The practice of reprocessing endoscopes and its effectiveness was evaluated in 37 services. Contamination of at least 1 endoscope could be identified in 34 (91.6%) of 37 services. Bacteria, fungi, and/or mycobacteria were isolated from 84.6% (33/39) of the colonoscopes (110-32,000 colony-forming units [CFUs]/mL) and from 80.6% (50/62) of the gastroscopes (100-33,000 CFUs/mL). Not all services followed recommended guidelines. Therefore, patients who underwent gastrointestinal endoscopies were exposed to diverse pathogens.

Objective: to assess the efficacy and the effectiveness of 60-80% alcohol (v/v) in the disinfection of semi-critical materials which were either previously cleaned or not. Method: studies obtained from BIREME, IBECS, MEDLINE, ScIELO, PubMed, Ask Medline web portals, and references from other studies. Criteria were created to assess the methodological quality of articles. Out of the 906 studies found, 14 have been included. Results: after materials were disinfected with alcohol, microorganisms were detected in 104/282 (36.9%) effectiveness tests and in 23/92 (25.0%) efficacy tests that were conducted. In the field studies, disinfection was not achieved for 74/218 (33.9%) of the products that were submitted to previous cleaning and for 30/64 (46.9%) of the ones which were not submitted to previous cleaning. In the experimental studies, alcohol disinfection was not efficacy in 11/30 (36.7%) and 12/62 (19.4%) of products, respectively. The studies were not found to have followed standardized methods. Conclusion: disinfection of semi-critical products with alcohol 70% - or in an approximate concentration - cannot be recommended to all health care products in an unrestricted way. However, according to the type of semi-critical product, disinfection can be attained with or without previous cleaning.

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Objective: To evaluate the efficacy of detergent and friction on removal of traditional biofilm and cyclic-buildup biofilm (CBB) from polytetrafluoroethylene (PTFE) channels and to evaluate the efficacy of glutaraldehyde to kill residual bacteria after cleaning. Methods: PTFE channels were exposed to artificial test soil containing 108 CFU/mL of Pseudomonas aeruginosa and Enterococcus faecalis, followed by full cleaning and high-level disinfection (HLD) for five repeated rounds to establish CBB. For traditional biofilm, the HLD step was omitted. Cleaning with enzymatic and alkaline detergents, bristle brush, and Pull Thru channel cleaner were compared to a water flush only. Carbohydrate, protein, viable count, adenosine triphosphate (ATP) levels were analyzed and atomic force microscopy (AFM) was performed. Results: In the absence of friction, cleaning of traditional biofilm and CBB was not effective compared to the positive control (Dunn-Bonferroni tests; P > .05) regardless of the detergent used. ATP, protein, and carbohydrate analyses were unable to detect traditional biofilm or CBB. The AFM analysis showed that fixation resulted in CBB being smoother and more compact than traditional biofilm. Conclusion: Friction during the cleaning process was a critical parameter regardless of the detergent used for removal of either traditional biofilm or CBB. Glutaraldehyde effectively killed the remaining microorganisms regardless of the cleaning method used.