Enteroviruses, endoscopy and infection control: an applied study

Area of Science:

• Microbiology
• Infectious Diseases
• Medical Device Decontamination

Background:

• Enteroviruses pose a significant challenge to medical equipment decontamination due to their resistance to standard disinfection protocols.
• Current decontamination methods primarily rely on bacterial studies, potentially underestimating the required efficacy against more robust viral agents like enteroviruses.

Purpose of the Study:

• To evaluate the effectiveness of cleaning and disinfection protocols in eliminating enteroviruses from medical endoscopes.
• To assess the efficacy of 2% alkaline glutaraldehyde in inactivating poliovirus, a representative enterovirus, under various conditions.

Main Methods:

• Poliovirus was used to contaminate the suction-biopsy channels of five gastroscopes.
• Endoscopes underwent cleaning with detergent followed by disinfection with 2% alkaline glutaraldehyde.
• Viral load was quantified using plaque assays before and after cleaning, and at various disinfection time points.
• The inactivation of dried, cell-free, and cell-associated poliovirus by glutaraldehyde was also investigated.

Main Results:

• Standard cleaning procedures reduced poliovirus contamination by a mean of 4.6 log10 plaque-forming units (pfu)/mL.
• Disinfection with 2% alkaline glutaraldehyde rendered the endoscope channels virus-free within 2 minutes.
• Glutaraldehyde rapidly inactivated dried poliovirus on surfaces within 1 minute, achieving a reduction of over 6 log10 pfu/mL.

Conclusions:

• Effective cleaning is crucial for managing high levels of viral contamination on endoscopes.
• 2% alkaline glutaraldehyde demonstrates rapid and potent antiviral activity against poliovirus, including when dried in organic matter.
• These findings support the use of glutaraldehyde-based disinfection for ensuring the safety of medical endoscopes against enterovirus contamination.