title: Experimental evaluation of an automated endoscope reprocessor with in situ generation of peracetic acid for disinfection of semicritical devices.
abstract: OBJECTIVE
  To evaluate the effectiveness of a high-level disinfection solution generated inside an endoscope processing system for decontaminating external and internal surfaces of experimentally contaminated heat-sensitive medical devices.
  
  
  METHODS
  The American Society for Testing and Materials Simulated-Use Test protocol (E1837-02), which incorporates a soil load in each inoculum, was used to evaluate the efficacy of the system when processing 4 common types of endoscopes contaminated separately with 5 types of nosocomial pathogens: Pseudomonas aeruginosa (ATCC 15442), spores of Clostridium difficile (ATCC 9689), a glutaraldehyde-resistant strain of Mycobacterium chelonae, a vancomycin-resistant strain of Enterococcus faecalis, and a methicillin-resistant strain of Staphylococcus aureus. Rinse solution samples from channels and from surfaces of the processed endoscopes were tested for any microbicidal residues.
  
  
  RESULTS
  For all organisms tested, the baseline level of contamination of the endoscopes ranged from 5 log(10) to greater than 7 log(10) at each external surface site and internal channel. All tests showed reductions in viability of the test organisms to undetectable levels. All rinse solution samples from external and internal sites of the endoscopes proved to be free of any residual microbicidal activity.
  
  
  CONCLUSIONS
  The endoscope reprocessor, with its processor-generated high-level disinfection solution, successfully reduced the numbers of selected, clinically relevant pathogens to undetectable levels both in the channels and on the outside surfaces of the 4 representative endoscopes tested in this study.
authors.affiliation: Centre for Research on Environmental Microbiology, University of Ottawa, Ottawa, ON, Canada. ssattar@uottawa.ca
authors.forename: Syed A
authors.initials: SA
authors.lastname: Sattar
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kibbee
authors.forename: Jason A
authors.initials: JA
authors.lastname: Tetro
authors.forename: Tony A
authors.initials: TA
authors.lastname: Rook
mesh_terms: D003428:Cross Infection / Q000517:prevention & control; D004202:Disinfectants / Q000494:pharmacology*; D004203:Disinfection / Q000295:instrumentation* / Q000379:methods*; D019723:Endoscopes / Q000145:classification / Q000382:microbiology*; D004866:Equipment Contamination / Q000517:prevention & control*; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006801:Humans; D017053:Infection Control / Q000379:methods; D010463:Peracetic Acid / Q000494:pharmacology*; D013171:Spores, Bacterial / Q000187:drug effects
chemical_list: D004202:Disinfectants; D010463:Peracetic Acid