Li Zhanjie, Liu Bo, Zhu Qingtang, Ge Zijun, Zang Feng, Chen Wensen, Zhang Yongxiang, Ding Xiafen, Ding Jing, Zhang Weihong
Department of Infection Control, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
Department of Endoscopy Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
Antimicrob Resist Infect Control. 2025 Apr 30;14(1):40. doi: 10.1186/s13756-025-01560-3.
There is a lack of a universally accepted standard or guideline for the frequency of disinfection in purified water pipelines. Furthermore, there is no standardized method for detecting microorganisms in the final rinse water utilized for endoscope cleaning.This study aims to examine the current management and microbial monitoring practices concerning the final rinse water used for flexible endoscope cleaning in medical institutions.
A questionnaire was designed using a convenience sampling method to gather data on the maintenance and microbial monitoring of final rinse water for flexible endoscopes in 290 medical institutions across Jiangsu Province, China.
Purified water is used for endoscope rinsing by 93.45% of institutions, with 78.62% employing centralized water supply. Membrane filtration devices at the terminal are installed by 82.07%, mainly with a 0.2μm pore size (76.47%), and are replaced quarterly (32.77%). Disinfection devices are present at 52.76% of terminals, with varied disinfection frequencies; chlorine-containing disinfectants (48.15%) and peracetic acid (34.92%) are predominant. Inadequate disinfection, filter membrane neglect, sampling contamination, and biofilm formation are identified as reasons for non-compliant final rinse water. Actions include filter replacement, pipeline disinfection, and flushing. Microbial mornitoring occurs quarterly (70.96%), with faucet outlets as primary sampling sites. Standards are based on 10cfu/100ml (87.58%), using membrane filtration (40.81%) and nutrient agar plates (82.72%). A cultivation period of 2 days predominated (72.43%), with a temperature range of 35-37°C (76.47%).
While purified water and terminal filters are common for final rinsing of endoscopes, there is variation in maintenance and supply line disinfection. Current microbiological methods' reliability is considered low, necessitating further research to establish unified standards for effective endoscope final rinse water management and monitoring.
纯化水管道消毒频率缺乏普遍认可的标准或指南。此外，用于内镜清洗的终末漂洗水中微生物的检测方法也未标准化。本研究旨在调查医疗机构中柔性内镜清洗终末漂洗水的现行管理及微生物监测情况。
采用便利抽样法设计问卷，收集中国江苏省290家医疗机构中柔性内镜终末漂洗水的维护及微生物监测数据。
93.45%的机构使用纯化水进行内镜漂洗，78.62%采用集中供水。82.07%的机构安装了终端膜过滤装置，主要孔径为0.2μm（76.47%），且每季度更换一次（32.77%）。52.76%的终端设有消毒装置，消毒频率各异；含氯消毒剂（48.15%）和过氧乙酸（34.92%）使用居多。消毒不充分、滤膜疏于管理、采样污染及生物膜形成被确定为终末漂洗水不合格的原因。应对措施包括更换滤芯、管道消毒及冲洗。微生物监测每季度进行一次（70.96%），主要采样部位为水龙头出水口。标准基于10cfu/100ml（87.58%），采用膜过滤法（40.81%）和营养琼脂平板法（82.72%）。培养期以2天为主（72.43%），温度范围为35 - 37°C（76.47%）。
虽然纯化水和终端过滤器常用于内镜终末漂洗，但维护及供水管线消毒存在差异。目前微生物学方法的可靠性被认为较低，需要进一步研究以建立有效的内镜终末漂洗水管理及监测统一标准。
