Aeration time following ethylene oxide sterilization for reusable rigid sterilization containers: concentration of gaseous ethylene oxide in containers

Because ethylene oxide (EO) gas is toxic to humans, restrictions have been imposed on its use for sterilization, specifying allowable levels of residual EO remaining in sterilized apparatus and materials. However, the aeration time that optimizes the removal of the remaining EO when a rigid sterilizing container is used for a vessel had not been identified. Therefore, polyvinyl chloride, which easily adsorbs EO, was placed in rigid sterilizing containers, and aeration was carried out after 1, 8, 12, 17, and 24 hours. After standard EO sterilization, the EO concentrations remaining in the air in the rigid containers were measured. The results indicate that a period of 17 hours of aeration is appropriate when a rigid sterilizing container is used.     

Comparison of European and US biological indicators for ethylene oxide sterilization

Summary Biological indicators (BIs) are used to monitor ethylene oxide (EO) gas sterilization processes for medical devices. Several European and United States BIs for EO sterilization were evaluated for resistance according to both United States Pharmacopeia (USP) XXI and United Kingdom's (UK) tests for D-values. US BIs areB. subtilis var. niger spores on paper strips or disc carriers while European BIs use aluminum strips, quartz sand, or cotton yarn. Numerous BIs per run and runs per lot, as well as 2–3 different lots of BIs from each manufacturer, were examined. Both British and US BIs met their respective label claims for rates of inactivation when tested against British and USP EO test parameters, respectively. However, Danish BIs, on cotton yarn or quartz sand, were not inactivated following USP specifications during the exposure dwell times tested (600 mg L^–1 EO, 54°C, 60% RH, 0–110 min). The Danish BIs will require further testing in order for us to determine if theirB. subtilis spores are unusually resistant to EO or if the spore carrier substrates protect the spores from the sterilizing gas. In conclusion, the British and American BIs for EO sterilization are equivalent in resistance despite differences in carrier substrate, recovery conditions, calculation methods for D-values, and the labeled sterilization conditions for use.     

A stochastic model of bacterial spore germination

A stochastic approach is utilized to develop a model equation capable of describing the time course of germination in a sample of bacterial spores. The time required by a spore to complete the change characteristic of germination consists of an initial interval of no change followed immediately by the duration of the change itself. The experimental basis of the proposed model is the observation that each of these time intervals is distributed over a range of values in a spore sample. Mixed continuous and discrete probabilities are employed in arriving at an average single-spore germination curve which, to a different scale, describes the sample in time.     

Effects of temperature and relative humidity on biological indicators used for ethylene oxide sterilization.

A study was made to determine the effects of temperature and moisture on the D-value of a common biological indicator. Relative humidity (RH) was varied between 10 and 70% in increments of 10%, and temperature was varied between 30 and 70 degrees C in increments of 10 degrees C. Temperature was found to have a pronounced effect on the D-value. At 60% RH, the D-value varied from 15.0 min at 30 degrees C to 1.1 min at 70 degrees C. When RH was plotted against the average D-value at the various temperatures, the temperature curves at or above 50 degrees C were more erratic and the RH had a significant effect. The study showed that temperature and RH must be controlled if biological indicators are to be properly calibrated for use in ethylene oxide sterilization.     

Physico-chemical and toxicologo-hygienic aspects of using ethylene oxide for the sterilization of medical appliances. Part I. Sorption and diffusion of ethylene oxide in polymeric materials

Sorption ability of polymeric materials for medical purposes was studied with respect to the sterilizing gas - ethylene oxide - at 23, 35 and 55 degrees C. Sorption coefficients of ethylene oxide (EO) for the materials under study were calculated on the basis of results. Investigation of the kinetics of desorption of EO from the polymeric materials for medical purposes has shown that its content changes exponentially depending on the time of degassing. However, the lines in the 1g Q/Q0 - tau coordinates show a sharp break which testifies to a change in the mechanism of the process determining the character of the mentioned dependence. In the first region, corresponding to high concentrations and short periods of time, the determining process is diffusion while in the second region (low concentrations, long time intervals) - it is desorption of EO molecules most firmly bound to the polymer. Diffusion coefficients were calculated for the first region. The possibility of predicting the time periods of removing ethylene oxide from the polymeric materials was demonstrated for both stages on the basis of calculated diffusion coefficients and kinetic curves of degassing. Recommendations were given for the use of polymers for medical appliances and apparatuses.     

Studies on the sterilization of pharmaceutical base materials with ionizing radiation and ethylene oxide.

The use of ionizing radiation and ethylene oxide for the sterilization of pharmaceutical base materials of animal origin, used to produce organopreparations, was studied. The materials included liver extract, pancreas extract, dried thyroid and intrinsic factor. The effective sterilizing doses for the examined materials and dependence between effective ionizing radiation dose and primary contamination were determined.     

Physico-chemical and toxico-hygienic aspects of using ethylene oxide for the sterilization of articles for medical use. Part 2. Toxicity and risk of ethylene oxide entering the organism by non-inhalation routes

Results of investigation of toxicity of ethylene oxide (EO) entering the organism by routes other than inhalation (subcutaneous, intramuscular, intraperitoneal, intravenous) have demonstrated that the substance causes intoxication characterized by polytropic effect on many vitally important organs and systems. The changes in most of the indices under study show a phasic character and dose-time dependence. In both the acute and chronic effect, impairment of the state of the nervous system, the liver, kidney, blood and reactivity of the organism come to the foreground. After one single entrance, EO becomes manifest as a low-risk (class 4) compound (Limac for subcutaneous, intraperitoneal and intravenous routes being 5.0, 0.5 and 1.0 mg/kg, respectively); after repeated exposure as a high-risk (class 2) compound (Limchr for subcutaneous and intraperitoneal route being 1.0 and 0.1 mg/kg, respectively). In comparison with the subcutaneous route, the intravenous and intraperitoneal routes are more dangerous. The obtained parameters of EO toxicometry can be used as a basis for the calculation of safe levels of residual quantities of the compound in articles for medical use.     

Initiation of bacterial spore germination

To investigate the problem of initiation in bacterial spore germination, we isolated, from extracts of dormant spores of Bacillus cereus strain T and B. licheniformis, a protein that initiated spore germination when added to a suspension of heat-activated spores. The optimal conditions for initiatory activity of this protein (the initiator) were 30 C in 0.01 to 0.04 m NaCl and 0.01 m tris(hydroxymethyl)aminomethane (pH 8.5). The initiator was inhibited by phosphate but required two co-factors, l-alanine (1/7 of K(m) for l-alanine-inhibited germination) and nicotinamide adenine dinucleotide (1.25 x 10(-4)m). In the crude extract, the initiator activity was increased 3.5-fold by heating the extract at 65 C for 10 min, but the partially purified initiator preparation was completely heat-sensitive (65 C for 5 min). Heat stability could be conferred on the purified initiator by adding 10(-3)m dipicolinic acid. A fractionation of this protein that excluded l-alanine dehydrogenase and adenosine deaminase from the initiator activity was developed. The molecular weight of the initiator was estimated as 7 x 10(4). The kinetics of germination in the presence of initiator were examined at various concentrations of l-alanine and nicotinamide adenine dinucleotide.     

Bioengineering bacterial cellulose/poly(ethylene oxide) nanocomposites

By adding poly(ethylene oxide) (PEO) to the growth medium of Acetobacter xylinum, finely dispersed bacterial cellulose (BC)/PEO nanocomposites were produced in a wide range of compositions and morphologies. As the BC/PEO w/w ratio increased from 15:85 to 59:41, the cellulose nanofibers became smaller but aggregated in larger bundles, indicating that PEO mixed with the cellulose on the nanometer scale. Fourier transform infrared spectroscopy suggested intermolecular hydrogen bonding and also preferred crystallization into cellulose Ibeta in the BC/PEO nanocomposites. The fine dispersion of cellulose nanofibers hindered the crystallization of PEO, lowering its melting point and crystallinity in the nanocomposites although remaining bacterial cell debris also contributed to the melting point depression. The decomposition temperature of PEO also increased by approximately 15 degrees C, and the tensile storage modulus of PEO improved significantly especially above 50 degrees C in the nanocomposites. It is argued that this integrated manufacturing approach to fiber-reinforced thermoplastic nanocomposites affords a good flexibility for tailoring morphology and properties. These results further pose the question of the necessity to remove bacterial cells to achieve desirable materials properties in biologically derived products.     

Stability of Bacillus pumilus spore strips used for monitoring radiation sterilization.

Dried Bacillus pumilus spore strips had a stable D-value of 0.17 to 0.18 Mrad after 1 year at 5 or 25 C, but resistance was lost at 35 C. Refrigeration did not have an adverse effect on resistance to irradiation. The presence of water at the time of initial preparation increased this resistance to 0.23 to 0.25 Mrad. Proper drying is essential to achieve reproducible results in sterility tests using USP-type biological indicators.     

An autocatalytic model for bacterial spore germination.

The sigmoidal response observed in kinetic studies of germinating bacterial spores, using nephelometric techniques and phase contrast microscope photometry, is analysed by postulating an autocatalytic process. A scheme A to B to C, where B catalyses the degradation of A, is applied to describe the response accurately by three rate constants. The autocatalytic model is compared with previous proposals for quantifying germination studies and for interpreting the effect of different experimental conditions on initiation of germination. Its effectiveness is demonstrated by quantifying published results for a germinating single spore determined by phase contrast microscopy, and nephelometric results for spore suspensions, including the effect of temperature on the rate of initiation of germination. Although developed for quantitative analysis of spore germination, the model is applicable to other autocatalytic phenomena. To assist the experimentalist, a simple accurate method for deriving the three constants specifying the sigmoidal characteristic is described.