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Can Whipple's disease be transmitted by gastroscopes?

Bernard La Scola1, Jean-Marc Rolain, Max Maurin

  • 1Unité des Rickettsies, CNRS UMR 6020, Faculté de médecine, 27 Boulevard Jean Moulin, 13385 Marseille 05, France.

Infection Control and Hospital Epidemiology
|April 10, 2003
PubMed
Abstract

Insights

Current gastroscope disinfection methods may not fully eliminate Tropheryma whipplei bacteria. Standard protocols using glutaraldehyde or peracetic acid may be insufficient to prevent Whipple's disease transmission.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Whipple's disease is a rare systemic infection caused by Tropheryma whipplei.
  • Gastroscopes are medical instruments used for examining the upper digestive tract and require thorough disinfection.
  • Inadequate disinfection can lead to the transmission of infectious agents.

Observation:

  • The study evaluated the effectiveness of 2% glutaraldehyde and two peracetic acid solutions against Tropheryma whipplei.
  • T. whipplei cultures grown in cell monolayers were used to assess disinfectant efficacy.
  • The study considered the context of patients diagnosed with Whipple's disease years after intestinal biopsies.

Findings:

  • Disinfectants reduced T. whipplei by approximately 2 to 3 log10 after 5 to 60 minutes of contact.
  • Significant bactericidal activity is typically defined as a 5 log10 or greater reduction in bacterial titers.
  • The tested disinfectants did not achieve the standard threshold for significant bacterial reduction.

Implications:

  • Current disinfection protocols for gastroscopes using 2% glutaraldehyde or peracetic acids for 20 minutes may be insufficient.
  • Insufficient disinfection could potentially lead to the transmission of T. whipplei via contaminated gastroscopes.
  • This may also contribute to false-positive results in polymerase chain reaction (PCR) testing for T. whipplei.

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