Can Whipple's disease be transmitted by gastroscopes?
OBJECTIVE
To determine whether disinfection protocols currently used for gastroscopes are effective against cultures of Tropheryma whipplei.


METHODS
The bactericidal activity of 2% glutaraldehyde and two peracetic acids on the Twist-Marseille strain of T. whipplei grown in cell monolayers was determined.


METHODS
Two patients who were diagnosed as having Whipple's disease 3 years after they had had intestinal biopsies.


RESULTS
The disinfectants reduced bacteria by approximately 2 log to 3 log10 after 5 to 60 minutes of contact.


CONCLUSIONS
The bactericidal activity of a disinfectant is usually considered significant if it causes a 5 log10 or greater reduction in viable bacterial titers. Disinfecting gastroscopes with 2% glutaraldehyde or peracetic acids for 20 minutes may be insufficient to prevent transmission of T. whipplei on the instruments or stop false-positive results on polymerase chain reaction.
La Scola
Bernard
B
Unité des Rickettsies, CNRS UMR 6020, Faculté de médecine, 27 Boulevard Jean Moulin, 13385 Marseille 05, France.
Rolain
Jean-Marc
JM
Maurin
Max
M
Raoult
Didier
D
D000192:Actinomycetales / Q000302:isolation & purification / Q000472:pathogenicity*; D000328:Adult; D000368:Aged; D018562:Disease Transmission, Infectious; D004202:Disinfectants / Q000494:pharmacology*; D004866:Equipment Contamination; D017743:Equipment Reuse; D005260:Female; D020699:Gastroscopes / Q000382:microbiology*; D005976:Glutaral / Q000494:pharmacology*; D006801:Humans; D008297:Male; D010463:Peracetic Acid / Q000494:pharmacology*; D008061:Whipple Disease / Q000209:etiology*
D004202:Disinfectants; D010463:Peracetic Acid; D005976:Glutaral