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Frequency for Autoclave Spore Testing

Q: When we do weekly autoclave spore testing, are we required to run a "control" along with it?

A: Run controls according to the spore test package instructions. This usually involves incubating two tests: one spore strip or vial that was included in the autoclave cycle and one that wasn't (the control). After overnight incubation, the control vial/strip should contain live spores, usually visualized through cloudiness or a color change. The autoclaved vial will remain unchanged, indicating that spores were killed.

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Posted by Quality America on December 30, 2005 | Comments (12)


If we are not using the autoclave that often maybe 1-2x a month how often do we do a spore test. We are a new office.

Posted by: kathy at April 19, 2006 10:55 AM

The US Public Health Service recommends running biological indicators once per week. Since hospitals run several autoclave loads per day, we think it makes sense for those who use the autoclave infrequently to stipulate in your policies and procedures that you will run biological indicators every fifth load. If you have Quality America's OSHA Manual, this is stipulated on page 8-10.

If you decide to use the "once every 5 loads" criteria, remember that if you end up only running a biological indicator, say, once a month, then if the biological indicator test fails, indicating that sterilization was not achieved, you will need to:

-Repeat the test. If the repeat test fails, remove all objects sterilized since the last favorable biological monitor test from storage. Quarantine them until the autoclave is serviced.

-Perform maintenance to ensure that the autoclave works properly.

-Repeat the biological monitor test. Once results are acceptable, repeat sterilization of items that were improperly sterilized. Include another biological test in this autoclave cycle.

Depending on how many instruments you keep in stock, you may want to just bite the bullet and run BI every time you autoclave, assuming of course, that it's less often than once per week.

Posted by: Dr. Dunn at April 25, 2006 03:47 PM

Is Live spore testing required by OSHA?

Posted by: Vanessa Ortega at September 20, 2006 02:32 PM

The Occupational Safety and Health Administration (OSHA) is the Federal agency responsible for worker safety, as such OSHA does not issue requirements for patient safety. A negative patient outcome is the likely result of inadequate sterilization, so live spore testing is a good idea from a liability standpoint. Live spore testing, also called Biological Indicator (BI) testing, is recommended by the Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA). It is also mandated in some states -- California, Florida, Indiana, Nebraska, Ohio, Oregon, and Washington, among others.

Posted by: Sarah Alholm at September 20, 2006 03:12 PM

A question has come up regarding the frequency of checking the autoclave with a spore strip. We perform the test once every five loads is this often
enough or how frequent should it be? Also, we are in the state of Ohio and one manufacturer states we need to do the check every week. If you could
please guide me to the correct website I would appreciate your help.

Posted by: Sherry Whipple at October 26, 2006 03:32 PM

Ohio's state requirements are specific to dental practices. I know your practice is not a dental practice, so these laws won't apply specifically to you.

The Infection Control guidance provided for Ohio dentists at http://dental.ohio.gov/icmanual.pdf is very specific:

"All heat sterilizing devices in the office that may be readily used must be tested every 7 days (one calendar week), unless the dental office/practice is closed for 1 or more complete calendar weeks. The closure of the office/practice (i.e. vacation, etc.) should be documented accordingly. Testing must be done in a consistent manner (i.e. every Monday unless the office/practice is closed for a holiday/vacation, in which case the testing must be performed on the next available working day in which the office/practice is open for business)."

The bottom line is to test frequently enough, that if a biological indicator test fails, you can segregate the items sterilized since the last successful spore test before any of the questionable instruments are used on patients.

If you can't do that based upon your current operation you have two solutions:

1. Increase your inventory levels.
2. Spore test more frequently.

Posted by: Sarah Alholm at October 26, 2006 03:35 PM

On Sept. 20, 2006, a post noted that live spore testing is mandated in the state of Oregon. I have been able to find legislation re that for businesses that tattoo, pierce, and apply permanent makeup. Is it also mandated for medical clinics?

Posted by: Ann Penny at October 31, 2006 11:58 AM

Most of the state legislation referred to in the Sep 20th post applies to dental practices. Since Quality America serves both medical and dental customers, we thought those mandates were important to include. Currently, in Oregon, dental practices must perform weekly spore testing. We searched for, but didn't find any Oregon state legislation for medical practices.

Please understand Quality America cannot and does not render legal advice. Opinions expressed on this blog are intended to be educational in nature. For all states, we recommend contacting your Medical Board (or Dental Board for dental practices) for full information on state and local requirements.

All accrediting agencies, such as JCAHO require BI's at a minimum of once per week. Medical practices can expect that any insurance plan auditors will require this also.

Posted by: Sarah Alholm at November 1, 2006 11:46 AM

I'm seeking literature on Dental equipment and office Sterilization for training and resource.

Posted by: Vernita Howell at May 21, 2007 10:57 PM

Thanks for your question, Vernita. One option would be to download Quality America's White Paper "A Disinfection and Chemical Sterilization Primer" from:


More information is also available in Tab 5 of the Quality America Dental OSHA Safety Program Manual. Check out this link for details:


Hope this helps!

Posted by: Sarah Alholm at May 23, 2007 10:14 AM

I work at a dental office in Oregon and i was wondering how frequent spore testing must be done for an autoclave...and how do you segragate the instruments when most testing takes a couple of days.

Posted by: Erica at July 5, 2007 05:13 PM

In Oregon, dental practices must perform weekly spore testing. I'd recommend having a specially labeled storage area where sterilized instruments can be held pending acceptance. If inventory levels create a problem when segregating instruments, consider some of the new quick spore tests. For example, 3M's Attest Rapid Readout biological indicator retruns results in three hours for standard steam cycles.

Posted by: Sarah Alholm at July 11, 2007 10:09 AM

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