Evaluation of the Effectiveness of an Enzymatic Cleaner and Glutaraldehyde-Based Disinfectant for Chemothermal Processing of Flexible Endoscopes in Washer-Disinfectors in Accordance with prEN ISO 15 883

Zühlsdorf, B.; Kampf, Günter

doi:10.1055/s-2006-925133

Cited by 12 publications

(5 citation statements)

References 20 publications

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“…The cleaning agent should be compatible with the disinfectant agent. The entire process may then achieve a 9 log10 reduction of microorganisms in a tube simulating an endoscope channel [57] . Other processes using different types of cleaning or disinfection agents have revealed lower overall reductions, e.g., a 7 log10 reduction [58] .…”

Section: Cleaning Agentsmentioning

confidence: 99%

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: Cleaning Agentsmentioning

confidence: 99%

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

Kampf

Fliss

Martiny

2014

WJGE

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“…Zühlsdorf and Kampf also determined in vitro efficacy of the enzymatic cleaner and Glutaraldehydebased disinfectant for chemo thermal processing of flexible endoscopes in a washer disinfector. 24 This is important for clinical practice in developed countries, where ETO or plasma sterilization systems are not available easily. Use of these portable solutions for instrument processing becomes cheaper and handy in remote areas.…”

Section: Discussionmentioning

confidence: 99%

An insight into outbreak of atypical mycobacterial infection following percutaneous nephrolithotomy - Role of cleaning and sterilization techniques inspected

Arpan Choudhary,

Manas Sharma,

Deep Kumar Jain

et al. 2023

Asian J Med Sci

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Background: Atypical wound infections following minimal access surgery continue to affect smooth recovery. Percutaneous nephrolithotomy (PCNL) for renal stones involves various small-sized nephroscopes and accessories. Improper cleaning and disinfection of which may result in bacterial biofilms formation and infections. Aims and Objectives: We inspected an outbreak of atypical wound infection after PCNL to find the responsible factor. Materials and Methods: This retrospective observational study had three groups based on cleaning and sterilization methods. In group A, manual cleaning of instruments was done followed by high-level disinfection using glutaraldehyde 2% solution with 20 min submersion. In group B, manual cleaning was supplemented with multienzyme cleaning with 10 min submersion but disinfection method was same as in group A. In group C, manual and enzyme cleaning was combined with ethylene oxide (ETO) sterilization. The outcome was assessed as wound infection occurrence at 1-month follow-up. Results: The study had 81 participants with 61 male and 20 females. The mean age was 36±16 years. Group A, B, and C had 32, 24, and 25 participants, respectively. Pre-operative parameters were comparable among the groups. Late wound infection (at 1-month follow-up) occurred in 11 cases from group A, but none from others (P=0.004). Culture-revealed atypical mycobacterial growth in four cases, while Staphylococcus in another. Rests were sterile. Six patients were relieved after clarithromycin course for 1–5 months. Three patients needed scar excision. Conclusion: Manual cleaning with high-level disinfection is not adequate against atypical mycobacterial infections. A combination of enzymatic cleaning and high-level disinfection with glutaraldehyde or ETO sterilization effectively minimizes these infections.

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“…Brazil), adapted from a previously described model 20 . High organic load suspensions containing 0.3% of red blood sheep cells (BioCampo, Bom Jardim, RJ, Brazil), 0.3% bovine serum albumin (Sigma-Aldrich, St. Louis, Mo, USA), and 10 8 CFU/mL were prepared immediately before the test.…”

Section: Contamination and Disinfection Of Test Piecesmentioning

confidence: 99%

Effectiveness of current disinfection procedures against biofilm on contaminated GI endoscopes

Neves

Silva

Ventura

et al. 2016

Gastrointestinal Endoscopy

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Evaluation of the Effectiveness of an Enzymatic Cleaner and Glutaraldehyde-Based Disinfectant for Chemothermal Processing of Flexible Endoscopes in Washer-Disinfectors in Accordance with prEN ISO 15 883

Cited by 12 publications

References 20 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?

An insight into outbreak of atypical mycobacterial infection following percutaneous nephrolithotomy - Role of cleaning and sterilization techniques inspected

Effectiveness of current disinfection procedures against biofilm on contaminated GI endoscopes

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