What are enzymes?

Enzymes are proteins that act as catalysts, meaning they speed up chemical reactions. They are found everywhere — from the bottom of the ocean to your backyard, and even inside our own bodies.

Where are enzymes used today?

For thousands of years, humans have used enzymes in brewing, baking and making cheese.4 While they are still employed for those purposes, the science of enzymes has evolved in leaps and bounds. This has created opportunities for new applications in many industries.
 
Now, enzymes are used to manufacture a variety of everyday products like sugar, beer, yogurt, textiles and ethanol. Enzymes are also routinely added to detergents to help remove stains from fabrics, caked on food from dirty dishes, and patient soils from surgical instruments, including endoscopes. 

Use of enzymes in medical device cleaning

Enzymatic detergents designed specifically for cleaning reusable medical devices have been around for decades. In fact, studies have demonstrated their improved performance over non-enzymatic detergents in this application.5

Enzymatic detergents are also referenced in multiple industry standards such as AAMI ST79 and the guidelines established by the FDA and the CDC. 6-7

Types of enzymes used in medical detergents

The two main enzymes used to clean medical devices today are protease and lipase. 

Proteases are designed to break down protein-rich soils like blood, while lipases target fatty soils like adipose tissue. Other enzymes traditionally used in this application are amylases and cellulases, which break down starch and cellulosic polymers to facilitate their removal. These target soils may be found in human waste such as feces. 

Combining multiple enzymes with a properly formulated detergent can help break down a variety of human soils and waste.

Enzyme functionality

Enzymes are an important component of a good cleaning detergent. They work in synergy with surfactants, or wetting agents, to aid in the complete removal of clinical soils from surgical instruments. 

Depending on the type of enzyme used, enzymatic detergents can break down soils under a wide range of temperatures. And, they can also function at different pH levels, from neutral to alkaline conditions. 

Added to a detergent, enzymes can enhance cleaning and safety and be used in multiple hospital applications — from the pre-cleaning at “bedside” to automatic washing in a hospital’s sterile processing department.

What’s new with enzymes?

Though enzymes have long been used in medical device cleaning, the science of enzymes is always moving forward. As such, advancements in technology have enabled the development of newer and better molecules that deliver improved performance.

Want to learn more?

Explore how the Enzyme Technical Association is assisting in the development of regulations and policies that affect the enzyme industry. 

Learn how detergents with enzymes can be optimized in our recent study

References
[1] The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention, 2009. Available from https://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf  Accessed April 4, 2019. Note: dollar values are based on 2007 dollars using CPI.
[2] Cdc.gov. (2019). HAI Data | CDC. [online] Available at https://www.cdc.gov/hai/data/portal/index.html Accessed 22 Mar. 2019.
[3] Improved cleaning with enzymes. Available here.
[4] Fernandes, P. (2010). Enzymes in Food Processing: A Condensed Overview on Strategies for Better Biocatalysts. Enzyme Research, 2010, 1-19. doi:10.4061/2010/862537
[5] Merritt, K., Hitchins, V. M., & Brown, S. A. (2000). Safety and cleaning of medical materials and devices. Journal of Biomedical Materials Research, 53(2), 131-136. doi:10.1002/(sici)1097-4636(2000)53:23.0.co;2-i
[6] Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling, 2015. Available from https://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm253010.pdf Accessed April 16, 2018.
[7] Guideline for disinfection and sterilization in healthcare facilities, 2008. Available from: https://www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines.pdf. Accessed February 26, 2016.