title: Autoclave sterilization of instruments used on women with cervical neoplasia is an effective method of eradicating residual human papillomavirus DNA: a polymerase chain reaction-based evaluation.
abstract: OBJECTIVE
  To determine whether autoclave sterilization eradicates human papillomavirus (HPV) DNA on specula and instruments used to treat women with cervical neoplasia.
  
  
  METHODS
  Specula and instruments used in two referral colposcopy clinics were evaluated to determine the PGMY9/11 primer system's ability to amplify residual HPV DNA. Each speculum and instrument was sampled with a Dacron swab and stored in PreservCyt solution (Cytyc Corporation, Marlborough, MA) at 4 degrees C. DNA amplification was performed under standard conditions with appropriate controls followed by HPV typing using the reverse line blot test (Roche Molecular Systems, Alameda, CA). Once validated, the same polymerase chain reaction method was used on autoclave-sterilized specula and biopsy instruments and heated glass bead- and Cidex bath (Johnson & Johnson, New Brunswick, NJ)-sterilized instruments. All results, with appropriate positive and negative controls, were confirmed in triplicate.
  
  
  RESULTS
  A total of 140 instruments (70 used and 70 autoclaved) were sampled for residual HPV DNA. Five samples in the contaminated specula arm were excluded from analysis secondary to insufficient sampling. Of the remaining samples, 52.3% (34/65) of contaminated instruments-both specula and biopsy instruments-had detectable HPV DNA. Fifty-five percent of contaminated biopsy instruments (11/20) were positive and 51.1% of contaminated specula (23/45) were positive. All 70 autoclaved samples (50 specula and 20 biopsy instruments) were negative for residual HPV DNA or beta-globin. One instrument in the glass bead and Cidex group that was presumed sterile was positive for HPV 16 DNA.
  
  
  CONCLUSIONS
  The PGMY9/11 primer system is an effective method to detect residual HPV DNA. Autoclave sterilization appears to eradicate HPV DNA to levels undetectable with this sensitive assay, whereas heated glass beads followed by Cidex bath appears to be inadequate methods. These results suggest that autoclave sterilization is effective when using nondisposable instruments and should be the method of choice in studies using polymerase chain reaction-based amplification of HPV DNA.
authors.affiliation: Division of Gynecologic Oncology, The University of Alabama-Birmingham, Birmingham, AL 35249, USA. jmestes21@mac.com
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Estes
authors.forename: Tyler O
authors.initials: TO
authors.lastname: Kirby
authors.forename: Warner K
authors.initials: WK
authors.lastname: Huh
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000302:isolation & purification*; D003127:Colposcopy; D004279:DNA, Viral / Q000302:isolation & purification*; D004866:Equipment Contamination; D005260:Female; D006176:Gynecology / Q000295:instrumentation*; D006801:Humans; D016133:Polymerase Chain Reaction; D013242:Sterilization / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology
chemical_list: D004279:DNA, Viral