Hughes C E, Gebhard R L, Peterson L R, Gerding D N
Gastrointest Endosc. 1986 Feb;32(1):7-9. doi: 10.1016/s0016-5107(86)71719-7.
We have evaluated a standard procedure for cleaning and disinfection of endoscopes for efficacy in eradicating a spore-forming bacterial organism, Clostridium difficile. Initially, 23 endoscopes were cultured for the presence of C. difficile after hanging in storage for at least 24 hours after cleaning and disinfection. All cultures were negative. Subsequently, endoscopes used in 15 patients who had stool cultures positive for C. difficile were cultured immediately after use and again after cleaning and disinfection with 2% alkaline glutaraldehyde for 5 min. Ten of 15 (67%) endoscopes were culture positive for C. difficile immediately after use. After cleaning and disinfection, all of the endoscopes were culture negative except one, which yielded two negative cultures and two cultures showing late growth of rare C. difficile colonies, but contamination could not be ruled out. In vitro exposure to 2% alkaline glutaraldehyde for 5 min resulted in 99% or greater killing of C. difficile spores. We conclude that cleaning and a minimum of 5 min of disinfection with 2% alkaline glutaraldehyde are likely to be effective in killing C. difficile vegetative organisms and spores on endoscopes.
我们评估了一种用于内窥镜清洁和消毒的标准程序，以确定其根除产芽孢细菌艰难梭菌的效果。最初，23条内窥镜在清洁和消毒后悬挂储存至少24小时后进行艰难梭菌培养。所有培养结果均为阴性。随后，对15例粪便培养艰难梭菌呈阳性患者使用过的内窥镜在使用后立即进行培养，并在用2%碱性戊二醛消毒5分钟后再次培养。15条内窥镜中有10条（67%）在使用后立即培养出艰难梭菌。清洁和消毒后，除一条内窥镜外，所有内窥镜培养结果均为阴性，该内窥镜有两次培养结果为阴性，两次培养显示有罕见的艰难梭菌菌落晚期生长，但不能排除污染。体外暴露于2%碱性戊二醛5分钟可导致99%或更高比例的艰难梭菌芽孢死亡。我们得出结论，清洁以及用2%碱性戊二醛至少消毒5分钟可能有效杀灭内窥镜上的艰难梭菌营养体和芽孢。
