We Received a Positive Spore Test… Now What?

Sterilizer monitoring in a dental office, when properly implemented, is an important part of infection control verification. Both the Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) recommend, and most state dental boards require, dental offices to monitor office sterilizers cycle at least weekly using a biological indicator such as a spore test.

But what if we receive a positive test?

If a spore test turns positive, then contact your biological monitoring service immediately for assistance. Generally, a single positive spore test probably does not indicate sterilizer malfunction, especially if the mechanical and chemical indicators demonstrate sterilizer effectiveness.

Your sterilizer monitoring service will likely tell you to retest with another biological indicator immediately. Ensure that the biological indicator has not expired and that the testing protocol has been met. Check the sterilizer for any obvious inconsistencies. Also, sterilizer operating procedures should be reviewed, including packaging, loading, and spore testing, with all persons who work with the sterilizer to determine whether operator error could be responsible.

Common factors for improper sterilization include chamber overload, excessive packaging material, inadequate exposure time, incorrect temperature/pressure settings, failure to preheat the sterilizer (if indicated), interruption of the cycle, and expired chemical solution (chemiclaves only).

If the repeat spore test is negative, and chemical and mechanical indicators indicate adequate processing, the sterilizer can be put back into service. If the repeat spore test is positive, and packaging, loading, and operating procedures have been confirmed as performing correctly, the sterilizer should remain out of service until it has been inspected, repaired, and cleared to be put back into service.

Since 1992, OSHA Review, Inc. has provided dental professionals with comprehensive programs to support regulatory compliance and infection control. We are a registered continuing education provider in the state of California, specializing in Dental Practice Act, infection control, and OSHA training.

In addition, OSHA Review, Inc. provides sterilizer monitoring services in all 50 states through OSHA Review’s Spore Check System. The Spore Check System is endorsed by the Arizona, California, Ohio and Texas Dental Association.