Kaczmarek R G, Moore R M, McCrohan J, Goldmann D A, Reynolds C, Caquelin C, Israel E
Center for Devices and Radiological Health, Food and Drug Administration, Rockville, Maryland 20852.
Am J Med. 1992 Mar;92(3):257-61. doi: 10.1016/0002-9343(92)90074-l.
The purpose of this investigation was to observe and assess the actual disinfection or sterilization of endoscopes in health care facilities.
A total of 22 hospitals and four ambulatory care centers in three states were studied. Facility protocols were reviewed, interviews conducted with relevant personnel, actual disinfection or sterilization procedures observed, and biologic tests performed to determine and assess disinfection/sterilization procedures.
Fundamental errors observed during the course of the investigation included respective failures to time the period of disinfection, to clean all channels, to flush all channels with disinfectant, to fully immerse the endoscope in the disinfectant solution, and to use a disinfectant. At 78% of the facilities, failure to sterilize all biopsy forceps was observed. A total of 23.9% of the bacterial cultures from the internal channels of 71 gastrointestinal endoscopes grew 100,000 colonies or more of bacteria. These cultures were obtained after the completion of all disinfection/sterilization procedures and the device was deemed ready for use in the next patient.
These data indicate that actual disinfection/sterilization procedures for endoscopes are not always optimal, and high-level disinfection of gastrointestinal endoscopes is not always achieved.
本调查的目的是观察和评估医疗机构中内镜的实际消毒或灭菌情况。
对三个州的22家医院和四个门诊护理中心进行了研究。审查了机构规程，与相关人员进行了访谈，观察了实际消毒或灭菌程序，并进行了生物学测试以确定和评估消毒/灭菌程序。
调查过程中观察到的基本错误包括消毒时间不足、未清洁所有通道、未用消毒剂冲洗所有通道、未将内镜完全浸入消毒溶液以及未使用消毒剂。在78%的机构中，观察到活检钳灭菌失败。71条胃肠道内镜内部通道的细菌培养物中，共有23.9%培养出100,000个或更多菌落。这些培养物是在完成所有消毒/灭菌程序且设备被认为可用于下一位患者后获得的。
这些数据表明内镜的实际消毒/灭菌程序并不总是最佳的，胃肠道内镜的高水平消毒也并非总能实现。
