Disinfection in upper-digestive-tract endoscopy in Britain

Area of Science:

• Gastroenterology
• Infection Control
• Medical Device Reprocessing

Background:

• Contaminated endoscopes pose infection risks during upper-gastrointestinal-tract endoscopy (oesophago-gastro-duodenoscopy, endoscopic cholangio-pancreatography).
• Infection transmission occurs between patients or via bacterial multiplication on instruments during storage.
• Current disinfection methods like glutaraldehyde have limitations, including staff sensitivity issues.

Purpose of the Study:

• To highlight the risks associated with endoscope contamination in gastrointestinal endoscopy.
• To evaluate the effectiveness and safety of current disinfection protocols.
• To emphasize the urgent need for improved disinfection methods for fibreoptic instruments.

Main Methods:

• Review of infection transmission routes in upper-gastrointestinal-tract endoscopy.
• Assessment of disinfection efficacy with glutaraldehyde, other aldehydes, and povidone-iodine.
• Analysis of reported issues with glutaraldehyde use, including staff sensitivity.

Main Results:

• Glutaraldehyde, while effective, causes sensitivity problems in 37% of users in some centers.
• Few centers in Britain employ fully effective disinfection procedures.
• Existing disinfection methods are not consistently safe or effective.

Conclusions:

• A significant gap exists in the safe and effective disinfection of endoscopes in British centers.
• Current disinfection practices present risks to both patients and healthcare staff.
• There is an urgent requirement for a rapid, safe, and effective disinfection method for fibreoptic endoscopes.