Desinfecção térmica de produtos para saúde e sua preservação em sistema de barreira

Introduction: The control of healthcare associated infections and their prevention depend on multiple actions, the correct processing of Healthcare Devices and Equipment (HDE) items among them. General purpose: Evaluating the time for the preservation of the disinfection of semi-critical HDE items used in respiratory assistance undergoing thermal disinfection with controlled physical parameters (time and temperature), packed in a barrier system and stored in a Material and Sterilization Center (MSC). Method: Experimental study to validate the thermal disinfection of semi-critical HDE items used in respiratory assistance and their preservation. The amount of 272 fragments (3 cm long x 4 cm wide) of semi-critical HDE items used in respiratory assistance initially processed and sterilized in low temperature by means of hydrogen peroxide compose the sample. Later, the sample was sent to a microbiology laboratory and inoculated with an Artificial Test Soil (ATS) solution, Pseudomonas aeruginosa ATCC 27853, and saline solution at 0.9%. They were set aside for six hours for drying and then the fragments were sent back to the MSC for the processing of thermal disinfection at 93°C for 10 minutes. After thermal disinfection, the dried HDE items were packed in a barrier system deemed adequate for disinfected products, the packaged were heat sealed and stored in the MSC in controlled conditions of temperature and moisture. Of all the samples, 12 were used for the evaluation of the bacterial load of the artificially contaminated fragments (positive control), 120 had an immediate reading, and 140 had readings throughout 70 days. The fragments were sent to the laboratory for analysis, 260 fragments of HDE items in total having their collection carried out in 10 weeks. Sample seeding was carried out in Peptone Water in Plate Count Agar (PCA). The plates were incubated at 35 to 36oC, for 24 and 48 hours. At the end of each of the following 10 storage weeks, 14 collections were taken. Results: In different moments of the experiment, cleaning tests, called ATP Complete®, were carried out in 41 fragments (15%). Satisfying results were attained, reaching the approval criteria for cleanliness, which foresee a value between 0 and 45 RLUs. In the fragments tested, RLU measurements were below the maximum acceptable value: 35 fragments presented zero RLUs, five presented one RLU, and one presented three RLUs. In the laboratory tests carried out in the Microbiology Laboratory for the recovery and numbering of microorganisms of viable reference, the quantitative collections being done by using the microbiologic method of verification of microbial load of the samples (bioburden), all the analyzed fragments showed Absence of Bacterial Growth (ABG). After the process of thermal disinfection and storage for 70 days, there was no bacterial growth, which indicates safety in the re-usage of semi-critical products processed in controlled conditions. Conclusion: On evaluating the time for the preservation of the disinfection of semi-critical HDE items used in respiratory assistance, it was possible to validate thermal disinfection with controlled physical parameters (time and temperature), packed in a barrier system and stored in an MSC, by evidencing that these HDE items remained safe to be used up to 70 days after being processed. This study contests the existing paradigm, which says that disinfected HDE items must be used immediately and resulted in the production of an educational video aimed at diffusion.