Author: Mr.Masahiro Taoka, Kaikokai medical corporation, Meiko kyoritsu clinic(Japan)

Objective

1) Verify disinfection effect with Peracetic acid : Use double agent

2) To reduce disinfection time : Use single disinfectant for 1 day

Select disinfectant

•Specification of disinfectant used for dialysate line management

Stability of diluted peracetic acid disinfectant

*1 Peracetic acid disinfectant: PAA 4~4.5%, Acetic acid approx40%, H2O2 less than6%
*2 Diluted peracetic acid disinfectant was storage 28days in room temperature. After that, measured quantity of peracetic acid. Each initial value was set to 100 and the amount of peracetic acid was calculated in number of days.

What expect from Peracetic acid ?

•Peracetic acid : disinfection, sterilization

•Acetic acid : remove carbonate

•Hydrogen peroxicide : decomposing/removing the organic   substances

Disinfection effect of sodium hypochlorite and peracetic acid

Logarithmic Reduction Value (20℃×30min)

Effectiveness of peracetic acid  for spore bearing bacterium

Test method

•There are two independent of dialysate feeding apparatus supply for 41 bed of hemodialysis  devices.

• Two independent of dialysate feeding apparatus was washed by the following way that they were evaluated with water and in piping contamination.

Line 1  Common acid and Alkali(Sodium hypochlorite)
Line 2  Peracetic acid

Test method: disinfectant and diluted rate

Test method: Cleaning and Disinfection process

Line1. Common acid and Alkali(Sodium hypochlorite)

Mon, Wed, Fri

*night-storage

Tue, Thu, Sat

Line2  Peracetic acid *Use single disinfectant for 1 day

Mon, Wed, Fri

Tue, Thu, Sat

Evaluation method

  • Bacterium examination for dialysate feeding apparatus supply devise
      culture bacterium with “SensiMedia” for 7days
  • Measure endotoxin activity
      with EG Reader SV-12
  • Visual check
  • Evaluate 10 of sample from belonging different line
  • Survey period: Jan 2007 ~ June 2011

Results

Peracetic acid affect the below:

1.The endotoxin activity and the bacterium examination were below the standard for both ways.
ET: line 1) 0.085±0.128EU/L:n=1,061(Sodium hypochlorite)
       line 2)0.075±0.124EU/L:n=782(Peracetic acid)
Bacterium: 1 positive in Line 1 and Line2

2.No dirty in pipe for both ways.

3.It were able to enough time for washing RO devise due to been single agent.

4.Peracetic acid is expensive, but it saved water due to single agent .

Conclusion

•There are many kind of peracetic acid, so that The peracetic acid could be selected depend on the situation.

•Although there were not obvious effect in double agent, but it seems to be effective for prevention of bacteria.

• Effective for maintenance of RO equipment for facilities that conduct night dialysis.