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Preventing infection from reusable medical equipment: a systematic review

Sopwith, Will, Hart, Tony and Garner, Paul ORCID: (2002) 'Preventing infection from reusable medical equipment: a systematic review'. BMC Infectious Diseases, Vol 2, p. 4.

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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
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: The electronic version of this article is the complete one and can be found online at:
Subjects: ?? R1 ??
WX Hospitals and Other Health Facilities > Hospital Administration > WX 167 Cross infection prevention and control
WX Hospitals and Other Health Facilities > WX 20 Research (General)
Faculty: Department: Groups (2002 - 2012) > International Health Group
Digital Object Identifer (DOI):
Related URLs:
Depositing User: Ms Julia Martin
Date Deposited: 26 Jun 2008 12:20
Last Modified: 06 Sep 2019 10:14


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