A Review of Current Disinfectants for Gastrointestinal Endoscopic Reprocessing

Park, Sanghoon; Jang, Jae Young; Koo, Ja Seol; Park, Jeong Bae; Lim, Yun Jeong; Hong, Su Jin; Kim, Sang Woo; Chun, Hoon Jai

doi:10.5946/ce.2013.46.4.337

Cited by 26 publications

(18 citation statements)

References 23 publications

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“…The present study results showed that there was minimal compliance for processing of endoscopic accessory equipment. This agrees with the results of another study which found that a third of respondents reported that they reused disposable accessories (12). Reuse of disposable accessories should be avoided so as to limit the likelihood of cross-infection between patients and staff (17).…”

Section: Discussionsupporting

confidence: 82%

“…Compliance with national guidelines was achieved for disinfection steps with partial compliance for treatment of the endoscope after disinfection. Another study found that most practitioners complied with the established disinfection guidelines (12), while Seoane-Vazquez and colleagues reported that the primary cause of endoscopy-related infections was poor reprocessing practices (13).…”

Section: Discussionmentioning

confidence: 99%

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Reprocessing practices for gastrointestinal endoscopes: a multicentre study in Egyptian university hospitals

El-Sokkary

Wegdan

Mosaad

et al. 2017

East Mediterr Health J

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The aim of this study was to assess the practices of health care workers during gasterointestinal endoscope reprocessing, evaluate their knowledge about reprocessing, and verify their compliance with laboratory and microbiological tests in endoscopy units at Zagazig University and Fayoum University hospitals. All nursing staff on duty from 10 endoscopy units, with 16 flexible endoscopes, were included. Knowledge and practice were assessed by a questionnaire and a checklist. The mean knowledge score was 7.5 (SD 1.9), which was poor. Compliance was 90% for disinfection and 74% for endoscope processing after disinfection. Before reuse after cleaning, no organisms were detected in 5 endoscopes, while 8 colony forming units were found in 2. Pseudomonas aeruginosa was the most common organism isolated. Strict implementation of the reprocessing guidelines are needed, especially the pre-cleaning stage and leak testing. Repeating high level disinfection after storage and before use must be followed. Pratiques de traitement des endoscopes gastro-intestinaux : étude multicentrique dans des hôpitaux universitaires en ÉgypteRÉSUMÉ La présente étude avait pour objectif d'évaluer les pratiques des agents de soins de santé lors du traitement des endoscopes gastro-intestinaux, de mesurer leur connaissance du traitement, et de vérifier leur bonne exécution des tests de laboratoire et des tests microbiologiques dans les unités d'endoscopie des hôpitaux universitaires de Zagazig et de Fayoum. Toutes les équipes de personnels infirmiers issues de 10 unités d'endoscopie, avec 16 endoscopes souples, ont été incluses dans l'étude. Les connaissances et les pratiques ont été évaluées par un questionnaire et une liste de contrôle. Le score de connaissance moyen était de 7,5 (ET 1,9). La conformité était de 90 % pour la désinfection, et de 74 % pour le traitement des endoscopes après désinfection. Après nettoyage et avant réutilisation, aucun organisme n'a été détecté pour cinq endoscopes, et huit unités formant des colonies ont été trouvées dans deux autres endoscopes. Pseudomonas aeruginosa était l'organisme le plus couramment isolé. Une application stricte des directives de traitement est requise, notamment à l'étape du pré-nettoyage et des essais d'étanchéité. Il est important d'effectuer une désinfection de haut niveau répétée après entreposage et avant utilisation.‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫العرشون‬ ‫و‬ ‫الثالث‬ ‫املجلد‬ ‫السابع‬ ‫العدد‬ 515

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Reprocessing practices for gastrointestinal endoscopes: a multicentre study in Egyptian university hospitals

El-Sokkary

Wegdan

Mosaad

et al. 2017

East Mediterr Health J

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“…As the characteristics of propofol include a rapid onset of action with a short-term effect, a shorter recovery time, and greater patient and endoscopist satisfaction,22 propofol use may be preferred by endoscopists practicing in primary clinic setting 19. Our survey findings suggested suboptimal performance of endoscopy reprocessing, as 28% of respondents used unapproved disinfectants or did not know main ingredient of their disinfectants as well as 15% to 17% of respondents did not follow reprocessing protocols 23. A Chinese survey from 122 endoscopy units and an Italian survey from 278 endoscopy units also showed significant room for improvement in the practice of endoscopic reprocessing 24,25.…”

Section: Discussionmentioning

confidence: 85%

National Endoscopy Quality Improvement Program Remains Suboptimal in Korea

et al. 2016

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Background/AimsWe evaluated the characteristics of the National Cancer Screening Program (NCSP) and opinions regarding the National Endoscopy Quality Improvement Program (NEQIP).MethodsWe surveyed physicians performing esophagogastroduodenoscopy and/or colonoscopy screenings as part of the NCSP via e-mail between July and August in 2015. The 32-item survey instrument included endoscopic capacity, sedation, and reprocessing of endoscopes as well as opinions regarding the NEQIP.ResultsA total of 507 respondents were analyzed after the exclusion of 40 incomplete answers. Under the current capacity of the NCSP, the typical waiting time for screening endoscopy was less than 4 weeks in more than 90% of endoscopy units. Performance of endoscopy reprocessing was suboptimal, with 28% of respondents using unapproved disinfectants or not knowing the main ingredient of their disinfectants and 15% to 17% of respondents not following reprocessing protocols. Agreement with the NEQIP was optimal, because only 5.7% of respondents did not agree with NEQIP; however, familiarity with the NEQIP was suboptimal, because only 37.3% of respondents were familiar with the NEQIP criteria.ConclusionsThe NEQ-IP remains suboptimal in Korea. Given the suboptimal performance of endoscopy reprocessing and low familiarity with the NEQIP, improved quality in endoscopy reprocessing and better understanding of the NEQIP should be emphasized in Korea.

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“…Glutaraldehyde damages DNA (Hopwood, 1975) and compromises the PCR ability of DNA after some days of incubation only (Das et al, 2014). In clinical procedures, an exposure of 20 min at 20 • C in a 2% w/w glutaraldehyde solution is solely used to disinfect medical instruments (Park et al, 2013). We showed that this short incubation time of 20 min was not enough to impact the integrity and PCR ability of DNA.…”

Section: Pure λ Dna Amplification Efficiency Decreased Under Long Micmentioning

confidence: 84%

Anticipating Xenogenic Pollution at the Source: Impact of Sterilizations on DNA Release From Microbial Cultures

Calderón-Franco

Lin

Loosdrecht

et al. 2020

Front. Bioeng. Biotechnol.

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The dissemination of DNA and xenogenic elements across waterways is under scientific and public spotlight due to new gene-editing tools, such as do-it-yourself (DIY) CRISPR-Cas kits deployable at kitchen table. Over decades, prevention of spread of genetically modified organisms (GMOs), antimicrobial resistances (AMR), and pathogens from transgenic systems has focused on microbial inactivation. However, sterilization methods have not been assessed for DNA release and integrity. Here, we investigated the fate of intracellular DNA from cultures of model prokaryotic (Escherichia coli) and eukaryotic (Saccharomyces cerevisiae) cells that are traditionally used as microbial chassis for genetic modifications. DNA release was tracked during exposure of these cultures to conventional sterilization methods. Autoclaving, disinfection with glutaraldehyde, and microwaving are used to inactivate broths, healthcare equipment, and GMOs produced at kitchen table. DNA fragmentation and PCR-ability were measured on top of cell viability and morphology. Impact of these methods on DNA integrity was verified on a template of free λ DNA. Intense regular autoclaving (121 • C, 20 min) resulted in the most severe DNA degradation and lowest household gene amplification capacity: 1.28 ± 0.11, 2.08 ± 0.03, and 4.96 ± 0.28 logs differences to the non-treated controls were measured from E. coli, S. cerevisiae, and λ DNA, respectively. Microwaving exerted strong DNA fragmentation after 100 s of exposure when free λ DNA was in solution (3.23 ± 0.06 logs difference) but a minor effect was observed when DNA was released from E. coli and S. cerevisiae (0.24 ± 0.14 and 1.32 ± 0.02 logs differences with the control, respectively). Glutaraldehyde prevented DNA leakage by preserving cell structures, while DNA integrity was not altered. The results show that current sterilization methods are effective on microorganism inactivation but do not safeguard an aqueous residue exempt of biologically reusable xenogenic material, being regular autoclaving the most severe DNA-affecting method. Reappraisal of sterilization methods is required along with risk assessment on the emission of DNA fragments in urban systems and nature.

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A Review of Current Disinfectants for Gastrointestinal Endoscopic Reprocessing

Cited by 26 publications

References 23 publications

Reprocessing practices for gastrointestinal endoscopes: a multicentre study in Egyptian university hospitals

Reprocessing practices for gastrointestinal endoscopes: a multicentre study in Egyptian university hospitals

National Endoscopy Quality Improvement Program Remains Suboptimal in Korea

Anticipating Xenogenic Pollution at the Source: Impact of Sterilizations on DNA Release From Microbial Cultures

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