A comparison of two methods for preventing cross-contamination when using flexible fiberoptic endoscopes in an otolaryngology clinic: disposable sterile sheaths versus immersion in germicidal liquid.

OBJECTIVES/HYPOTHESIS: To assess the efficacy of using a sterile sheath to prevent cross-contamination when using a fiberoptic nasopharnygolaryngoscope (FNPL) in an otolaryngology clinic.

STUDY DESIGN

Prospective controlled trial.

METHODS

All FNPLs were disinfected according to applicable current guidelines recommended by the US Center for Disease Control. Swabs were taken from multiple sites on 100 FNPLs for cultures to detect the presence of bacteria, viruses, or both. Each FNPL was then assigned to either the sheath alone (experimental) or germicidal immersion (control) group. After using an FNPL in a patient, swabs were again taken so that a comparison could be made in microbes on the scopes. Throughout the study, the steps in the disinfection process taken by medical assistants as they worked with the FNPLs were observed and recorded.

RESULTS

Microbial counts on insertion shafts of FNLPs for the sheath and immersion groups were similar, with 1/50 versus 0/50, respectively. Time spent using the sheath method averaged 89 seconds, whereas immersion in the germicidal liquid took 14 minutes. No breaches in adherence to applicable protocols were observed.

CONCLUSIONS

Using an individually packaged disposable sterile sheath on a FNLP prevents microbes from adhering to the shaft of the scope, thus providing a reasonably safe method of avoiding the transmission of infection from one patient to the next patient when using an FNLP successively in multiple patients in an otolaryngology clinic.