Researchers Investigate Flexible Endoscope Decontamination

Jadczak, et al. (2017) report that Lovisenberg Diakonale Hospital has Olympus EDT machines for cleaning of endoscopes. In the standard program the wash time is 3 minutes with special detergent and the disinfection time is 5 minutes. Periodical testing of final rinse-water is performed regularly with good results. Microbiological control of the final rinse-water from the washer-disinfector for endoscopes (EWD) is the most widely used methods for detecting growth of bacteria. The validation process is a comprehensive procedure that requires both resources, time, knowledge, special equipment and access to the microbiological laboratory. The hospital wanted to assure the quality of decontamination of their endoscopes. The researchers say they have established a partnership with the Department of Infection Control at Oslo University Hospital in order to validate the EWD.

The decontamination of flexible endoscopes must be tested and validated according to the standard EN ISO 15883. To validate the disinfection process and secure a repeatable method, the researchers used a surrogate endoscope (Spypach). This is equipped with biological indicators, temperature sensors and pressure- and flow-measures.

Microbiological control of final rinse-water: satisfactory results according to standard. Cultivation of biological indicators: unsatisfactory results according to standard. Discovery of protein and fibrin in surrogate endoscope: unsatisfactory results according to standard. Measurement of temperature, pressure and flow: no deviation

The researchers conclude that the endoscope was not adequately cleaned during decontamination. Final rinse-water had satisfactory quality but remaining biological indicators and protein residues showed that the decontamination was not satisfactory. Alternative solutions may include: increasing the wash time and/ or modify the contents of detergent.

Reference: Jadczak U, Elvelund K, Johnsen M, Borgen B and Lingaas E. DS4 Flexible endoscope decontamination - is it good enough? Abstracts from the 8th International Congress of the Asia Pacific Society of Infection Control (APSIC); Bangkok, Thailand. Feb. 12-15, 2017. Accessed at: http://aricjournal.biomedcentral.com/articles/10.1186/s13756-017-0176-1#Sec116