Chemical Colitis Due to Glutaraldehyde: Case Series and Review of the Literature

Ahıshalı, Emel; Uygur-Bayramiçli, Oya; Dolapcioglu, Can; Dabak, Reşat; Mengi, Alperen; Işik, Aygün; Ermiş, Elvan

doi:10.1007/s10620-008-0630-2

Cited by 32 publications

(13 citation statements)

References 11 publications

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“…Gutterman et al [209] identified only eight studies "which reported numerous adverse outcomes to healthcare personnel associated with endoscope reprocessing", including one case report with asthma for workers using a peracetic acid and hydrogen peroxide based product. The most commonly-reported side effect of peracetic acid in patients is a form of colitis, previously known as pseudolipomatosis [210] , which is commonly induced by hydrogen peroxide and peracetic acid but occasionally also by glutaraldehyde [211] . The colitis is often self-limiting but sometimes requires medical treatment.…”

Section: Clinical Side Effects Of Peracetic Acidmentioning

confidence: 99%

Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes?

Kampf

Fliss

Martiny

2014

WJGE

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The bioburden (blood, protein, pathogens and biofilm) on flexible endoscopes after use is often high and its removal is essential to allow effective disinfection, especially in the case of peracetic acid-based disinfectants, which are easily inactivated by organic material. Cleaning processes using conventional cleaners remove a variable but often sufficient amount of the bioburden. Some formulations based on peracetic acid are recommended by manufacturers for the cleaning step. We performed a systematic literature search and reviewed the available evidence to clarify the suitability of peracetic acid-based formulations for cleaning flexible endoscopes. A total of 243 studies were evaluated. No studies have yet demonstrated that peracetic acidbased cleaners are as effective as conventional cleaners. Some peracetic acid-based formulations have demonstrated some biofilm-cleaning effects and no biofilmfixation potential, while others have a limited cleaning effect and a clear biofilm-fixation potential. All published data demonstrated a limited blood cleaning effect and a substantial blood and nerve tissue fixation potential of peracetic acid. No evidence-based guidelines on reprocessing flexible endoscopes currently recommend using cleaners containing peracetic acid, but some guidelines clearly recommend not using them because of their fixation potential. Evidence from some outbreaks, especially those involving highly multidrug-resistant gram-negative pathogens, indicated that disinfection using peracetic acid may be insufficient if the preceding cleaning step is not performed adequately. Based on this review we conclude that peracetic acid-based formulations should not be used for cleaning flexible endoscopes. Key words: Peracetic acid; Cleaning; Flexible endoscope; Biofilm; Resistance; Bioburden; Blood; Disinfection; Reprocessing Core tip: Some formulations based on peracetic acid (PAA) are recommended by manufacturers for cleaning flexible endoscopes. We reviewed 243 studies to analyse the evidence for this recommendation. No study demonstrated that PAA-based cleaners were as effective as conventional cleaners, and some PAA-based formulations had clear biofilm-fixation potential. Dried blood and nerve tissue were substantially fixed by PAA. Some outbreaks, especially of highly multidrug-resistant gram-negative pathogens, indicated that insufficient cleaning could not be compensated for by using PAA in the disinfection step. PAA-based formulations should not be used for cleaning flexible endoscopes.

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Section: Clinical Side Effects Of Peracetic Acidmentioning

confidence: 99%

Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes?

Kampf

Fliss

Martiny

2014

WJGE

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“…This finding is considered to be important for applying ESW to disinfection method in clinical settings. High-level disinfectants, such as glutaraldehyde (GA), have disinfection potentials against any microorganisms; however, it has been reported that it may be harmful to patients and healthcare workers (1,2). ESW is considered less toxic than GA (13), and it has been reported to be effective against disinfectantresistant bacteria, such as Pseudomonas aeruginosa (6), spore-forming bacteria (3,4,6), and bloodborne infectious pathogens such as hepatitis B virus (8,11) and HIV (5) depending on the condition.…”

Section: -10mentioning

confidence: 99%

Disinfection potential of electrolyzed strongly acidic water against Mycobacteria: Conditions of disinfection and recovery of disinfection potential by reelectrolysis

Nakano

Hayashi

et al. 2015

Biomed. Res.

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We attempted to clarify in detail the conditions of disinfection using electrolyzed strongly acidic water (ESW) against Mycobacteria, and the recovery of the disinfection potential of inactivated ESW by re-electrolysis. We mixed ESW containing 10, 20, and 30 ppm free chlorine with M. bovis cells (10 5 -10 8 CFU/mL) for 0-7 min. The disinfection potential of ESW positively correlated with free chlorine concentration, and negatively correlated with the initial density of bacterial cells. To clarify the recovery of the disinfection potential of inactivated ESW by re-electrolysis, we mixed ESW containing 10 ppm free chlorine with M. bovis cells (10 7 CFU/mL) for 1 min. The number of viable cells decreased to 1/10 3 , but the cells were still detected. After re-electrolysis for 7 min, viable cells were not detected. Moreover, we confirmed by reusing the re-electrolyzed water against M. bovis cells that it regained its disinfection potential. These findings indicate that ESW once inactivated during disinfection can be re-activated by re-electrolysis. In conclusion, we were able to clarify in detail the conditions of ESW against Mycobacteria, and found the recovery of the disinfection potential of inactivated ESW by re-electrolysis.Electrolyzed strongly acidic water (ESW) has been widely used for infection control in clinical settings (7, 9) because it has been proved to be effective for the disinfection of disinfectant-resistant bacteria, such as Mycobacteria (15), Pseudomonas aeruginosa (6), and spore-forming bacteria (3, 4, 6), and viruses causing blood-borne infections such as hepatitis B virus (8, 11) and HIV (5). ESW is also expected to be used against pathogens of emerging diseases, such as the avian influenza virus H5N1 (12). Free chlorine (residual chlorine), which is the active component of ESW for disinfection, is easily inactivated by organic molecules. This feature of ESW is advantageous in terms of reducing environmental load and safety for patients and healthcare workers; however, it may be a disadvantage due to its unstable disinfective effect. Considering the effectiveness and the stability of the disinfective effect of ESW, high free chlorine concentrations are better for infection control; however, ESW with high free chlorine concentrations is corrosive against metals. There are no data available regarding the relationship between the free chlorine concentration of ESW and the number of bacterial

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“…Splenic hematoma and rupture, intramural hematoma, subcutaneous emphysema in the absence of frank colonic perforation, tearing of mesenteric vessels with intra-abdominal bleeding, thrombosis in carotid-subclavian artery bypass graft, thrombophlebitis in the intravenous site, intestinal obstruction, and ischemic and chemical colitis secondary to glutaraldehyde or air insufflation have been reported following colonoscopy in literature [3,14,15,23,31,57,58].…”

Section: Miscellaneousmentioning

confidence: 99%

Complications of Colonoscopy

Waye

Aisenberg

Rubin

2013

Practical Colonoscopy

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Chemical Colitis Due to Glutaraldehyde: Case Series and Review of the Literature

Cited by 32 publications

References 11 publications

Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes?

Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes?

<b>Disinfection potential of electrolyzed strongly acidic water against </b><i><b>Mycobacteria</b></i><b>: Conditions of disinfection and recovery of disinfection potential by reelectr</b><b>olysis </b>

Complications of Colonoscopy

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