Real-time monitoring in managing the decontamination of flexible gastrointestinal endoscopes.
OBJECTIVE
To evaluate the efficacy of endoscope reprocessing using bacteriologic methods and adenosine triphosphate (ATP) bioluminescence and to evaluate the potential benefits of the latter in managing the process.


METHODS
An endoscopy unit in each of 2 acute district general hospitals in the United Kingdom.


METHODS
Following visual observation, 8 locations important in the decontamination of gastrointestinal (GI) endoscopes were monitored during reprocessing by bacteriologic sampling (paddle method) and ATP bioluminescence.


RESULTS
Endoscope reprocessing was conducted in accordance with British Society of Gastroenterology guidelines. Bacteriologic tests required 24 hours for results to be obtained; ATP tests were completed within 2 minutes. Of the 504 sites tested throughout the decontamination process, bacterial growth was recorded on 32 occasions, 3 from the end product. Throughout the decontamination process, ATP tests obtained 95 results above benchmark values and 1 from the end product.


CONCLUSIONS
The bacteriologic results after terminal disinfection indicated that the reprocessing was carried out effectively overall. ATP results prior to disinfection indicated that manual cleaning might not have always been performed adequately and that this could have impaired the disinfection process. ATP provided a rapid means of assessing the efficacy of cleaning steps prior to terminal disinfection.
Obee
Peter C
PC
School of Applied Sciences, University of Wales Institute, Cardiff, United Kingdom. pobee@uwic.ac.uk
Griffith
Chris J
CJ
Cooper
Rose A
RA
Cooke
Richard P
RP
Bennion
Nerys E
NE
Lewis
Michael
M
D000255:Adenosine Triphosphate / Q000378:metabolism; D003428:Cross Infection / Q000517:prevention & control; D004203:Disinfection / Q000379:methods*; D020776:Endoscopes, Gastrointestinal / Q000382:microbiology*; D004866:Equipment Contamination; D006801:Humans; D008156:Luciferases
D000255:Adenosine Triphosphate; D008156:Luciferases