Effectiveness of Cleaning and Disinfection Processes on the Bioburden on Endoscopes
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Background & Objectives: Awareness about infections transmitted through endoscopes is increasing. Every incident is due to a breach in cleaning and disinfection protocol. No study in India evaluated the bio burden on endoscopes and the effectiveness of cleaning and disinfection of endoscopes. Methods: A cross-sectional study, 30 endoscopes (20 gastroscopes and 10 colonoscopes) were conveniently sampled at the department of gastroenterology in a tertiary care center in Coimbatore. Sterile water flushed through the suction biopsy channel - after use, post water cleaning, post manual cleaning and post disinfection - were collected for microbiological analysis. Results: A mean bioburden of 3.5 x 104 CFU/ml, upto 4.2 x 105 CFU/ml was obtained from endoscopes after use with a culture positivity of 97% (29/30). After manual cleaning the bioburden on gastroscopes reduced by 2 logs and on colonoscopes by 1 log. Post disinfection, 7% (2/30) endoscopes were contaminated. Both were colonoscopes and had colony counts of 1.8 x 103 and 2.8 x 102 CFU/ml. Immediately after use, gastroscopes grew gram-negative organisms like E.coli, Klebsiella, Enterobacter and Pseudomonas. Microbial burden in 4 endoscopes after water cleaning was greater than after patient use. Two of them grew different flora in after-use and post-water-clean samples. Average time taken for manual cleaning was 3.3 minutes. Interpretations & Conclusions: The reasons for inadequate cleaning and disinfection were contaminated rinse water and inadequate manual cleaning. Adherence to standard reprocessing protocols is required to avoid transmission of infection through contaminated endoscopes.
Authors and Affiliations
Smrithi Maamidi, Appalaraju Boppe
Keywords
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- DOI 10.9790/0853-1804136875.
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