ENZYME USE IN MEDICAL DEVICE CLEANING

ENZYME USE IN MEDICAL DEVICE CLEANING How Can We Improve Hospital Hygiene Through Biology? The annual cost of hospital-acquired infections (HAI) to the United States ranges between USD 28,000 and USD 45,000 on average, and it is estimated to cost approximately 72,000 lives per year. There are many ways to reduce HAI, but in this context, the cleaning of surgical instruments is critical, and enzymes are among the key components used in cleaning. By using enzymes correctly, you can improve cleaning and hygiene performance.

What Are Enzymes?

Enzymes are proteins that act as catalysts and accelerate chemical reactions. They can be found everywhere—from the ocean floor to our garden at home and even inside our bodies.

Where Are Enzymes Used Today?

People have used enzymes in baked goods and cheese production for thousands of years. While enzymes continue to serve these fields, enzyme science has developed rapidly over time, creating opportunities for new applications in many areas of industry. Today, enzymes are used in the production of many products that enter our daily lives, such as sugar, yogurt, textiles, and ethanol. Similarly, as an ingredient in detergent products, they are routinely used to remove stains on textiles, food residues on dishes, and patient stains on endoscopy and surgical instruments.

Use of Enzymes in Medical Device Cleaning

In recent years, various enzymatic detergents have been developed specifically for cleaning reusable medical devices. Studies have shown that enzymatic products in these applications increase detergent performance compared to detergents without enzymes.

Enzymes

Are biomolecules that accelerate reactions, and certain types specifically target stains on medical devices. • They are gentle on delicate medical instruments and equipment. Compared to alternative applications, they offer much safer solutions for sensitive and expensive equipment. • They are biodegradable. • When factors such as temperature, dosage, and time are optimized, they improve cleaning effectiveness. Enzymatic detergents also comply with guidelines accepted by the FDA and CDC, such as AAMI ST79.

Optimizing Medical Device Cleaning with Enzymes

Insufficient cleaning of medical devices can have serious consequences, which not only means significant costs for hospitals but also poses a serious potential risk in terms of loss of life. Today, medical device cleaners may not perform effectively enough to meet expectations on clinical stains. Enzymatic detergents have been used for the past ten years in cleaning reusable medical devices, and studies show significant performance improvements compared to non-enzymatic detergents. • 34% of operating room delays are due to insufficient cleaning before sterilization. • These delays cost approximately USD 100 million per year in the United States alone and result in 43,000 hours of delays. • Hospital-acquired infections (HAI) cause approximately USD 30 billion in costs per year, including medication and treatment expenses, and 72,000 deaths.

How Do Enzymes Work on Clinical Stains?

Enzymes work synergistically with surfactants and wetting agents to help remove clinical stains from surgical instruments. Depending on the type of enzyme used, enzymatic detergents can break down stains across a wide range of temperatures. Enzymes also function at different pH levels, from neutral to alkaline conditions. When enzymes are added to detergents, in addition to improving cleaning, they can be used in many hospital applications, from pre-cleaning in patient beds to automatic washing in the sterilization department. (See Image 1: The effect of enzymes on clinical stains.)

Example Application Study Effect of Enzymes in Medical Device Cleaning

Novozymes conducted a study with the US-based Stryker Corporation on the cleaning effectiveness of enzymatic, optimized enzymatic, and non-enzymatic detergents. Surgical instruments containing dried clinical stains were immersed in different detergent solutions for 10 minutes and rinsed with water. Blade tips were photographed before and after cleaning. ProReveal, a high-sensitivity fluorescence-based protein detection test, was applied before and after to generate fluorescence images.

Study Results

Under visual analysis, optimized enzymatic detergents left no visible stain residue in blade tests compared to non-enzymatic and standard detergents. These results can be explained by the use of new-generation enzymes and an increase in enzyme dosages compared to standard enzymatic detergents. Subsequent fluorescence analysis confirms this result.

While optimized enzymatic detergents left no stain residue after washing, some residue was observed on the blades with standard enzymatic detergents. However, the washing performance of non-enzymatic detergents was significantly lower, as shown in the images above. (See Image 2: Study results.) Key Takeaway

Optimized enzymatic detergents provide superior performance improvement according to industry-standard cleaning protocols, reduce rewashing rates, lower waste and costs in hospitals, and can improve patient outcomes. Enzyme performance can be optimized by using the appropriate enzymes at proper dosages and under proper cleaning conditions. The improvements mentioned above can be directly observed by minimizing or eliminating the risk of contaminated equipment. Written and Compiled by: Ufuk Gül Business Development Manager Household Care Novozymes