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Updated: Feb 21, 2026

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
[The implementation of a manual pretreatment phase increases the efficacy of automated reprocessing procedures in
Lamia Melalka1, Nada Saout1, Fouad Assi1
1University of Tunis El Manar, Faculty of Medicine of Tunis, National Institute of Nutrition and Food Technology of Tunis, Department A.
Introduction:
The reprocessing of flexible endoscopes has become a major research topic in recent decades. The risk of endoscopy-related bacterial, fungal or viral outbreaks is increasing, particularly those involving multi-resistant strains.
Aim:
The aim of the present study was to assess the importance of implementing a manual pre- treatment phase in conjunction with HDL (High Level Disinfection) cleaning using a Steelco automated washer-disinfector. The aim of the study was to determine whether neglecting the manual pre-treatment phase, despite the use of a high-quality automated disinfector, leads to the spread of biofilms and of germs likely to cause healthcare-associated infections.
Methods:
To achieve this objective, an extensive microbiological sampling process was carried out on bronchoscopes under normal cleaning and disinfection conditions prior to the introduction of the pre-treatment phase. Based on the results of these samplings, the Quality Control Circle (QCC) team proceeded to identify and analyze potential causes using the ISHIKAWA diagram during brainstorming sessions, following which microbiological sampling of the bronchoscopes after implementation of the results of the cause analysis was carried out.
Results:
The results indicate complete elimination of bacterial strains after implementation of manual pretreatment followed by automated treatment, in line with international disinfection standards.
Conclusion:
The implementation of a pre-treatment phase followed by a Steelco automated washer-disinfector significantly reduced microbial contamination in bronchoscopes.
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