Objective: This study was undertaken to evaluate the efficacy of 4 new low-temperature sterilization technologies: ethylene oxide with hydrochlorofluorocarbons, a liquid peracetic acid immersion system (Steris System 1 Processor), and 2 plasma sterilization processes that use vaporized hydrogen peroxide (Sterrad 100 and the Sterrad 100S). The Sterrad 100S system potentially improves sterilizer efficacy by using 2 cycles of a diffusion stage and a plasma stage per sterilization cycle.
Methods: Flat stainless steel carriers were inoculated with approximately 10(6) Bacillus stearothermophilus spores. These carriers were aseptically placed in the middle of 40 cm long stainless steel lumens (hollow tubes). Two types of lumen were used:(1) a lumen test unit with a removable 5 cm center piece (1.2 cm diameter) of stainless steel sealed to the narrower steel tubing by hard rubber septums and (2) a straight lumen. Three different diameters of the lumen test unit (1, 2, and 3 mm) and a single diameter of the straight lumen (3 mm) were studied. At least 40 replicates were performed for each type of lumen and sterilization method. After inoculation, the test unit was evaluated in 1 of the low-temperature sterilization technologies. After sterilization, the carriers were cultured in trypticase soy broth for 14 days at 55 degrees C and assessed for growth of B stearothermophilus spores.
Results: Our results demonstrated that ethylene oxide with hydrochlorofluorocarbons, the Sterrad 100s, and the Sterrad 100S half cycle were highly effective in killing approximately 10(6) B stearothermophilus spores present in the center of narrow-lumen stainless steel tubes. As the lumen diameter decreased with the lumen test unit, the Sterrad 100 demonstrated reduced ability to kill B stearothermophilus spores present on the carrier. At the smallest diameter tested (1 mm), the Sterrad 100 system failed 74% of the time. The Steris System 1 was not effective in completely eliminating the 10(6) inoculum under test conditions.
Conclusion: The Sterrad 100S was significantly superior to the Sterrad 100 system and equivalent to ethylene oxide with hydrochlorofluorocarbons. Introduction of this new Sterrad 100S system should improve the margin of safety and reduce processing costs by its use of a shorter cycle time. The Steris System 1 is limited by diffusion of the chemical sterilant into the interior of the lumen test unit.