Italian National Survey of Digestive Endoscopy Disinfection Procedures

Inadequate disinfection of endoscopes and associated instrumentation can result in transmission of bacterial infections to patients. The aim of this study was to investigate the disinfection procedures carried out in the Italian centers of digestive endoscopy.

An anonymous postal questionnaire on the methods of cleaning and disinfecting endoscopy equipment in Italy was sent to 781 digestive endoscopy centers; 386 units (49.4 %) replied.

Automatic washers were available in 47.6% of units. Nearly all the respondets (99.2%) cleaned the instruments before disinfection, using detergent, germicidal or enzymatic cleaner, but only 69.7% carried out brushing. Most centers (89.2 %) used a glutaraldehyde-based disinfectant (51 % used 2 % glutaraldehyde; 26.9% used 0.4% glutaraldehyde with 1.41% phenol and 0.26% sodium phenate; 5.9% used either; 5.4% did not specify glutaraldehyde formulation). The contact time of the disinfectant was < 10 minutes (1.8%), between 10 and 19 minutes (47.4%), between 20 and 29 minutes (31.9 %) and > or = 30 minutes (16.6%). The use-life of the disinfectant was > or = 14 days in 27.3 % of the centers with automatic washers and 30.8% in all centers. Only 25.4% of the centers carried out some form of sterilization for biopsy forceps. The majority (83.4 %) modified their disinfection procedures in the case of infectious disease patients. Quality control tests on the efficacy of the endoscopy disinfection procedures were carried out in 44.6 % of units. Only 43 % of the centers were based in hospitals with an infection control (surveillance) program.

The data collected in the study showed that, in general, there is compliance with the Società Italiana di Endoscopia Digestiva (SIED) and Società Italiana di Gastroenterologia (SIGE) guidelines, although with some important exceptions.