title: Deficiencies of automatic endoscopic reprocessors: a method to achieve high-grade disinfection of endoscopes.
abstract: BACKGROUND
  We show that disinfection using the automatic endoscopic reprocessor is not complete and propose a method for high-grade disinfection of endoscopes.
  
  
  METHODS
  We used an automatic endoscopic reprocessor, Pyser System 83, and 2% glutaraldehyde. After each endoscopic procedure, the endoscopes were divided into three groups. Endoscopes in group A were washed only by the reprocessor. Group B endoscopes were washed by the reprocessor after the connectors were soaked in glutaraldehyde for 5 minutes. The channels, valves, connecting sections of group C endoscopes, and the connectors of the machine were sprayed with glutaraldehyde before machine-washing. Swabs were taken from all 13 parts of each endoscope and machine for microbiologic culture.
  
  
  RESULTS
  Six endoscopes were positive, cumulatively, for bacterial contamination in group A. Among group B endoscopes, one remained contaminated. No endoscope was positive in group C. The difference between group A and C was statistically significant (p < .05).
  
  
  CONCLUSIONS
  Machine washing by automatic endoscopic reprocessors may not achieve complete disinfection. Additional procedures are necessary. High-grade disinfection of the connectors is critical. Disinfection of the interface between the connectors is important.
authors.affiliation: Department of Gastroenterology, Jichi Medical School, Tochigi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ido
authors.forename: Y
authors.initials: Y
authors.lastname: Ishino
authors.forename: Y
authors.initials: Y
authors.lastname: Ota
authors.forename: K
authors.initials: K
authors.lastname: Kihira
authors.forename: Y
authors.initials: Y
authors.lastname: Taniguchi
authors.forename: K
authors.initials: K
authors.lastname: Saifuku
authors.forename: K
authors.initials: K
authors.lastname: Satoh
authors.forename: C
authors.initials: C
authors.lastname: Kawamoto
authors.forename: M
authors.initials: M
authors.lastname: Hayashi
authors.forename: K
authors.initials: K
authors.lastname: Kimura
mesh_terms: D004203:Disinfection / Q000295:instrumentation* / Q000379:methods / Q000592:standards*; D019723:Endoscopes; D004866:Equipment Contamination / Q000517:prevention & control*; D005976:Glutaral / Q000494:pharmacology
chemical_list: D005976:Glutaral