Zur Aufbereitung von Medizinprodukten unter besonderer Berücksichtigung der Creutzfeldt-JakobKrankheit und ihrer Variante: Eine Betrachtung 20 Jahre nach dem Bericht der deutschen Task Force vCJK.

The novel emergence of variant Creutzfeldt-Jakob disease (vCJD) in the United Kingdom in 1995/96 as a result of the transmission of bovine spongiform encephalopathy (BSE) agents from cattle to humans triggered a previously unprecedented crisis in Europe at the interface of animal health and human public health. This prompted Germany to reconsider, among other things, the practice of reprocessing medical devices with regard to the unconventional BSE/ vCJD pathogens, so-called prions (from “proteinaceous infectious particles”). In 2002, a vCJD task force set up with this objective presented recommendations for minimizing/reducing the risk of vCJD transmission through surgical instruments and other medical devices. According to these recommendations, routine reprocessing should combine at least two procedures that are also (at least partially) suitable for decontamination/inactivation of these pathogens if there is no identifiable risk of contamination with prions. In practice, this includes in particular careful cleaning (decontamination), preferably with alkaline detergents, and subsequent sterilization with moist heat (“steam sterilization”) at 134°C with a holding time of 5 minutes. The validation of the processes is of great importance. From today’s point of view, the central recommendations of the vCJD Task Force for medical device reprocessing have proven to be sustainable with good practicability. The effectiveness of the recommended measures against prions has been confirmed on a broad basis in numerous studies. In line with the paradigmatically high demands that prions place on hygiene in the reprocessing of medical devices, this effectiveness in practice extends simultaneously to conventional pathogens such as bacteria, viruses or fungi. In perspective, this also applies at least in part to potential new challenges, such as those that have been discussed for some time with regard to self-replicating protein particles of Alzheimer’s or Parkinson’s disease and other protein aggregation diseases. [ABSTRACT FROM AUTHOR]