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Endoscope washers--a protocol for their use.

M G Marchetti1, G Salvatorelli, G Finzi

  • 1Cattedra di Citologia ed Istologia, Università di, Ferrara, Italy.

The Journal of Hospital Infection
|November 14, 2000
PubMed
Summary
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This study details a disinfection protocol for endoscopes, achieving high microbial reduction rates. Further disinfection after overnight storage and washer maintenance are crucial for patient safety.

Area of Science:

  • Infection Control
  • Medical Device Reprocessing
  • Microbiology

Background:

  • Endoscopes require rigorous disinfection to prevent patient-to-patient transmission of infections.
  • Complex internal channels of endoscopes pose significant disinfection challenges.

Purpose of the Study:

  • To evaluate a multi-step disinfection protocol for gastroduodenoscopes, cholangiopancreatography endoscopes, and colonoscopes.
  • To assess the efficacy of the protocol in reducing microbial contamination in endoscope channels.

Main Methods:

  • A three-step manual and automated washing protocol using specific disinfectants (didecyldimethylammonium chloride, benzoisothiazolone, glutaraldehyde).
  • Microbial analysis of wash liquids from disinfected endoscopes (colonoscopes, gastroduodenoscopes, cholangiopancreatography endoscopes).

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Main Results:

  • Achieved <1 microorganism/ml in 75-83% of channels across all endoscope types.
  • No microbial growth detected in 14-50% of channels, depending on endoscope type and channel.
  • Protocol demonstrated adequate disinfection of challenging endoscope channels.

Conclusions:

  • The described protocol effectively disinfects endoscope channels.
  • Overnight storage can increase contamination; re-disinfection is recommended.
  • Washer maintenance and water system integrity are critical to prevent recontamination and ensure patient safety.