A neurosurgical theatre receives instruments that were used on a patient who later died of sporadic Creutzfeldt-Jakob disease. According to recommended practice for prion-contaminated reusable instruments, the most appropriate reprocessing protocol is:
- A Immersion in 1N sodium hydroxide followed by autoclaving at 134 degrees Celsius, or single-use disposal by incineration ✓
- B Immersion in 2% glutaraldehyde for 10 hours followed by normal steam sterilisation
- C Standard autoclaving at 121 degrees Celsius for 15 minutes after routine detergent washing
- D Pasteurisation at 75 degrees Celsius for 30 minutes followed by ethylene oxide sterilisation
Correct answer: A. Immersion in 1N sodium hydroxide followed by autoclaving at 134 degrees Celsius, or single-use disposal by incineration
Explanation
Prions resist conventional steam sterilisation, glutaraldehyde, formaldehyde and ethylene oxide. Recommended protocols combine exposure to 1N sodium hydroxide with autoclaving at 134 degrees Celsius, and disposable instruments or tissues from definite CJD cases should be incinerated. Option C fails because standard autoclave cycles do not reliably inactivate prion infectivity, and option B fails because glutaraldehyde has virtually no activity against prions despite its sporicidal action.
Reference: Ananthanarayan and Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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