Ido K, Ishino Y, Ota Y, Kihira K, Taniguchi Y, Saifuku K, Satoh K, Kawamoto C, Hayashi M, Kimura K
Department of Gastroenterology, Jichi Medical School, Tochigi, Japan.
Gastrointest Endosc. 1996 Nov;44(5):583-6. doi: 10.1016/s0016-5107(96)70013-5.
We show that disinfection using the automatic endoscopic reprocessor is not complete and propose a method for high-grade disinfection of endoscopes.
We used an automatic endoscopic reprocessor, Pyser System 83, and 2% glutaraldehyde. After each endoscopic procedure, the endoscopes were divided into three groups. Endoscopes in group A were washed only by the reprocessor. Group B endoscopes were washed by the reprocessor after the connectors were soaked in glutaraldehyde for 5 minutes. The channels, valves, connecting sections of group C endoscopes, and the connectors of the machine were sprayed with glutaraldehyde before machine-washing. Swabs were taken from all 13 parts of each endoscope and machine for microbiologic culture.
Six endoscopes were positive, cumulatively, for bacterial contamination in group A. Among group B endoscopes, one remained contaminated. No endoscope was positive in group C. The difference between group A and C was statistically significant (p < .05).
Machine washing by automatic endoscopic reprocessors may not achieve complete disinfection. Additional procedures are necessary. High-grade disinfection of the connectors is critical. Disinfection of the interface between the connectors is important.
我们发现使用自动内镜清洗消毒机进行的消毒并不彻底，并提出了一种对内镜进行高水平消毒的方法。
我们使用了一台自动内镜清洗消毒机，Pyser System 83，以及2%的戊二醛。每次内镜检查后，将内镜分为三组。A组内镜仅由清洗消毒机进行清洗。B组内镜在连接器浸泡于戊二醛5分钟后由清洗消毒机进行清洗。C组内镜在机器清洗前，对其通道、阀门、连接部位以及机器的连接器喷洒戊二醛。从每台内镜和机器的所有13个部位采集拭子进行微生物培养。
A组中，累计有6台内镜存在细菌污染阳性。B组内镜中，有1台仍有污染。C组中没有内镜呈阳性。A组和C组之间的差异具有统计学意义（p < 0.05）。
自动内镜清洗消毒机进行的机器清洗可能无法实现彻底消毒。需要额外的步骤。连接器的高水平消毒至关重要。连接器之间接口的消毒很重要。
