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Abstract

TRANSMISSION OF PRIONS BY REUSABLE MEDICAL DEVICES: EVALUATION OF PROFESSIONAL PRACTICES AND MANAGEMENT OF RISK IN MOROCCO

M. R. Sefrioui*, S. Ibnoulafkih, J. Elharti, Y. Sekhsokh, Y. Cherrah and S. Derraji

ABSTRACT

Introduction: Creutzfeldt-Jakob disease is a neurodegenerative disease of humans, caused by unusual infectious pathogens called prions or UnConventional Transmissible Agents (UCTA). Prions possess common properties of resistance to the usual methods of inactivating microbiological agents. Reusable medical devices (RMD) in hospitals are one of the most common and dangerous modes of transmission. The objective of our investigation is to evaluate the professional practices related to the treatment of RMD and the management of the risk of transmission by the RMD to the hospital. Material and Method: This is a prospective and descriptive study of professional practices in hospital sterilization services and units, over a period of 2 months, from October 02, 2017 to December 05, 2017. Our survey covered 39 sterilization services and units of 34 public or private health facilities in 3 major cities in Morocco. The results are exploited using computer software, survey and statistical data analysis, the Sphinx plus V.5. Results: Our survey reveals that 56% of health facilities visited does not have a special sterilization process to combat UCTA. All hospitals use pressurized steam sterilizers. Prion Standard Protocol (PSP) parameters for inactivation of UCTAs (134 ° C for 18min with a pressure of 2.1Bar) are consistent in 94% of sterilization units and services. Conclusion: The hospital civil liability branch has been in a deficit position for several years, which calls into question the very insurability of hospitals. New risks such as contamination with prion disease, the new variant of Creutzfeldt-Jakob disease, are making the situation worse. It is therefore more urgent than ever to introduce modern risk management.

Keywords: Prion - UCTA - Creutzfeldt-Jakob disease - Reusable Medical Devices - Transmission – Sterilization.


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