Mbithi J N, Springthorpe V S, Sattar S A, Pacquette M
Department of Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ontario, Canada.
J Clin Microbiol. 1993 Nov;31(11):2988-95. doi: 10.1128/jcm.31.11.2988-2995.1993.
Baths with 2% alkaline glutaraldehyde are often reused for 14 days to decontaminate flexible fiberoptic endoscopes (FFEs) between patients, but the effect of such reuse on the disinfectant's activity has not been known. Many busy endoscopy units also disinfect FFEs with contact times shorter than those recommended by the disinfectant manufacturer. We therefore collected samples of the disinfectant over the 14-day reuse period from two manual and one automatic bath used for bronchoscopes and gastroscopes at a local hospital. Control samples were also collected from a manual bath of 2% alkaline glutaraldehyde which did not receive any endoscopes. The germicidal activities of the samples were assessed in a carrier test against a mixture of hepatitis A virus, poliovirus 1 (Sabin), and Pseudomonas aeruginosa; the mixture also contained either Mycobacterium bovis or Mycobacterium gordonae. Bovine serum (5%) was the organic load. The criterion of efficacy was a minimum of a 3-log10-unit reduction in the infectivity titers of the organisms tested. The initial disinfectant concentration in all the baths was nearly 2.25%; it became about 1.8% in the control bath and fell to approximately 1% in the three test baths after 14 days. No protein was detected in the control bath, while its concentration rose gradually in the test baths to a maximum of 1,267 micrograms/ml after 14 days. With a contact time of 10 min at 20 +/- 2 degrees C, all the samples from the control bath were effective against all the test organisms and all the samples from all the test baths were also effective against P. aeruginosa. With a contact time of 10 or 20 min at 20+/-2 degrees C, the virucidal and mycobactericidal activities of the samples from the test baths showed broad-spectrum germicidal activity when the contact time was increased to 45 min and the temperature was raised to 25 degrees C. These findings emphasize the care needed in the disinfection of FFEs, especially in view of the increasing threat of AIDS and the resurgence of tuberculosis.
含2%碱性戊二醛的浸泡液常被重复使用14天，用于在患者之间对软性纤维内镜（FFEs）进行去污处理，但这种重复使用对消毒剂活性的影响尚不清楚。许多繁忙的内镜科室对FFEs进行消毒时，其接触时间也短于消毒剂制造商推荐的时间。因此，我们在当地一家医院，从两个用于支气管镜和胃镜的手动浸泡槽以及一个自动浸泡槽中，收集了在14天重复使用期内的消毒剂样本。对照样本也从一个未接触任何内镜的含2%碱性戊二醛的手动浸泡槽中收集。在载体试验中，针对甲型肝炎病毒、脊髓灰质炎病毒1型（萨宾株）和铜绿假单胞菌的混合物评估样本的杀菌活性；该混合物中还含有牛分枝杆菌或戈登分枝杆菌。5%的牛血清作为有机负荷。效力标准是受试微生物的感染性滴度至少降低3个对数10单位。所有浸泡槽中消毒剂的初始浓度接近2.25%；对照浸泡槽中的浓度在14天后变为约1.8%，而三个试验浸泡槽中的浓度在14天后降至约1%。对照浸泡槽中未检测到蛋白质，而试验浸泡槽中的蛋白质浓度在14天后逐渐上升，最高达到1267微克/毫升。在20±2℃下接触10分钟时，对照浸泡槽的所有样本对所有受试微生物均有效，所有试验浸泡槽的所有样本对铜绿假单胞菌也均有效。在20±2℃下接触10或20分钟时，当接触时间增加到45分钟且温度升至25℃时，试验浸泡槽样本的杀病毒和杀分枝杆菌活性显示出广谱杀菌活性。这些发现强调了FFEs消毒时需要谨慎，特别是考虑到艾滋病威胁的增加和结核病的再度流行。
