Efficacy of 10 different cleaning processes in a washer–disinfector for flexible endoscopes

Zühlsdorf, B.; Floss, H.; Martiny, H

doi:10.1016/j.jhin.2004.01.001

Cited by 34 publications

(30 citation statements)

References 22 publications

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“…Some cleaning agents are enzymatic, others are non-enzymatic [55,56] . The cleaning agent should be compatible with the disinfectant agent.…”

Section: Cleaning Agentsmentioning

confidence: 99%

“…In contaminated test tubes the cleaning step during automatic processing of flexible endoscopes shows variable results, depending on the type of process and the cleaning agent [58] . Some cleaning processes using a detergent were significantly less effective (0.3 log10-steps) than water alone (1.1-2.6 log10-steps), indicating that the entire cleaning process needs to be evaluated critically [55,56] . In contrast, other cleaning processes were significantly more effective (4.1 log10-steps) [56] .…”

Section: Pathogens On Flexible Endoscopes After Cleaningmentioning

confidence: 99%

“…Some cleaning processes using a detergent were significantly less effective (0.3 log10-steps) than water alone (1.1-2.6 log10-steps), indicating that the entire cleaning process needs to be evaluated critically [55,56] . In contrast, other cleaning processes were significantly more effective (4.1 log10-steps) [56] . HCV is usually completely removed from the biopsy suction channel by the cleaning step alone, as demonstrated in 19 upper gastrointestinal endoscopic procedures in patients with chronic replicative hepatitis C [85] .…”

Section: Pathogens On Flexible Endoscopes After Cleaningmentioning

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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“…Some cleaning agents are enzymatic, others are non-enzymatic [55,56] . The cleaning agent should be compatible with the disinfectant agent.…”

Section: Cleaning Agentsmentioning

confidence: 99%

Section: Pathogens On Flexible Endoscopes After Cleaningmentioning

confidence: 99%

Section: Pathogens On Flexible Endoscopes After Cleaningmentioning

confidence: 99%

See 1 more Smart Citation

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

Kampf

Fliss

Martiny

2014

WJGE

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show abstract

“…Kurz nach Publikation der RKI-Empfehlungen zur Endoskopaufbereitung wurden Ergebnisse zur Effektivität verschiedener bei der Aufbereitung eingesetzter Reiniger publiziert [56,57]. Der Befund, dass einige Reiniger nicht besser sind als Wasser, ist später von einer anderen Arbeitsgruppe bestätigt worden [58].…”

Section: Reinigung: Alkalisch -Neutralenzymatisch?unclassified

Fünf Jahre Empfehlungen der Kommission für Krankenhaushygiene zur Aufbereitung flexibler Endoskope

Leiß

Bader²,

Mielke

et al. 2008

Bundesgesundheitsbl.

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“…[1][2][3][4][5] Over recent years, the driv ing force for highlighting the need to improve standards in decontamination has been the occurrence of vCJD in the UK and elsewhere, 6 although it should also be recognised that there also exists the risk of cross-infection from other pathogens, such as blood borne viruses.…”

Section: Introductionmentioning

confidence: 99%

The availability and content of dental instrument manufacturers' decontamination information

Roebuck¹,

Strang²,

Green

et al. 2008

Br Dent J

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Efficacy of 10 different cleaning processes in a washer–disinfector for flexible endoscopes

Cited by 34 publications

References 22 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?

Fünf Jahre Empfehlungen der Kommission für Krankenhaushygiene zur Aufbereitung flexibler Endoskope

The availability and content of dental instrument manufacturers' decontamination information

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