CIDEX OPA, The High-Level Disinfection Standard

CIDEX OPA Solution is a quick and effective high-level disinfectant used on a wide variety of semi-critical, heat-sensitive medical devices in medical facilities all over the world. CIDEX OPA is very effective against a wide range of microorganisms has a near neutral pH level.

CIDEX OPA Solution provides a quick five-minute advanced sterilization for disinfection in an automatic endoscope reprocessor at 25º C or more, or in 12 minutes at 20º C processed manually. No other new high-level disinfectant with such broad material compatibility like a glutaraldehyde solution has been made available in the last 30 years. Specifically targeting a wide range of mycobacteria, like strains of glutaraldehyde solution resistant M.chelonae.

CIDEX OPA solution is ready to use right from the bottle and does not require activation or mixing. CIDEX products are a vital link in the chain of modern medical facility disinfection for medical and surgical facilities. While it is used extensively in medical facilities, it is also used for items such as SCUBA (self-contained breathing apparatus) gear by non-medical personnel.

How to Use CIDEX OPA to Disinfect Medical Equipment

The steps to use CIDEX activated dialdehyde disinfectant solution as a high-level disinfectant in a medical setting are:

• Wear Your Personal Protective Equipment
• Clean the medical instruments prior to CIDEX OPA
• Testing the CIDEX OPA Solution
• How to Use CIDEX OPA
• Disinfection Procedure
• Rinsing the Instruments
• Drying the Instruments
• Disposal of used CIDEX Solution

Wear Your Personal Protective Equipment

It is vital that personnel always wear their personal protective equipment as they handle the contaminated medical devices, sterilization products and instruments that require decontaminating. Wear a fluid-repellent gown, gloves and eye protection during the entire decontamination procedure.

Discolored skin, mucous membranes and stained clothing or other surfaces are to be expected if they come into contact with the CIDEX OPA Solution. If skin contact is made, wash the area with soap and water for several minutes. Any discoloration will disappear within a couple of days. Avoid contact with floors, walls, and counters. Specific trays are manufactured to use in the disinfection process to avoid skin contact, spilling, splatter and contact with other surfaces.

Clean the medical instruments prior to CIDEX OPA

Before the advanced sterilization and high-level disinfection can begin, a thorough basic cleaning of the medical devices and instruments is required. All semi-critical medical devices reprocessed in CIDEX OPA Solution must first be cleaned according to a validated cleaning protocol or standard, such as the ASTM F 1518 “US Standard Practice for Cleaning and Disinfection of Flexible Fiberoptic and Video Endoscopes Used in the Examination of the Hollow Viscera.”

• Remove all debris. Completely clean all of the surfaces of the devices and instruments, inside and out. Clean all lumens of any hollow instruments like flexible endoscopes with any mild detergent designed to dissolve proteins, like ENZOL Enzymatic Detergent.
• Highly acidic or highly alkaline detergents are not appropriate cleaning agents for use with CIDEX OPA Solution. Use only a mild enzymatic detergent, neutral in pH, that is low foaming, and can be easily rinsed from the medical devices and instruments.
• After a thorough cleaning, rinse every surface with copious amounts of clean water to be certain the detergent residue has been removed
• Carefully remove excessive amounts of water left after the rinsing since the water will dilute the CIDEX OPA Solution and interfere with the disinfection and sterilization products. If the CIDEX is diluted below a minimum effective concentration (MEC) it will be necessary to repeat the disinfection procedure with fresh solution.

Each medical device and instrument will be labelled with manufacturer’s instructions for cleaning, decontaminating, disassembly and reassembly as well as leak testing. Be sure to check those instructions for each device.

Testing CIDEX OPA Solution

The CIDEX OPA Solution requires testing before each use.  CIDEX OPA Solution Test Strips are used to confirm that the level of concentration of the ortho-phthalaldehyde meets the minimum effective concentration (MEC) required for high-level disinfection. The MEC required is 0.3%. Even if the concentration level remains high enough, the disinfection and sterilization products are still discarded after two weeks. Check the CIDEX OPA test strips package insert for detailed instructions.

How to Use CIDEX OPA Solution

CAUTION: Always read the directions on the package insert and the label before each use.

CIDEX OPA Solution does not require activation or mixing. Simply open the bottle and pour the solution directly into a CIDEX solution tray or another suitable container.

• An unopened bottle has a long shelf life, allowing it to be stored in appropriate conditions for two years. An opened bottle must be used within 75 days.
• Only use CIDEX OPA Solution in a validated reprocessing procedure in an automatic flexible endoscope reprocessor. Keep records of the dates your solutions are poured from the containers and calculate when the date the reuse life will end, which must be not more than 14 days. We recommend using a CIDEX OPA log sheet to keep track of this.

Disinfection Procedure

• The clean, mostly dry devices can now be immersed completely in the sterilization disinfecting solution.
• Fill any lumens.
• Fit the tray cover onto the tray.
• Soak for 12 minutes at room temperature (20º C) to achieve the high-level disinfectant standard.

Rinsing the Instruments

Following the disinfection, the instruments must be rinsed thoroughly.

• Flush any channels with a sterile water source.
• Rinse each medical device three times.
• Rinse for a minimum of one minute, using at least two gallons of clean water each time.
• Advanced Sterilization Products (the manufacturer) recommends using sterile water unless potable water is acceptable.

Drying the Instruments

Each medical device and instrument must now be thoroughly dried. The disinfected medical equipment is now ready for use. If it is to be stored, be careful to store it while considering the risk of recontamination.

Disposal of the Used CIDEX Solution

Used CIDEX OPA Solution can usually be discarded down the drain at the hospital or doctor’s office. Always check your local regulations before disposing down a drain. if required, glycine (free base) may be used as a neutralizer for CIDEX OPA Solution prior to disposal. A minimum of 25 grams of glycine (free base) should be used to neutralize one gallon of CIDEX OPA Solution. The minimum recommended neutralization time is one hour. After discarding the solution into drain, flush drain thoroughly with water.

Ortho-phthalaldehyde, the FDA and the CDC

In October of 1999, the Food and Drug Administration (FDA) approved the use of ortho-phthalaldehyde for use as an advanced sterilization high-level disinfectant. The FDA approved ortho-phthalaldehyde because studies found what were described as “excellent microbiocidal activity in in-vitro studies.” According to the Centers for Disease Control and Prevention, ortho-phthalaldehyde eliminated several microorganisms, such as mycobacateria and Bacillus subtilis spores. These microorganisms were found to be resistant to glutaraldehyde solutions, which was commonly used at the time.

Quick and Easy High-Level Disinfection

Time spent in non-patient care in medical facilities is always at a premium.

• A quick five-minute soak at 25°C in automated flexible endoscope reprocessors, or for 12 minutes at 20° C with manual processing, makes CIDEX disinfectant a quick way to achieve high-level disinfection.
• Heat-sensitive medical devices are preserved, and the highest level of disinfection is achieved, quickly and efficiently.
• The lack of activation, mixing or other preparation saves time. The ready-to-use disinfection and sterilization products solution means disinfecting begins as soon as the initial cleaning is complete.
• A quick soak, a thorough rinse and a dry, and high-level disinfectant is achieved.

Safety Precautions

Disinfecting instruments, medical devices and equipment always requires care and special attention.

• CIDEX disinfectant is often preferred since it is virtually odorless.
• CIDEX does not require any special ventilation since it does not cause irritation to the eyes or nasal passages, but it is best to use in a well-ventilated area.
• Avoid contact with eyes, skin, and clothing. Always be sure to wear a fluid-repellent gown, gloves and protective eyewear when handling the fluid and equipment, as CIDEX does stain.

Disadvantages

• CIDEX OPA stains skin with contact. It stains mucous membranes. It stains clothing. It stains counters, walls or floors.
• Staining will occur with direct contact such as a spill, but also can occur if instruments or equipment are not rinsed well enough and they come into contact with patient skin or mucous membranes. Be certain to rinse all disinfected items thoroughly.
• Direct contact with eyes and skin may cause irritation. Repeated contact with skin may cause skin sensitization.
• CIDEX OPA Minimum Effective Concentration (MEC) must be verified by a CIDEX OPA Solution Test Strip prior to each use to determine that the concentration of ortho-phthalaldehyde is above the MEC of 0.3%.

Frequently Asked Questions

How to remove a CIDEX stain?

The short answer is, you probably can’t. It only takes a couple of days for the grey stain to fade on skin or mucous membranes.

On equipment, the area can be wiped clean with 70% isopropyl alcohol and a lint-free cloth if the manufacturer’s instructions allow it. This process will minimize staining but doesn’t completely eliminate long-term potential stains. Often it will not remove any existing stain.

What does CIDEX OPA kill?

CIDEX has been tested and proved to minimize the growth rates of a wide range of various bacteria, including:

• Staphylococcus aureus
• Salmonella choleraesuis
• Pseudomonas aeruginosa
• Methicillin-resistant Staphylococcus aureus (MRSA)
• Vancomycin-resistant Enterococcus faecalis (VRE)
• Staphylococcus aureus
• Enterococcus hirae
• Pseudomonas aeruginosa

CIDEX has been tested to kill these various viruses:

• Adeno 2
• Virucidal Coxsackie Type B- 3
• Virucidal Cytomegalovirus
• Virucidal Herpes Simplex Type 1 & 2 (HSV1 & HSV2)
• Virucidal HIV-1
• Virucidal Human Coronavirus
• Virucidal Influenza Type A (Hong Kong)
• Virucidal Polio 1
• Virucidal Rhinovirus Type 42
• Virucidal Vaccinia

CIDEX has been tested to kill these types of spores:

• Clostridium sporogenes
• Bacillus subtilis

How Toxic is CIDEX OPA Solution?

CIDEX OPA Solution has been studied extensively to determine its toxicity. The results demonstrate the disinfection and sterilization products solution to be safe when it is used as directed. It may cause eye, skin, and respiratory irritation. Use CIDEX OPA in a well-ventilated area with personal protection equipment. For more details, see the CIDEX OPA Material Safety Data Sheet.

How does CIDEX OPA Solution Compare to Metricde OPA Plus Solution?

MetriCide OPA Plus Solution is similar to CIDEX OPA Solution. The MetriCide OPA contains a slightly greater amount of the active ingredient. They are both equally stable, safe, and effective. They both have a long shelf life and the same materials compatibility. The MetriCide OPA Disinfectant Solution can be used more often within a two-week period, which can help busy medical facilities save costs.

What is the difference between CIDEX Activated Dialdehyde Solution and CIDEX OPA? Which one is better for bladder cancer patients?

CIDEX OPA is different from CIDEX Activated Dialdehyde Solution. CIDEX Activated Dialdehyde Solution uses glutaraldehyde as the disinfectant while CIDEX OPA uses ortho-phthalaldehyde. Bladder cancer patients are more sensitive to ortho-phthalaldehyde. CIDEX OPA should not be utilized to process any urological instrumentation used to treat patients with a history of bladder cancer.

What is the difference between peracetic acid and CIDEX products?

Peracetic is highly effective and is used as an alternative to glutaraldehyde. The acid has a vinegar aroma but can be somewhat less irritating to some. Peracetic acid must be used in exhaust-ventilated or sealed facilities. It is significantly more expensive, less stable, has a shorter shelf life, and only large volumes can be stored. Cosmetic damage is caused to endoscopes, and this acid is not universally compatible with disinfectors and washers.

What are the CIDEX OPA Solution Test strips and what are they used for?

CIDEX OPA Test Strips are designed to be used to test the CIDEX OPA disinfectant solution before each use. The test strips measure the MEC (minimum effective concentration) of the disinfectant solution. They are simple to use and read.

CIDEX OPA and CIDEX Activated Dialdehyde Solution are industry standards for high-level disinfection. There are many benefits such as efficacy, a long shelf life, and ease of use, proving an excellent choice for any facility requiring infection prevention. Hospitals, dentists, doctor’s offices, clinics, surgeries and veterinary care locations across the country are all achieving high-level disinfection with CIDEX OPA and CIDEX solutions. CIDEX products are manufactured by Advanced Sterilization Products, a division of Ethicon (a Johnson & Johnson company).

CIDEX OPA is an effective medical instrument disinfectant and it is not to be used on skin. For a skin antiseptic and antimicrobial skin cleanser use  Hibiclens. Hibiclens gently and effectively cleanses skin and superficial wounds and can protect the skin for up to 24 hours. For more information on Hibiclens see our blog article Hibiclens: Antiseptic Skin Cleanser.

CIDEX OPA and a wide range of  CIDEX products are available through USAMedicalSurgical.com. Not all CIDEX products are listed on the website, so if you do not find what you are looking for, please call for pricing and availability on our toll-free number 1-866-561-2380, or Email Us.