Cleaning and disinfection in gastrointestinal endoscopy: current status in Romania.

BACKGROUND

Today, endoscopic procedures have become an important tool in the diagnosis and treatment of gastrointestinal diseases. In order to prevent cross infections, the cleaning and disinfection/sterilisation procedures of the endoscopes and accessories are primordial. The GOAL of this paper was to assess the way and the conditions in which endoscopic disinfection is achieved in our country.

METHODS

A study-type questionnaire with eighteen questions, about reprocessing of flexible endoscopes and accessories, was addressed to 37 centres from Romania known to perform digestive endoscopy.

RESULTS

Twenty-nine centres (78.37%) answered the questionnaire. In all the cases, the reprocessing is based on pre-established protocols and the endoscopy nurse has the principal responsibility (62.06%). Enzymatic type detergents are available in 75.86% and glutaraldehyde is the most used disinfector (55.17%). The costs (41.38%) and the financial resources (27.6%) are considered when selecting a product. Despite their advantages, automatic-disinfectors are available in only 34.48% of the cases. All the participants in the study (100%) reused endoscopic instruments, but only 31.03% used them after sterilization by steam autoclaving or ethylene oxide. Adequate facilities for manipulating potential toxic solutions are assured in 48.27%, but separate purpose-designed rooms are available in only 27.58%. Most centres (86.20%) regularly control the quality of the cleaning and disinfection by sampling.

CONCLUSIONS

In general, the disinfection and sterilization of the endoscopes and accessories are carried out in good conditions. With regard to European Union integration, adequate facilities and funds are required to improve the reprocessing activity.