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Case ReportCase Study

The Role of Heat-Tolerant Endotoxin-Retentive Ultrafilters (UFs) for the Remediation of Reverse Osmosis (RO) Plants Employed for Surgical Hand Antisepsis Using Periodic Thermal Disinfection—A Ten Year Longitudinal Experience Study in the Operating Theater

Yushi Uetera, Hiroshi Yasuhara, Naohito Kumada, Yoshiki Misawa, Yoshiyuki Terada, Yoshio Satou, Tamaki Suhara and Kunio Kawamura
PDA Journal of Pharmaceutical Science and Technology July 2018, 72 (4) 420-437; DOI: https://doi.org/10.5731/pdajpst.2017.008482
Yushi Uetera
1Surgical Center, University of Tokyo Hospital, Tokyo, Japan;
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  • For correspondence: uetera-tky@umin.ac.jp
Hiroshi Yasuhara
1Surgical Center, University of Tokyo Hospital, Tokyo, Japan;
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Naohito Kumada
1Surgical Center, University of Tokyo Hospital, Tokyo, Japan;
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Yoshiki Misawa
2Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan;
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Yoshiyuki Terada
3Mitsubishi Chemical Aqua Solutions Co., Ltd., Tokyo, Japan;
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Yoshio Satou
4Kuraray Co., Ltd., Tokyo, Japan; and
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Tamaki Suhara
4Kuraray Co., Ltd., Tokyo, Japan; and
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Kunio Kawamura
5Otsuka Pharmaceutical Company, Tokushima, Japan
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Abstract

Recently, the use of filters has come into light for sanitizing water plants. This study investigated the role of heat-tolerant ultrafilters (UFs) for the remediation of reverse osmosis (RO) plants using periodic thermal disinfection. Two completely identical RO plants (RO plants A and B) were installed in 2006 for surgical hand antisepsis in the operating theater. RO water was stored in the 300 L storage tank and recirculated in the 190 meter-long loop delivering water to 12 faucets in each RO plant. Periodic thermal disinfection came into practice periodically when a UF module was retrofitted to the recirculation loop of each RO plant in 2010. Endotoxin was monitored closely before and after thermal disinfection. Before UF modules were retrofitted, endotoxin increased to a maximum of 0.301 EU/mL in RO plant A and 1.446 EU/mL in RO plant B after thermal disinfection, respectively. Since a UF module was retrofitted to each RO plant in 2010, endotoxin has been continuously below 0.025 EU/mL in RO plant A and exceeded this level five times in RO plant B. On one occasion, endotoxin increased in all samples collected simultaneously after solenoid valves were replaced in the recirculation loop near the air conditioner outlet. At this time, the inside of the pipework was exposed to the ventilation airflow. After the valves were replaced again, this time with the workplace isolated using a curing sheet, endotoxin decreased. On the other occasions, endotoxin increased only in one sample and decreased after thermal disinfection. Annually replaced UF modules were examined twice for estimating the amounts of immobilized endotoxin. The estimated amounts decreased in 2013 by the order of 10–3 in comparison with those in 2011 in both RO plants. The present study suggested that UFs acted synergistically with periodic thermal disinfection for the remediation of RO plants.

  • Reverse osmosis (RO) plants
  • Thermal disinfection
  • Hot water sanitization
  • A0 (A naught) concept
  • Endotoxin
  • Heat-tolerant ultrafilters (UFs)
  • © PDA, Inc. 2018
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PDA Journal of Pharmaceutical Science and Technology: 72 (4)
PDA Journal of Pharmaceutical Science and Technology
Vol. 72, Issue 4
July/August 2018
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The Role of Heat-Tolerant Endotoxin-Retentive Ultrafilters (UFs) for the Remediation of Reverse Osmosis (RO) Plants Employed for Surgical Hand Antisepsis Using Periodic Thermal Disinfection—A Ten Year Longitudinal Experience Study in the Operating Theater
Yushi Uetera, Hiroshi Yasuhara, Naohito Kumada, Yoshiki Misawa, Yoshiyuki Terada, Yoshio Satou, Tamaki Suhara, Kunio Kawamura
PDA Journal of Pharmaceutical Science and Technology Jul 2018, 72 (4) 420-437; DOI: 10.5731/pdajpst.2017.008482

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The Role of Heat-Tolerant Endotoxin-Retentive Ultrafilters (UFs) for the Remediation of Reverse Osmosis (RO) Plants Employed for Surgical Hand Antisepsis Using Periodic Thermal Disinfection—A Ten Year Longitudinal Experience Study in the Operating Theater
Yushi Uetera, Hiroshi Yasuhara, Naohito Kumada, Yoshiki Misawa, Yoshiyuki Terada, Yoshio Satou, Tamaki Suhara, Kunio Kawamura
PDA Journal of Pharmaceutical Science and Technology Jul 2018, 72 (4) 420-437; DOI: 10.5731/pdajpst.2017.008482
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Keywords

  • Reverse osmosis (RO) plants
  • thermal disinfection
  • hot water sanitization
  • A0 (A naught) concept
  • Endotoxin
  • heat-tolerant ultrafilters (UFs)

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