruments will not be used for patient care. These monitoring methods may be the first indication something has gone wrong and may differentiate between processed and unprocessed items. Fluent (MTF): That is a great question! Both mechanical and chemical indicators are the first steps in quality assurance and should be performed for each sterilization cycle. Infection control coordinator (ICC): First, if mechanical and chemical indicators do not “prove” sterilization has taken place, why are these monitoring methods necessary?ĭr. This interview addresses why BIs are the best assurance that sterilization has occurred. Yet, neither of these methods guarantee sterilization-they merely detect procedural errors and equipment malfunctions. Chemical indicator tapes, strips, or tabs and marking on packaging materials change color when exposed to high temperatures or combinations of time and temperature. These parameters may be observed during the sterilization cycle and may serve as a first indication of any malfunction.Ĭhemical indicators (CI) use sensitive chemicals to assess the physical conditions during the sterilization process. Mechanical indicators assess the cycle time, temperature, and pressure found on displays and printouts of autoclaves. According to the Centers for Disease Control and Prevention (CDC), the ability of a sterilizer to reach conditions necessary to achieve sterilization should be monitored using a combination of mechanical, chemical, and biological indicators (BI). ![]()
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