Current limitations about the cleaning of luminal endoscopes

Area of Science:

• Gastroenterology
• Infectious Disease Prevention
• Medical Device Reprocessing

Background:

• Patient material, such as proteins, can accumulate in endoscope lumens, leading to toxic reactions, device damage, and pathogen transmission.
• Biofilm development and inadequate disinfection are significant risks associated with protein build-up in endoscopes.

Purpose of the Study:

• To assess protein deposition and removal within flexible endoscope channels after a single contamination and cleaning cycle.
• To evaluate the effectiveness of current initial cleaning techniques on proteinaceous residues in endoscope lumens.

Main Methods:

• Protein contamination levels were assessed on disposable endoscopy forceps used in biopsy channels.
• Protein adsorption factors and the efficacy of initial cleaning methods were studied using a proteinaceous test soil and fluorescence epimicroscopy.
• The impact of immediate post-contamination rinsing was also evaluated.

Main Results:

• Disposable endoscopy accessories contribute to lumen contamination and indicate the amount of proteinaceous soil.
• Enzymatic cleaning and channel brushing were ineffective in completely removing protein residues from new endoscope channels after one contamination cycle.
• Immediate rinsing provided only a marginal improvement in decontamination.

Conclusions:

• Current decontamination procedures have limited effectiveness in removing proteinaceous residues from endoscope channels.
• The absence of quality control methods to verify channel cleanliness between patients heightens the risk of cross-infection.
• Endoscopic procedures carry an increased risk of transmitting harmful microorganisms and molecules due to inadequate cleaning.