Disinfection of upper gastrointestinal fibreoptic endoscopy equipment: an evaluation of a cetrimide chlorhexidine solution and glutaraldehyde.

Abstract

SUMMARY There is little information available on the bacteriological contamination of upper gastrointestinal fibreoptic endoscopes during routine use and the effects of 'disinfecting solutions'. A bacteriological evaluation was therefore made of cleaning an endoscope and its ancillary equipment with (1) water, (2) an aqueous solution of 1 % cetrimide with 0.1 % chlorhexidine, and (3) activated aqueous 20% glutaraldehyde. All equipment, but particularly the endoscope itself, was found to be heavily contaminated after use with a wide variety of organisms of which 53 % were Gram positive.Cleaning the endoscope and ancillary equipment with water and the cetrimide/chlorhexidine solution alone or in combination was inadequate to produce disinfection but immersion in glutaraldehyde for two minutes consistently prcduced sterile cultures with our sampling technique. A rapid and simple method for disinfection of endoscopic equipment is therefore recommended and we think this is especially suitable for busy endoscopy units.

Antimicrobial Activity, Uses and Mechanism of Action of Glutaraldehyde

“…Compared with other disinfectants, glutaraldehyde was found to be superior for disinfection of face masks, breathing tubes and other instruments (Meeks et al 1967). It has proved highly effective for rapid and safe disinfection of gastrointestinal endoscopy equipment (Axon et al 1974;Elson et al 1975;Tolon et al 1976;Noy et al 1977;Carr-Locke & Clayton 1978) and has been used for sterilizing non-woven material for surgical use (LesAffre 1977).…”

Endoscope Disinfection Using Acidic Electrolytic Water

“…Contamination of endoscopes with bacteria and viruses is an important issue [1 -16], particularly since transmission of Helicobacter pylori via endoscopic instruments has been documented [17][18][19][20][21]. After ten minutes' exposure [7], dis infectants such as glutaraldehyde solution can eliminate 85-100% of the bacterial contamination caused by endos copy [6][7][8][9][10][11][12][13][14][15][16]. However, the disinfectants currently available are expensive, hazardous, and often require long periods of exposure.…”

“…Due to patient requests and screening measures, the frequency of endoscopic examinations may become more frequent in areas in which there is a high prevalence of H. pylori infection, in order to investigate H. pyloriassociated disorders and to detect the bacterium. Repeated use of endoscopes means that rapid, convenient, and safe disinfection of endoscopic instruments is extremely impor-Endoscopy 1999; 31 (7); 528-535 © Georg Thieme Verlag Stuttgart • New York ISSN 0013-726X tant; however, equipment meeting these requirements for cleaning and disinfection has so far not been available.…”

Alkali-induced revival of Bacillus spores after inactivation by glutaraldehyde

“…Glutaraldehyde is widely used in hospitals and industry as a chemosterilizing agent to inactivate vegetative cells and spores of microorganisms [1][2][3][4][5][6]. Although its mode of action is not fully established, it is thought that the two free aldehyde groups act on vegetative cell wall and spore coat or cortex causing cross-linking [7][8][9][10][11].…”