Monitoring Autoclave Performance and Sterilization Procedures in Fiji Dental Clinics

Objectives: To monitor biologically the efficacy of autoclaves using Bacillus stearothermophilus spores; and to identify factors contributing to the challenges faced during sterilization procedures in dental clinics in Fiji.Methods: Clinic based survey, supported with a questionnaire regarding pre-sterilization procedures. Ten private and public dental clinics around Fiji were visited, biological indicators were placed in the center of a normal sterilization load and processed. The same procedure was repeated the next day. Persons in charge of sterilization processes answered a questionnaire. Processed vials, and an unprocessed control, were cultured on tryptic-digest casein-soy blood agar plates. Color changes were noted at intervals of 12, 24, and 48 hours, following which colony of microorganism growth was determined.

Results: Although the sterilizers tested showed 80%(public) and 40%(private) desired color change (black) on chemical indicators, the biological indicators showed positive spore growth of 80% in private and 100% in government clinics. A failure amounting 40%, with autoclaves in use for more than 3 years without maintenance was noted for both sites. Conclusion: Findings suggest that monitoring of sterilization procedures is not effective and most likely not practiced. Chemical indicators were shown to be inadequate; hence the gold standard for autoclave efficacy testing needs utilization of biological indicators on a regular basis.