Hydrogen peroxide-related colitis (previously known as ”pseudolipomatosis“): a series of cases occurring in an epidemic pattern

Cammarota, Giovanni; Cesaro, Paola; Cazzato, Alessia; Fedeli, Paolo; Riccioni, Maria Elena; Sparano, L.; Vitale, Giovanna; Costamagna, Guido; Gasbarrini, G.; Larocca, Luigi Maria

doi:10.1055/s-2007-966652

Cited by 18 publications

(38 citation statements)

References 5 publications

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“…Gutterman et al [209] identified only eight studies "which reported numerous adverse outcomes to healthcare personnel associated with endoscope reprocessing", including one case report with asthma for workers using a peracetic acid and hydrogen peroxide based product. The most commonly-reported side effect of peracetic acid in patients is a form of colitis, previously known as pseudolipomatosis [210] , which is commonly induced by hydrogen peroxide and peracetic acid but occasionally also by glutaraldehyde [211] . The colitis is often self-limiting but sometimes requires medical treatment.…”

Section: Clinical Side Effects Of Peracetic Acidmentioning

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: Clinical Side Effects Of Peracetic Acidmentioning

confidence: 99%

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

Kampf

Fliss

Martiny

2014

WJGE

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“…Esses mesmos achados já tinham sido descritos em seres humanos submetidos à aplicação retal de H 2 O 2 que desenvolveram quadros graves de colite, até mesmo com evolução fatal 42,43 . Quando se constata que a deficiência de AGCC é capaz de deflagrar a CE é lícito supor que a aplicação regular de AGCC no cólon excluso, restabelecendo o fornecimento de butirato, poderia restabelecer o equilíbrio do metabolismo celular, reduzindo a lipoperoxidação e, consequentemente, a lesão tecidual.…”

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Efeitos do butirato nos níveis de peroxidação lipídica em células da mucosa cólica sem trânsito fecal: estudo experimental em ratos

Lameiro

Silva²,

Marques

et al. 2011

Rev bras. colo-proctol.

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“…A number of different pathogenetic mechanisms have been hypothesized for this condition, including intramucosal penetration of air by mechanical injury during insufflation, biopsy, or other procedures (3). Other authors have suggested that chemical injury by disinfectants, particularly hydrogen peroxide, contributes to the pathogenesis of these lesions (4,5). Here we report and discuss colonic pseudolipomatosis incidentally found in a series of patients undergoing routine colonoscopy and underline the endoscopic pattern and diagnostic difficulties.…”

Section: Introductionmentioning

confidence: 72%

Colonic mucosal pseudolipomatosis: Are we aware of it?

Ersöz¹,

Toros²,

Çakar³

et al. 2016

UCD

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Objective: Colonic mucosal pseudolipomatosis is rare, and its pathogenesis is controversial. A number of mechanisms, including mechanical injury during an endoscopic procedure or chemical injury by disinfectant, seem to contribute to its pathogenesis. Results:We found pseudolipomatosis in 14 of 1370 colonoscopy cases (1.02%). Of these 14 patients, 8 were male and 6 were female. The male patients were between 24 and 66 years, with a mean of 39; the female patients were between 26 and 58 years, with a mean of 42. Conclusion:Many endoscopists are unaware of the lesion, and the diagnosis is generally possible only after pathological assessment of multiple biopsies taken from suspect lesions. Here we report and discuss colonic pseudolipomatosis incidentally found in a series of patients undergoing routine colonoscopy, and we underline the endoscopic pattern and diagnostic difficulties.

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Hydrogen peroxide-related colitis (previously known as ”pseudolipomatosis“): a series of cases occurring in an epidemic pattern

Cited by 18 publications

References 5 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?

Efeitos do butirato nos níveis de peroxidação lipídica em células da mucosa cólica sem trânsito fecal: estudo experimental em ratos

Colonic mucosal pseudolipomatosis: Are we aware of it?

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