Risk of contamination of sterile biopsy forceps in disinfected endoscopes

Lee, R.M.; Ra, Kozarek; Raltz, SL; Sumida, SE

doi:10.1016/s0016-5107(97)80110-1

Cited by 4 publications

(4 citation statements)

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“…15 In addition, endoscope-transmitted infections have been reported, including Salmonella spp., E. coli, Klebsiella pneumoniae and Pseudomonas aeruginosa . 35 Long-term infection with H. pylori 15 or acid-suppressive therapy 16 enables non- Helicobacter bacteria to colonize the host stomach. A diverse community of 128 phylotypes was identified using large-scale 16S rRNA sequencing in 23 gastric endoscopic biopsy samples, suggesting that the human stomach may be host to a distinct microbial ecosystem.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pyloriattenuates lipopolysaccharide-induced nitric oxide production by murine macrophages

Tang

Chang

et al. 2011

Innate Immun

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Intragastric growth of Helicobacter pylori and non-Helicobacter microorganisms is thought to be associated with elevated levels of pro-inflammatory cytokines and the production of NO these effects can lead to chronic inflammation. Microorganisms can activate the expression of iNOS and the production of NO by macrophages through stimulation with bacterial LPS. Helicobacter pylori can evade these vigorous immune responses, but the underlying mechanism remains unknown. In this study, we used a murine model of macrophage infection to demonstrate that H. pylori inhibits LPS-induced expression of iNOS and production of NO by macrophages. Suppression of LPS-induced NO production by macrophages led to elevated survival of H. pylori in a trans-well system. This effect was abrogated in macrophages from iNOS(-/-) mice. Analysis of iNOS mRNA and protein levels revealed that H. pylori inhibits iNOS expression at both transcriptional and post-transcriptional levels, and that these effects occurred with live bacteria. Furthermore, the effect of H. pylori involved down-regulation of the mitogen-activated protein kinase pathway and the translocation of active NF-κB into the nucleus. Taken together, our results reveal a new mechanism by which H. pylori modulates the innate immune responses of the host and maintains a persistent infection within the stomach.

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Section: Discussionmentioning

confidence: 99%

Helicobacter pyloriattenuates lipopolysaccharide-induced nitric oxide production by murine macrophages

Tang

Chang

et al. 2011

Innate Immun

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“…The air and water channels may, however, also be contaminated [80] . If biopsy suction channels are not adequately cleaned, remaining pathogens may contaminate single-use sterile biopsy forceps during passage [81,82] . Infected patients leave their infectious flora on the endoscope.…”

Section: Effect Of Peracetic Acid On Pathogensmentioning

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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“…-kontaminiertes Leitungswasser oder unsteriles Aqua destillata zur Befüllung der Optikspülflasche -Bildung eines mikrobiellen Biofilms in der Flasche oder dem Anschlussschlauch des Optikspülsystems bei nicht korrekter Aufbereitung. [72][73][74][75][76][77][78][79]. Sie berücksichtigen die Leitlinien der Deutschen Gesellschaft für Verdauungs-und Stoffwechselkrankheiten (DGVS) [68] und die Leitlinien anderer europäischer [56-58, 60, 61, 69-71] und amerikanischer Fachgesellschaften [55,59] inkl.…”

Section: Mängel Des Endoskopischen Zusatzinstrumentariums Und Optikspunclassified

Anforderungen an die Hygiene bei der Aufbereitung von Medizinprodukten

2012

Bundesgesundheitsbl.

175

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Risk of contamination of sterile biopsy forceps in disinfected endoscopes

Cited by 4 publications

References 0 publications

Helicobacter pyloriattenuates lipopolysaccharide-induced nitric oxide production by murine macrophages

Helicobacter pyloriattenuates lipopolysaccharide-induced nitric oxide production by murine macrophages

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

Anforderungen an die Hygiene bei der Aufbereitung von Medizinprodukten

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