Do Conventional Cleaning and Disinfection Techniques Avoid the Risk of Endoscopic<i>Helicobacter pylori</i>Transmission?

Nürnberg, M.; Schulz, Heinrich; Rüden, H.; Vogt, Konstanze

doi:10.1055/s-2003-38149

Cited by 38 publications

(21 citation statements)

References 20 publications

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“…Infected patients leave their infectious flora on the endoscope. Hepatitis B virus DNA, hepatitis C virus RNA, human immunodeficiency virus DNA and H. pylori have been found after use of endoscopes in infected patients [83][84][85][86] , especially in the biopsy suction channel [87] , and even after cleaning [88] . It is estimated that, on average, 4 in every 1000 endoscopies result in transmission of H. pylori [89] .…”

Section: Effect Of Peracetic Acid On Pathogensmentioning

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: Effect Of Peracetic Acid On Pathogensmentioning

confidence: 99%

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

Kampf

Fliss

Martiny

2014

WJGE

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“…However, the finding of faecal bacteria is an indicator for other pathogenic organisms potentially present in that particular endoscope. In a recent study on Helicobacter pylori contamination of gastroscopes, the authors report on one contamination out of 128 samples of manually cleaned endoscopes [11]. …”

Section: Discussionmentioning

confidence: 99%

Quality control in colorectal cancer screening: Systematic microbiological investigation of endoscopes used in the NORCCAP (Norwegian Colorectal Cancer Prevention) trial

et al. 2003

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Background: Endoscopic colorectal cancer (CRC) screening is currently implemented in many countries. Since endoscopes cannot be sterilised, the transmission of infectious agents through endoscopes has been a matter of concern. We report on a continuous quality control programme in a large-scale randomised controlled trial on flexible sigmoidoscopy screening of an average-risk population. Continuously, throughout a two-year screening period, series of microbiological samples were taken from cleaned ready-to-use endoscopes and cultured for bacterial growth.

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“…La plupart des auteurs incriminent un défaut de désinfection dans la transmission de cette bactérie par l'endoscope [44,46,47,49]. Cependant, 3 études ont montré la persistance de l'HP dans l'endoscope après le nettoyage et la désinfection, détecté par culture dans deux études et par PCR dans la 3 ème [50][51][52]. Risque infectieux lié à l'endoscopie digestive élevée d'explorations endoscopiques digestives parmi les sujets séropositifs pour le VHC par rapport aux sujets témoins [63][64][65][66][67][68][69][70].…”

Section: Salmonellaunclassified

Risque infectieux lié à l’endoscopie digestive

et al. 2010

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Do Conventional Cleaning and Disinfection Techniques Avoid the Risk of EndoscopicHelicobacter pyloriTransmission?

Cited by 38 publications

References 20 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?

Quality control in colorectal cancer screening: Systematic microbiological investigation of endoscopes used in the NORCCAP (Norwegian Colorectal Cancer Prevention) trial

Risque infectieux lié à l’endoscopie digestive

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