title: Validation of Autoclave Protocols for Successful Decontamination of Category A Medical Waste Generated from Care of Patients with Serious Communicable Diseases.
abstract: In response to the Ebola outbreak in 2014, many hospitals designated specific areas to care for patients with Ebola and other highly infectious diseases. The safe handling of category A infectious substances is a unique challenge in this environment. One solution is on-site waste treatment with a steam sterilizer or autoclave. The Johns Hopkins Hospital (JHH) installed two pass-through autoclaves in its biocontainment unit (BCU). The JHH BCU and The Johns Hopkins biosafety level 3 (BSL-3) clinical microbiology laboratory designed and validated waste-handling protocols with simulated patient trash to ensure adequate sterilization. The results of the validation process revealed that autoclave factory default settings are potentially ineffective for certain types of medical waste and highlighted the critical role of waste packaging in successful sterilization. The lessons learned from the JHH validation process can inform the design of waste management protocols to ensure effective treatment of highly infectious medical waste.
authors.affiliation: Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA bgariba1@jhmi.edu.
authors.forename: Brian T
authors.identifier: 0000-0001-8632-5567
authors.initials: BT
authors.lastname: Garibaldi
authors.affiliation: Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Mallory
authors.initials: M
authors.lastname: Reimers
authors.affiliation: Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Neysa
authors.initials: N
authors.lastname: Ernst
authors.affiliation: Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Bova
authors.affiliation: Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Elaine
authors.initials: E
authors.lastname: Nowakowski
authors.affiliation: Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: James
authors.initials: J
authors.lastname: Bukowski
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Brandon C
authors.initials: BC
authors.lastname: Ellis
authors.affiliation: Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Smith
authors.affiliation: Johns Hopkins Office of Critical Event Preparedness and Response, Baltimore, Maryland, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Sauer
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: Dionne
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Carroll
authors.affiliation: Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Maragakis
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Parrish
mesh_terms: D003141:Communicable Diseases / Q000628:therapy*; D006801:Humans; D008506:Medical Waste; D013242:Sterilization / Q000379:methods*
chemical_list: D008506:Medical Waste
keywords: Ebola; autoclave; medical waste; serious communicable diseases; sterilization