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Significant factors in the disinfection and sterilization of flexible endoscopes
D Vesley1, K G Norlien, B Nelson
1School of Public Health, University of Minnesota, Minneapolis 55455.
Background:
Many nosocomial infection outbreaks have been linked to improper disinfection of the flexible endoscopes used in hospitals and clinics. The objective of this study was to evaluate the efficacy of scope disinfection with glutaraldehyde and hydrogen peroxide in manual and mechanical protocols.
Methods:
Bacillus subtilis and Pseudomonas cepacia were the test organisms. Each channel in two different endoscopes was seeded and evaluated separately. Residual chemical germicide levels in the channels and in the work environment were also measured.
Results:
Parametric analyses were carried out on log transformations of number of colony-forming units recovered. Repeated measures analysis demonstrated that both the type of disinfectant and the method of washing were significant factors for disinfection.
Conclusions:
Hydrogen peroxide proved to be more efficacious than glutaraldehyde for killing or removing B. subtilis in a 10-minute contact period. Automatic disinfection was more efficacious than manual disinfection for killing or removing B. subtilis in a 10-minute contact period. The channel being disinfected also proved to be a significant factor, with carbon dioxide and elevator channels the most difficult to disinfect consistently.
Insights
Hydrogen peroxide and automatic disinfection are more effective for cleaning flexible endoscopes than glutaraldehyde and manual methods. Specific endoscope channels require more attention for thorough disinfection to prevent infections.
Area of Science:
- Microbiology
- Infection Control
- Medical Device Disinfection
Background:
- Nosocomial infections are often linked to inadequate disinfection of flexible endoscopes.
- Effective disinfection protocols are crucial for patient safety in healthcare settings.
Purpose of the Study:
- To evaluate the efficacy of glutaraldehyde versus hydrogen peroxide for endoscope disinfection.
- To compare manual versus mechanical (automatic) disinfection protocols.
Main Methods:
- Two endoscopes were tested using Bacillus subtilis and Pseudomonas cepacia as challenge organisms.
- Disinfectant efficacy was assessed by quantifying residual organisms in endoscope channels.
- Chemical germicide levels were measured in channels and the work environment.
Main Results:
- Both disinfectant type and washing method significantly impacted disinfection effectiveness.
- Hydrogen peroxide showed superior efficacy against Bacillus subtilis compared to glutaraldehyde.
- Automatic disinfection was more effective than manual disinfection for Bacillus subtilis removal.
Conclusions:
- Hydrogen peroxide is a more effective disinfectant than glutaraldehyde for specific applications.
- Automatic disinfection protocols offer better efficacy than manual methods.
- Certain endoscope channels (CO2 and elevator) present disinfection challenges.