title: Microbial bioburden in endoscope reprocessing and an in-use evaluation of the high-level disinfection capabilities of Cidex PA.
abstract: Most endoscopy clinics use 2% glutaraldehyde as a high-level disinfectant for reprocessing flexible endoscopes. However, even with contact times greater than 30 minutes, survival of organisms has been documented. We compared the high-level disinfection capabilities of glutaraldehyde (45-minute immersion) with a new peracetic acid germicide (20- to 25-minute immersion). Channels, valve housings, and outer sheaths were sampled to quantify bioburden levels after a patient procedure, after manual cleaning, and after disinfection. Total mean bioburden after clinical use was greater than 6 log10 colony-forming units (CFU). Manual cleaning reduced the bioburden by means of 4.7 log10 CFU (gastroscopes) and 6.2 log10 CFU (colonoscopes). High-level disinfection with the new product was achieved in five of six (product stressed by EPA Reuse Test) and 7 of 10 (product stressed by dilution and organic load) successfully disinfected endoscopes, whereas glutaraldehyde achieved it in 4 of 10 (product stressed by dilution and organic load). We conclude that the new peracetic acid product (20- and 25-minute contact time) is at least as effective as glutaraldehyde (45-minute contact time) for reducing the bioburden of vegetative aerobic organisms in endoscopes.
authors.affiliation: Division of Environmental and Occupational Health, School of Public Health, University of Minnesota, Minneapolis 55455, USA.
authors.forename: D
authors.initials: D
authors.lastname: Vesley
authors.forename: J
authors.initials: J
authors.lastname: Melson
authors.forename: P
authors.initials: P
authors.lastname: Stanley
mesh_terms: D015169:Colony Count, Microbial; D003428:Cross Infection / Q000517:prevention & control; D004202:Disinfectants; D004203:Disinfection / Q000379:methods*; D004338:Drug Combinations; D004353:Drug Evaluation, Preclinical; D019723:Endoscopes / Q000382:microbiology*; D004724:Endoscopy / Q000451:nursing; D004866:Equipment Contamination / Q000517:prevention & control*; D005976:Glutaral; D006801:Humans; D010463:Peracetic Acid; D013997:Time Factors
chemical_list: D004202:Disinfectants; D004338:Drug Combinations; D010463:Peracetic Acid; D005976:Glutaral