Titre du document / Document title
Mycobacteria and glutaraldehyde : is high-level disinfection of endoscopes possible ?
Auteur(s) / Author(s)
URAYAMA S.
(1) ;
KOZAREK R. A.
(1) ;
SUMIDA S.
(1) ;
RALTZ S.
(1) ;
MERRIAM L.
(1) ;
PETHIGAL P.
(1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of Internal Medicine, Section of Gastroenterology, Virginia Mason Medical Center, Seattle, Washington, ETATS-UNIS
Résumé / Abstract
Background : High-level disinfection of endoscopes has traditionally been undertaken by manual or automatic scope cleaning plus a 10 to 20 minute soak in 2% alkaline glutaraldehyde. Mycobacteria species are less sensitive to glutaraldehyde, and a 45-minute instrument soak has recently been recommended by the manufacturer. Because of concerns over endoscope damage, need for more endoscopes, and perception that the current cleaning method is adequate, we prospectively studied mycobacteria-contaminated endoscopes at various stages of the cleaning process. Methods : All work was done under a laminar flow hood in a microbiology laboratory. Five gastrointestinal scopes were contaminated with 10
8 colony forming units per milliliter (CFU/mL) of Mycobacterium chelonei, an atypical mycobacterium similar in chemical resistance to Mycobacterium tuberculosis but with less infectious potential. Cultures of the sheath, biopsy channel, and elevator channel were taken at baseline, after manual cleaning, and after 10, 20, and 45 minutes of glutaraldehyde soak both before and after alcohol rinse. Results : Manual cleaning resulted in a mean of 4.7 log
10 reduction in viable mycobacterial colonies. Qualitative studies of the external endoscope surface as well as the air-water valve showed no detectable organisms after a 10-minute exposure to alkaline glutaraldehyde. Conventional quantitative culture techniques of the channels demonstrated one endoscope out of five with consistent growth after a 10-minute exposure to glutaraldehyde. Following alcohol treatment, there was no significant colony growth. In contrast, a quantitative membrane filter system showed the presence of at least one mycobacterial colony in four out of five scopes after a 45-minute glutaraldehyde exposure. Conclusions : Additional studies utilizing a standardized mycobacterial species, inoculum size, and suspension characteristics are recommended to delineate adequate duration of disinfectant exposure time.
Revue / Journal Title
Gastrointestinal endoscopy
ISSN 0016-5107
CODEN GAENBQ
Source / Source
1996, vol. 43, n
o5, pp. 451-456 (17 ref.)
Langue / Language
Anglais
Editeur / Publisher
Elsevier, New York, NY, ETATS-UNIS
(1965)
(Revue)
Mots-clés anglais / English Keywords
Endoscopy ;
Disinfection ;
Equipment ;
Solution ;
Cleaning ;
Product ;
Exposure time ;
Resistance ;
Mycobacterium ;
Result ;
Human ;
Mycobacteriaceae ;
Mycobacteriales ;
Actinomycetes ;
Bacteria ;
Public health ;
Biomedical equipment ;
Mots-clés français / French Keywords
Endoscopie ;
Désinfection ;
Equipement ;
Solution ;
Nettoyage ;
Produit ;
Temps exposition ;
Résistance ;
Mycobacterium ;
Résultat ;
Homme ;
Mycobacteriaceae ;
Mycobacteriales ;
Actinomycetes ;
Bactérie ;
Santé publique ;
Equipement biomédical ;
Mots-clés espagnols / Spanish Keywords
Endoscopía ;
Desinfección ;
Equipo ;
Solución ;
Limpieza ;
Producto ;
Tiempo exposición ;
Resistencia ;
Mycobacterium ;
Resultado ;
Hombre ;
Mycobacteriaceae ;
Mycobacteriales ;
Actinomycetes ;
Bacteria ;
Salud pública ;
Equipo biomédico ;
Localisation / Location
INIST-CNRS, Cote INIST : 16553, 35400004367646.0010
Nº notice refdoc (ud4) : 3099005