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A Prospective Randomized Trial Comparing Manual and Automated Endoscope Disinfection Methods

Published online by Cambridge University Press:  21 June 2016

Victoria J. Fraser ,
Gary Zuckerman ,
Ray E. Clouse ,
Susan O'Rourke ,
Marilyn Jones ,
Jean Klasner  and
Patrick Murray
Victoria J. Fraser*
Affiliation:
Division of Infectious Disease, Washington University School of Medicine and Barnes Hospital, St. Louis, Missouri
Gary Zuckerman
Affiliation:
Division of Gastroenterology, Washington University School of Medicine and Barnes Hospital, St. Louis, Missouri
Ray E. Clouse
Affiliation:
Division of Gastroenterology, Washington University School of Medicine and Barnes Hospital, St. Louis, Missouri
Susan O'Rourke
Affiliation:
Department of Pathology, Washington University School of Medicine and Barnes Hospital, St. Louis, Missouri
Marilyn Jones
Affiliation:
Department of Pathology, Washington University School of Medicine and Barnes Hospital, St. Louis, Missouri
Jean Klasner
Affiliation:
Department of Pathology, Washington University School of Medicine and Barnes Hospital, St. Louis, Missouri
Patrick Murray
Affiliation:
Department of Medicine, the Division of Laboratory Medicine, Washington University School of Medicine and Barnes Hospital, St. Louis, Missouri
*
Box 8051, Infectious Disease, Barnes Hospital, 660 S. Euclid, St. Louis, MO 63110
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Abstract

Objective:

To compare the efficacy of endoscope disinfection using automated and manual systems.

Design:

Prospective randomized trial.

Setting:

A 1,000-bed tertiary care referral center.

Methods:

All endoscopes underwent a three-stage decontamination process including brushing and cleaning with water and detergent, manual or automated disinfection with 2% glutaraldehyde, and 70% alcohol rinse with forced air drying. Cultures were obtained from endoscopes from both groups before and after alcohol rinse and then after overnight storage.

Results:

Cultures from 8/30 (27%) automated and 11/30 (37%) manually disinfected (P= 0.58) endoscopes grew gram-negative bacteria and/or nontuberculous mycobacteria before the alcohol rinse. After alcohol rinse, 3 (10%) of 30 automated and 8 (27%) of 30 manually disinfected endoscopes remained contaminated (P= 0.28). Manually disinfected endoscopes were contaminated more frequently with coliform bacteria, whereas endoscopes undergoing automated disinfection were more frequently contaminated with nontuberculous mycobacteria, but the differences were not statistically significant. After alcohol rinse and forced air drying, there was no difference in contamination rates between freshly disinfected endoscopes and those stored overnight (7/30 (23%) versus 4/30 (13%), P= 0.50). Colonoscopes and duodenoscopes were contaminated more often than gastroscopes (P=0.00001).

Conclusion:

The persistent endoscope contamination after manual and automated disinfection indicates the importance of developing more reliable and effective disinfection methods.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 14 , Issue 7 , July 1993 , pp. 383 - 389
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993

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