High-level disinfection or "sterilization" of endoscopes?

Area of Science:

• Medical Microbiology
• Infectious Disease Prevention
• Healthcare Associated Infections

Background:

• Sterilization of medical instruments can be challenging for heat-sensitive materials.
• Liquid chemical germicides are used for reprocessing instruments damaged by heat sterilization.
• Efficacy of disinfection versus sterilization processes has been debated.

Purpose of the Study:

• To compare the efficacy of disinfection and sterilization processes for medical instruments.
• To assess infection rates associated with high-level disinfection versus sterilization.
• To provide recommendations for reprocessing heat-sensitive medical instruments.

Main Methods:

• A comprehensive literature review was conducted.
• Studies comparing high-level disinfection and sterilization efficacy were analyzed.
• Infection rates associated with different reprocessing methods were assessed.

Main Results:

• High-level disinfection of thoroughly cleaned endoscopes showed no increased infection rate compared to sterilization.
• Thorough cleaning is a critical factor that minimizes clinical differences between disinfection and sterilization.
• High-level disinfection is a quick, effective, and cost-efficient reprocessing method.

Conclusions:

• High-level disinfection is a viable and recommended alternative to heat sterilization for medical instruments when heat sterilization is not feasible.
• Low-temperature sterilization should only be considered if cost-effective or offers clear advantages without instrument damage.
• Effective reprocessing of medical instruments, whether by disinfection or sterilization, is contingent upon thorough cleaning after use.