Evaluation of disinfection of flexible nasendoscopes using Tristel wipes: a prospective single blind study

Abstract

INTRODUCTIONThe otorhinolaryngology department at Northwick Park Hospital uses the Tristel wipes system for cleaning nasendoscopes in the outpatient clinics. This system uses chlorine dioxide as its only disinfectant. The manufacturer claims the system provides safe sterilisation of nasendoscopes. However, there appear to be no reports in the literature to date that evaluate the efficacy of this system in a clinical setting. The aim of this study was to evaluate the 'in use' efficacy of Tristel wipes in decontaminating nasendoscopes and to identify any significant contamination between cleaning and usage. METHODS A total of 31 cleaning episodes were performed. Each cleaning episode included two swabs after cleaning the scopes, one from the tip and the other from the handle. Another two swabs from the same areas were also taken before application to the patient. The microbiology unit evaluated all swabs for bacterial, fungal and mycobacterial growth. RESULTS Overall, 123 swabs from 31 cleaning episodes were tested. None of the swabs taken from the tips (n=31) or handles (n=31) after cleaning with Tristel wipes developed any organism growth. Furthermore, none of the swabs taken from the tip of the scopes before using on patients (n=31) developed any growth. Of the 31 swabs taken from the handle before use, 3 developed significant staphylococcal growth. CONCLUSIONS In our study, the 'in use' efficacy of Tristel wipes in cleaning the scopes of bacteria, fungi and mycobacteria was 100%. Attention to hand hygiene and the use of gloves should be considered when handling the cleaned scopes to minimise the risk of contamination between cleaning and application to patients.

Clinical Evaluation of Flexible Nasoendoscope Decontamination

“…This is further supported by the absence of reports of cross-infection from flexible nasoendoscope use. Unlike some of the other recent studies [7][8][9], some of our swabs (swab 3 and 4) showed some bacterial growths following decontamination with Anioxyde 1000 and automated washer. However, none of these growths are bacterial isolates from the corresponding swab 2.…”

Is a chlorine dioxide wiping procedure suitable for the high-level disinfection of nasendoscopes?

“…In our knowledge, this is the first reported study that used a nasendoscope as an in vitro test carrier in order to assess the sporicidal activity of a HLD wiping procedure. Nevertheless, a valuable study performed according to EN14561 standard (European Committee for standardization (CEN) 2007), where a frosted glass contaminated with Mycobacterium avium has undergone a disinfection with ClO 2 wipe, has already displayed a mycobactericidal activity (log 10 reduction >4) in 30 s CT with mechanical action (Tzanisakis et al, 2012). These results are consistent with those recorded in the present study despite the difference of the test carriers and the microorganisms.…”

Flexible nasoendoscopy decontamination: a comparison between Rapicide and Tristel wipes, a prospective cohort study

“…13 Tzanidakis et al illustrated that tristel wipes is a viable alternative in a clinical setting for flexible nasoendoscopy decontamination. 6 Most recently Hitchcock et al showed that Tristel wipes are equal to Perasafe and Cidex OPA in terms of microbiological efficacy.…”

“…5 A recent study in the UK validated the 'in use' efficacy of tristel wipes system in 2012, a chlorine dioxide based disinfectant, in the cleaning of flexible nasoendoscopes in preventing bacterial transmission in a clinic setting. 6 The tristel wipes system is a 3-part system that kills all organisms on a pre-cleaned surface in 30 seconds. 7 It is known to be easy to use and more economic than endoscope sheaths.…”

“…7 It is known to be easy to use and more economic than endoscope sheaths. 6 The health and safety executive of the NHS illustrated that Tristel wipes is the safer disinfectant, Class A (low hazard), when compared to Rapicide PA. 5 Additionally as a portable system, it is useful in an inpatient setting without access to disinfecting facilities.…”