A previous “Expert Series” segment addressed misinformation about the application of detergents for disinfection. Recently this issue came up in the Journal of Thoracic Disease when discussing reprocessing of bronchoscopes [1]. In a section titled “Infection control considerations for the use of bronchoscopes in suspected or confirmed COVID-19 patients” it is stated “The SARS-CoV-2 virus has a lipid envelope structure that makes it more resistant to disinfection by enzymatic detergents; therefore use of these cleaners alone is not sufficient for reuse of the bronchoscope.”
This statement illustrates continuing misunderstanding about the use of detergents for disinfection. Detergents may physically remove pathogens within bioburden but this is not a chemical disinfection action and not a claim supported by lab testing. Products making claims to inactive SARS-CoV-2 or other pathogens must have EPA registration on the label and may be identified as germicidal detergents or disinfectants with cleaning properties. If the product is a high-level chemical disinfectant, it is FDA reviewed and cleared and is NOT indicated for soil removal.
SARS-CoV-2 virus is a lipid enveloped virus. Enveloped virus types are more easily inactivated by disinfectants. Non-enveloped virus types such as Norovirus are more difficult to inactivate.
The role of detergents and enzymatic detergents is to reduce and eliminate all bioburden to allow subsequent disinfection and / or sterilization steps to be effective.
This issue underscores the need for certified, trained Sterile Processing technicians who understand principles of infection prevention and how to use device cleaning instructions.
[1] Society for Advanced Bronchoscopy Consensus Statement and Guidelines for bronchoscopy and airway management amid the COVID-19 pandemic. J Thorac Dis. 2020 May; 12(5): 1781–1798.
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