Effect of different stabilized preparations of peracetic acid on biofilm

Loukili, Noureddine; Granbastien, B.; Faure, Karine; Guery, Benoît; Beaucaire, G.

doi:10.1016/j.jhin.2005.11.015

Cited by 25 publications

(8 citation statements)

References 6 publications

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“…Under natural environmental conditions, biofilms are likely to be composed of a mixture of different species [131,132] . In the laboratory, they can be grown on various materials and devices, including polystyrene microtitre plates [133][134][135][136] , haemolysis glass tubes [137,138] , stainless steel coupons [134,139] and also in Teflon tubes [140][141][142][143] , similar to endoscope channels.…”

Section: General Backgroundmentioning

confidence: 99%

“…Four peracetic acid-based products were reported, two of which fixed artificial biofilms quite strongly, while the other two containing additional quaternary ammonium compounds showed no biofilm fixation [138] . An E. coli biofilm exposed to three different peracetic acid-based formulations (one with peracetic acid, one with additional non-ionic surfactant, and one with additional cationic surfactant) was partly removed by two formulations, and not fixed by any of the three formulations [137] . Finally, sublethal concentrations of chlorine dioxide, an active compound used for disinfection of endoscopes, may accelerate formation of B. subtilis or P. aeruginosa biofilms compared with biofilms grown in the absence of chlorine dioxide [186] .…”

Section: Effect Of Peracetic Acid On Biofilmmentioning

confidence: 99%

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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: General Backgroundmentioning

confidence: 99%

Section: Effect Of Peracetic Acid On Biofilmmentioning

confidence: 99%

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

Kampf

Fliss

Martiny

2014

WJGE

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“…Several chemicals used for high-level disinfection, such as glutaraldehyde and even some formulations with peracetic acid, can fixate proteins and thereby lead to bacterial accumulation in duodenoscope channels. 23,24 Therefore, removal of debris and bacteria during manual cleaning is essential for the effectivity of highlevel disinfection, and SDS could be an excellent addition in this regard, especially given its ability to disrupt biofilms. 25 Further research will be needed to evaluate the effect of SDS on bacteria in conjunction with organic debris.…”

Section: Discussionmentioning

confidence: 99%

A dynamic flow model mimicking duodenoscope reprocessing after bacterial contamination for translational research

Heuvelmans

Woudstra²,

Wunderink³

et al. 2022

ASHE

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Objective: Duodenoscopy-associated infections and outbreaks are reported globally despite strict adherence to duodenoscope reprocessing protocols. Therefore, new developments in the reprocessing procedure are needed. Design: We evaluated a novel dynamic flow model for an additional cleaning step between precleaning and manual cleaning in the reprocessing procedure. Methods: A parallel plate flow chamber with a fluorinated ethylene propylene bottom plate was used to mimic the duodenoscope channels. The flow chamber was inoculated with a suspension containing Klebsiella pneumoniae to simulate bacterial contamination during a duodenoscopic procedure. After inoculation the flow chamber was flushed with a detergent mimicking precleaning. Subsequently the flow chamber was subjected to different interventions: flow with phosphate-buffered saline (PBS), flow with 2 commercial detergents, flow with sodium dodecyl sulfate with 3 different concentrations, and flow with microbubbles. Adhering bacteria were counted using phase-contrast microscopy throughout the experiment, and finally, bacterial viability was assessed. Results: During precleaning both PBS and 1% (v/v) Neodisher Mediclean Forte were able to desorb bacteria, but neither proved superior. After precleaning only sodium dodecyl sulfate could desorb bacteria. Conclusions: Flushing during precleaning is an essential step for reducing adhering luminal bacteria, and sodium dodecyl sulfate is a promising detergent for bacterial desorption from duodenoscope channels after precleaning.

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“…The efficacy of peracetic acid against bacteria in biofilm is comparable to O -phatalaldehyde and is superior to glutaraldehyde [ 90 ]. It should however be noted that certain peracetic acid formulations can have a fixating effect on biofilm [ 91 , 92 ]. In a clinical setting peracetic acid has been compared to double HLD revealing similar effectiveness [ 93 ].…”

Section: Liquid Chemical Sterilizationmentioning

confidence: 99%

A narrative review on current duodenoscope reprocessing techniques and novel developments

Heuvelmans

Wunderink

Mei

et al. 2021

Antimicrob Resist Infect Control

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Duodenoscopy-associated infections occur worldwide despite strict adherence to reprocessing standards. The exact scope of the problem remains unknown because a standardized sampling protocol and uniform sampling techniques are lacking. The currently available multi-society protocol for microbial culturing by the Centers for Disease Control and Prevention, the United States Food and Drug Administration (FDA) and the American Society for Microbiology, published in 2018 is too laborious for broad clinical implementation. A more practical sampling protocol would result in increased accessibility and widespread implementation. This will aid to reduce the prevalence of duodenoscope contamination. To reduce the risk of duodenoscopy-associated pathogen transmission the FDA advised four supplemental reprocessing measures. These measures include double high-level disinfection, microbiological culturing and quarantine, ethylene oxide gas sterilization and liquid chemical sterilization. When the supplemental measures were advised in 2015 data evaluating their efficacy were sparse. Over the past five years data regarding the supplemental measures have become available that place the efficacy of the supplemental measures into context. As expected the advised supplemental measures have resulted in increased costs and reprocessing time. Unfortunately, it has also become clear that the efficacy of the supplemental measures falls short and that duodenoscope contamination remains a problem. There is a lot of research into new reprocessing methods and technical applications trying to solve the problem of duodenoscope contamination. Several promising developments such as single-use duodenoscopes, electrolyzed acidic water, and vaporized hydrogen peroxide plasma are already applied in a clinical setting.

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Effect of different stabilized preparations of peracetic acid on biofilm

Cited by 25 publications

References 6 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?

A dynamic flow model mimicking duodenoscope reprocessing after bacterial contamination for translational research

A narrative review on current duodenoscope reprocessing techniques and novel developments

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