Hervé, R. and Keevil, C.W.
Current limitations about the cleaning of luminal endoscopes
Journal of Hospital Infection, 83, (1), . (doi:10.1016/j.jhin.2012.08.008). (PMID:23098682).
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Background: The presence and potential build up of patient material such as proteins in endoscope lumens can have significant implications, including toxic reactions, device damage, inadequate disinfection/sterilisation, increased risk of biofilm development and potential transmission of pathogens.
Aim: We intended to evaluate the potential protein deposition and removal in the channels of flexible luminal endoscopes during a simple contamination/ cleaning cycle.
Methods: We evaluated the level of contamination present on disposable endoscopy forceps which come in contact with the lumen of biopsy channels. Following observations in endoscopy units, we evaluated some factors influencing protein adsorption inside luminal endoscope channels and the action of current initial cleaning techniques using a proteinaceous test soil and very sensitive fluorescence epimicroscopy.
Findings: Disposable endoscope accessories appeared likely to contribute to the contamination of lumens and were useful indicators of the amount of proteinaceous soil transiting through the channels of luminal endoscopes. Enzymatic cleaning according to the manufacturer’s recommendations and brushing of the channels were ineffective at removing all proteinaceous residues from new endoscope channels after a single contamination. Rinsing applied immediately after contamination only slightly improved decontamination outcome.
Conclusion: Limited action of current decontamination procedures and the lack of applicable quality control methods to assess channel cleanliness between each patient contribute to increasing the risk of cross infection of potentially harmful microorganisms and molecules during endoscopy procedures.
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