Skip to main content
SpringerLink
Log in

Disinfection of gastrointestinal endoscopes

  • Chapter
Procedures in Hepatogastroenterology

Part of the book series: Developments in Gastroenterology ((DIGA,volume 15))

Abstract

Any patient entering an endoscopy unit should have the guarantee that effective disinfection or decontamination steps have been taken, to prevent microbiological transmission during the endoscopic procedure1”5. The number of endoscopy procedures, in particular therapeutic interventions, is still steadily increasing; concern exists about possible microbiological transmission6”8, particular of the human immunodeficiency virus (HIV)9”. Transmission may occur between patients by contaminated endoscopic equipment, from infected patients to staff, or vice-versa. Documented events of bacterial or viral transmission by endoscopy or ancillary equipment have fortunately been rare, possibly because the infection is not recognized as a complication of the endoscopic procedure. However, one may expect that the character of gastrointestinal examinations in the future will be more and more complex and invasive; in addition the number of immune compromised patients (malignancy, systemic infections, AIDS, etc.) suffering from gastrointestinal diseases and needing endoscopic intervention will increase. Therefore the risk of endoscopic transmission of microbiological particles will be higher, and we have to focus on procedures to prevent these infections12-14.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Axon ATR, Bond W, Bottrill PM, et al. Endoscopic disinfection. J Gastroenterol Hepatol. 1990;Working Party Reports:46-50.

    Google Scholar 

  2. Frank U, Daschner FD. Disinfection in gastrointestinal endoscopy: current status. Endoscopy. 1989;21:276–279.

    Article  PubMed  CAS  Google Scholar 

  3. Cowen A. Infection and endoscopy. Gastrointest Endosc Clin N Am. 1993;3:483–496.

    Google Scholar 

  4. Martin MA, Reichelderfer M. A.P.I.C. guideline for infection prevention and control in flexible endoscopy. Am J Infect Control. 1994;22:19–38.

    Article  PubMed  CAS  Google Scholar 

  5. Babb JR, Bradley CR. Endoscope decontamination: where do we go from here? J Hosp Infect. 1995;30:543–551.

    Article  PubMed  Google Scholar 

  6. Elewaut A, De Man M, De Vos M, Barbier F. Endoscopic sclerotherapy: the value of balloon tamponade and the importance of disinfection. Endoscopy. 1988;20:48–51.

    Article  PubMed  CAS  Google Scholar 

  7. Cowen AE. Disinfection and endoscopy: the clinical risks of infection. J Gastroenterol Hepatol. 1991;6:25–30.

    Article  PubMed  CAS  Google Scholar 

  8. Gorse GJ, Messner RL. Infection control practices in gastrointestinal endoscopy in the United States: a national survey. Gastroenterol Nurs. 1991;14:72–79.

    Article  PubMed  CAS  Google Scholar 

  9. McAdam GJ. Infection in endoscopy. Protection of Staff. Gastrointest Endosc N Am. 1993;3:447–457.

    Google Scholar 

  10. Siegel JH, Kasmin EE, Cohen SA. Health hazards and endoscopy: the known and newly experienced —a personal report. Endoscopy. 1994;26:545–548.

    Article  PubMed  CAS  Google Scholar 

  11. Shapiro M, Brandt LJ. Endoscopy in the age of HIV: a study of current practices and attitudes. Gastrointest Endosc. 1994;40:477–480.

    Article  PubMed  CAS  Google Scholar 

  12. Meuwissen SGM, Meester HHM. Desinfektion von Endoskopen. In: Tytgat GNJ, Mulder CJJ, editors. Endoskopie bei Magen-, Darm-und Lebererkrankungen. Stuttgart: Thieme Verlag, 1990:308–315.

    Google Scholar 

  13. Axon AT. Disinfection of endoscopic equipment. Baillières Clin Gastroenterol. 1991;5:61–77.

    Article  PubMed  CAS  Google Scholar 

  14. Meuwissen SGM, Meester HHM. Disinfection of gastrointestinal fibreoptic endoscopes: a review. Procedures in Hepatogastroenterology, 1st Edn. Mur-Kostverloren, Aalsmeer. 1993;307–321.

    Google Scholar 

  15. Martin MA, Reichelderfer M. Draft APIC guideline for infection prevention and control in flexible endoscopy. Association for Practitioners in Infection Control, Inc. Am J Infect Control. 1993;21: 42A–66A.

    Article  CAS  Google Scholar 

  16. Tytgat GNJ. Endoscopic transmission of Helicobacter pylori. Aliment Pharmacol Ther. 1995;9(Suppl. 2): 105–110.

    PubMed  Google Scholar 

  17. Spach DH, Silverstein FE, Stamm WE. Transmission of infection by gastrointestinal endoscopy and bronchoscopy [see comments]. Ann Intern Med. 1993; 118:117–128.

    PubMed  CAS  Google Scholar 

  18. Sobala GM, Lincoln C, Axon AT. Does the endoscope control head need to be disinfected between examinations? Endoscopy. 1989;21:19–21.

    Article  PubMed  CAS  Google Scholar 

  19. Meuwissen SG, MacLaren DM, Rijsberman W, Boshuizen K. A simple method for cleaning flexible fibreoptic endoscopes by’ all-channel perfusion’. J Hosp Infect. 1983;4:81–86.

    Article  PubMed  CAS  Google Scholar 

  20. Babb JR, Bradley CR, Ayliffe GA. Comparison of automated systems for the cleaning and disinfection of flexible fibreoptic endoscopes. J Hosp Infect. 1984;5:213–226.

    Article  PubMed  CAS  Google Scholar 

  21. Nye K, Chadha DK, Hodgkin P, Bradley C, Hancox J, Wise R. Mycobacterium chelonei isolation from broncho-alveolar lavage fluid and its practical implications [see comments]. J Hosp Infect. 1990;16:257–261.

    Article  PubMed  CAS  Google Scholar 

  22. Jonas G, Mahoney A, Murray J, Gertler S. Chemical colitis due to endoscope cleaning solutions: a mimic of pseudomembranous colitis. Gastroenterology. 1988;95:1403–1408.

    PubMed  CAS  Google Scholar 

  23. Spaulding EH. Chemical disinfection of medical and surgical materials. In: Lawrence CA, Block SS, editors. Disinfection, sterilisation and preservation; Philadelphia: Lea & Febiger, 1968:111–119.

    Google Scholar 

  24. Gerding DN, Peterson LR, Vennes JA. Cleaning and disinfection of fiberoptic endoscopes: evaluation of glutaraldehyde exposure time and forced-air drying. Gastroenterology. 1982;83: 613–618.

    PubMed  CAS  Google Scholar 

  25. Noy MF, Harrison L, Holmes GK, Cockel R. The significance of bacterial contamination of fibreoptic endoscopes. J Hosp Infect. 1980; 1:53–61.

    Article  PubMed  CAS  Google Scholar 

  26. Babb JR, Bradley CR, Deverill CE, Ayliffe GA, Melikian V. Recent advances in the cleaning and disinfection of fibrescopes. J Hosp Infect. 1981;2:329–340.

    Article  PubMed  CAS  Google Scholar 

  27. Meuwissen SG, MacLaren DM. Disinfection of gastrointestinal fibre endoscopes. Technical and bacteriological aspects, clinical consequences. Neth J Med. 1983;26:23–28.

    PubMed  CAS  Google Scholar 

  28. Ridgway GL. Decontamination of fibreoptic endoscopes. J Hosp Infect. 1985;6:363–368.

    Article  PubMed  CAS  Google Scholar 

  29. Wagenvoort JH, van Blankenstein M, Kooyman-Op de Hoek G, Boks AL, van Oudenaarde PH. A simple device for disinfecting endoscopes. J Hosp Infect. 1986;7:78–81.

    Article  PubMed  CAS  Google Scholar 

  30. Collins FM. Bactericidal activity of alkaline glutaraldehyde solution against a number of atypical mycobacterial species. J Appl Bacteriol. 1986;61:247–251.

    Article  PubMed  CAS  Google Scholar 

  31. Hughes CE, Gebhard RL, Peterson LR, Gerding DN. Efficacy of routine fiberoptic endoscope cleaning and disinfection for killing Clostridium difficile. Gastrointest Endosc. 1986;32:7–9.

    Article  PubMed  CAS  Google Scholar 

  32. Babb JR, Bradley CR, Barnes AR. Question and answer. Disinfecting endoscopes. J Hosp Infect. 1992;20:51–54.

    Article  PubMed  CAS  Google Scholar 

  33. van Klingeren B, Pullen W. Glutaraldehyde resistant mycobacteria from endoscope washers [letter]. J Hosp Infect. 1993;25:147–149.

    Article  PubMed  Google Scholar 

  34. Russell AD. Glutaraldehyde: current status and uses. Infect Control Hosp Epidemiol. 1994; 15:724–733.

    Article  PubMed  CAS  Google Scholar 

  35. Bond WW. Disinfection and endoscopy: microbial considerations. J Gastroenterol Hepatol. 1991;6:31–36.

    Article  PubMed  CAS  Google Scholar 

  36. Anonymous. Cleaning and disinfection of equipment for gastrointestinal flexible endoscopy: interim recommendations of a Working Party of the British Society of Gastroenterology [see comments]. Gut. 1988;29:1134–1151.

    Article  Google Scholar 

  37. Karim QN, Rao GG, Taylor M, Baron JH. Routine cleaning and the elimination of Campylobacter pylori from endoscopic biopsy forceps. J Hosp Infect. 1989;13:87–90.

    Article  PubMed  CAS  Google Scholar 

  38. Fantry GT, Zheng QX, James SP. Conventional cleaning and disinfection techniques eliminate the risk of endoscopic transmission of Helicobacter pylori. Am J Gastroenterol. 1995;90:227–232.

    PubMed  CAS  Google Scholar 

  39. Roosendaal R, Kuipers EJ, Van Den Brule AJC et al. Importance of the fibreoptic endoscope cleaning procedure for detection of Helicobacter pylori in gastric biopsy specimens by PCR. J Clin Microbiol. 1994;32:1123–1126.

    PubMed  CAS  Google Scholar 

  40. Yang R, Naritoku W, Laine L. Prospective, randomized comparison of disposable and reusable biopsy forceps in gastrointestinal endoscopy. Gastrointest Endosc. 1994;40:671–674.

    Article  PubMed  CAS  Google Scholar 

  41. Corcoran GD, Holton J, Ridgway GL. Endoscope decontamination: a comparison of the Wolf 35100 and DSD-91 systems. J Hosp Infect. 1994;27:307–315.

    Article  PubMed  CAS  Google Scholar 

  42. Lynch DA, Parnell P, Porter C, Axon AT. Patient and staff exposure to glutaraldehyde from KeyMed Auto-Disinfector endoscope washing machine [see comments]. Endoscopy. 1994; 26:359–361.

    Article  PubMed  CAS  Google Scholar 

  43. Lynch DA, Porter C, Murphy L, Axon AT. Evaluation of four commercial automatic endoscope washing machines [see comments]. Endoscopy. 1992;24:766–770.

    Article  PubMed  CAS  Google Scholar 

  44. Bradley CR, Babb JR. Endoscope decontamination: automated vs. manual. J Hosp Infect. 1995;30:537–542.

    Article  PubMed  Google Scholar 

  45. Uttley AHC, Honeywell KM, Fitch LA et al Cross contamination of bronchial washings. Br Med J. 1990;301:1274.

    Article  CAS  Google Scholar 

  46. Potvin PEL. Machinale scopen desinfectie. Tijdschrift Hyg Infect. 1995;1:15–17.

    Google Scholar 

  47. Meester HHM, Van Loenen AC, De Goede PNFC, Koeleman JGM. Glutaraldehyde. Infect Contr Hosp Epidemiol. 1995.

    Google Scholar 

  48. Nakahara SA, Becker L, Biggerstaff-Pearson A, Hardy MJ. Standardizing glutaraldehyde use in a regional group of ten major medical centers. Am J Infect Control. 1994;22:50–56.

    Article  PubMed  CAS  Google Scholar 

  49. Rutala WA, Clontz EP, Weber DJ, Hoffmann KK. Disinfection practices for endoscopes and other semicritical items. Infect Control Hosp Epidemiol. 1991;12:282–288.

    Article  PubMed  CAS  Google Scholar 

  50. Casemore DP, Blewett DA, Wright SE. Cleaning and disinfection of equipment for gastrointestinal flexible endoscopy: interim recommendations of a Working Party of the British Society of Gastroenterology [letter; comment]. Gut. 1989;30:1156–1157.

    Article  PubMed  CAS  Google Scholar 

  51. Rutala WA. APIC guideline for selection and use of disinfectants. J Infect Control. 1990; 18: 99–117.

    Article  CAS  Google Scholar 

  52. Taylor EW, Mehtar S, Cowan RE, Feneley RC. Endoscopy: disinfectants and health. Report of a meeting held at the Royal College of Surgeons of England, February 1993. J Hosp Infect. 1994; 28:5–14.

    Article  PubMed  CAS  Google Scholar 

  53. Corrado OJ, Osman J, Davies RJ. Asthma and rhinitis after exposure to glutaraldehyde in endoscopy units. Human Toxicol. 1986;5:325–328.

    Article  CAS  Google Scholar 

  54. OConnor BH, Bennett JR, Alexander JG et al. Salmonellosis infection transmitted by fibreoptic endoscopes. Lancet. 1982;2:864–866.

    Article  CAS  Google Scholar 

  55. Norback D. Skin and respiratory symptoms from exposure to alkaline glutaraldehyde in medical services. Scand J Work Env Health. 1988;14:366–371.

    Article  CAS  Google Scholar 

  56. Felmingham D, Mowles J, Thomas K, Ridgway GL. Disinfection of gastrointestinal fibrescopes: an evaluation of the Pauldrach Endocleaner, and various chemical agents. J Hosp Infect. 1985; 6:379–388.

    Article  PubMed  CAS  Google Scholar 

  57. Hanson PJ, Bennett J, Jeffries DJ, Collins JV. Enteroviruses, endoscopy and infection control: an applied study. J Hosp Infect. 1994;27:61–67.

    Article  PubMed  CAS  Google Scholar 

  58. Hanson PJ, Gor D, Clarke JR et al. Contamination of endoscopes used in AIDS patients. Lancet. 1989;2:86–88.

    Article  PubMed  CAS  Google Scholar 

  59. Sattar SA, Best M, Springthorpe VS, Sanani G. Mycobactericidal testing of disinfectants: an update. J Hosp Infect. 1995;30:372–382.

    Article  PubMed  Google Scholar 

  60. Rutala WA, Weber DJ. FDA labeling requirements for disinfection of endoscopes: a counterpoint. Infect Control Hosp Epidemiol. 1995;16:231–235.

    Article  PubMed  CAS  Google Scholar 

  61. Fraise AP. Disinfection in endoscopy. Lancet. 1995;346:787–788.

    Article  PubMed  CAS  Google Scholar 

  62. Shorvon PJ, Eykyn S J, Cotton PB. Gastrointestinal instrumentation, bacteraemia, and endocarditis. Gut. 1983;24:1078–1093.

    Article  PubMed  CAS  Google Scholar 

  63. Malchesky PS. Peracetic acid and its application to medical instrument stérilisation. Artif Organs. 1993;17:147–152.

    Article  PubMed  CAS  Google Scholar 

  64. Crow S. Sterilisation processes. Meeting the demand of today’s health care technology. Nursing Clin N Am. 1993;28:687–695.

    CAS  Google Scholar 

  65. Bradley CR, Babb JR, Ayliffe GA. Evaluation of the Steris System 1 peracetic acid endoscope processor. J Hosp Infect. 1995;29:143–151.

    Article  PubMed  CAS  Google Scholar 

  66. Favero MS. Strategies for disinfection and sterilization of endoscopes: the gap between basic principles and actual practice [editorial]. Infect Control Hosp Epidemiol. 1991;12:279–281.

    Article  PubMed  CAS  Google Scholar 

  67. Birnie GG, Quigley EM, Clements GB, Follet EA, Watkinson G. Endoscopic transmission of hepatitis B virus. Gut. 1983;24:171–174.

    Article  PubMed  CAS  Google Scholar 

  68. Bond WW, Moneada RE. Viral hepatitis B infection risk in flexible fiberoptic endoscopy. Gastrointest Endosc. 1978;24:225–232.

    Article  PubMed  CAS  Google Scholar 

  69. Henderson DK, Saah AJ, Zak BJ et al. Risk of nosocomial infection with human T-cell lymphotropic virus type Ill/lymphadenopathy-associated virus in a large cohort of intensively exposed health care workers. Ann Intern Med. 1986;104:644–647.

    PubMed  CAS  Google Scholar 

  70. Henderson DK, Fahey BJ, Willy M et al. Risk for occupational transmission of human immunodeficiency virus type 1 (HIV-1) associated with clinical exposures. A prospective evaluation [see comments]. Ann Intern Med. 1990; 113:740–746.

    PubMed  CAS  Google Scholar 

  71. McEvoy M, Porter K, Mortimer P, Simmons N, Shanson D. Prospective study of clinical, laboratory, and ancillary staff with accidental exposures to blood or body fluids from patients infected with HIV. Br Med J Clin Res Ed. 1987;294:1595–1597.

    Article  PubMed  CAS  Google Scholar 

  72. Werner BG, Grady GF. Accidental hepatitis-B-surface-antigen-positive inoculations. Use of e antigen to estímate infectivity. Ann Intern Med. 1982;97:367–369.

    PubMed  CAS  Google Scholar 

  73. Werner HP. Automated cleaning and disinfection of flexible endoscopes. Zentr Steril. 1992;1: 29–32.

    Google Scholar 

  74. Klein RS, Friedland GH. Transmission of human immunodeficiency virus type 1 (HIV-1) by exposure to blood: defining the risk [editorial; comment]. Ann Intern Med. 1990;113:729–730.

    PubMed  CAS  Google Scholar 

  75. Friedland GH, Klein RS. Transmission of the human immunodeficiency virus. N Engl J Med. 1987;317:1125–1135.

    Article  PubMed  CAS  Google Scholar 

  76. Woodcock A, Campbell I, Collins JV et al Bronchoscopy and infection control [letter]. Lancet. 1989;2:270–271.

    Article  PubMed  CAS  Google Scholar 

  77. Langenberg W, Rauws EAJ, Oudbier JH et al Patient-to-patient transmission of Campylobacter pylori infection by fibreoptic gastroduodenoscopy and biopsy. J Infect Dis. 1990;161:507–511.

    Article  PubMed  CAS  Google Scholar 

  78. Mtysiak-Budnik T, Gosciniak G, Brugman D et al Seroprevalence of Helicobacter pylori infection in medical staff in Poland. Eur J Gastroenterol Hepatol. 1994;6:309–311.

    Google Scholar 

  79. Peura DA, Tramont EC. AIDS: the scope of the problem and the problem of the’ scope [editorial]. Gastrointest Endosc. 1987;33:122–124.

    Article  PubMed  CAS  Google Scholar 

  80. Brearly S, Buist LJ. Blood splashes: an underestimated hazard to surgeons. Br Med J. 1989; 299:1315.

    Article  Google Scholar 

Download references

Authors
  1. H. Tuynman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. H. M. Meester
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. G. M. Meuwissen
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. GE, AMC, Netherlands

    Guido N. J. Tytgat

  2. GE, Rijnstate Hospital, Arnhem, Netherlands

    Chris J. J. Mulder

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Tuynman, H., Meester, H.H.M., Meuwissen, S.G.M. (1997). Disinfection of gastrointestinal endoscopes. In: Tytgat, G.N.J., Mulder, C.J.J. (eds) Procedures in Hepatogastroenterology. Developments in Gastroenterology, vol 15. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5702-5_32

Download citation

  • DOI: https://doi.org/10.1007/978-94-011-5702-5_32

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6488-0

  • Online ISBN: 978-94-011-5702-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation