CLEANING AND DISINFECTION OF FIBEROPTIC ENDOSCOPE

Abstract

For evaluation of endoscopic transmission of bacteria and virus and their prevention, 9 parts of the gastrofiberscopes were cultured quantitatively for bacteria and 5 parts were examined for occult blood as illustrated in Table 1 and specimens were isolated at four time periods relative to procedures. Number of positive cultures for bacteria were only 3, incidence rates of positive cultures were 3/330 (0.9%). And bacterial counts were 102, 102 and 102. Mycobacteria was also not detected and not cultured. When endoscopes were recultured after a storage period, quantitative bacterial counts and positive cases did not increase. It is effective that manual cleanig protcols and disinf ection with 0.2% Tego51 in Automatic endoscope washing-machine before subse-quent routine endoscopic study, and with 0.2% Tego and 3.5% glutaraldehyd in the same machine and combined with disinf ection with 70% isoplopylalcohol and drying before storage were done meticulously. Reports of many in vivo, in vitro contamination-cleaning assays (HBsAg-positive and HCVAb-positive serum and blood subjects) demonstrated that cleaning and disinf ection procedures for endoscopes were effective in removal of these subjects from sufaces and channels of endoscope. If occult blood test is positive on the surface of endoscopes or their accessories after cleaning, it would mean poor cleaning. The number of positive tests for occult blood in flushed water through biopsy channel in this study were resulted in 5/63 (7.9%) positiv rate, and all the five were included in 28 cases of biopsy performed (17.9%), as illustrated in Table 4. Then, suction with 50 ml water through suction channel from biopsy valve to suction connector, and flush with 25 ml water through biopsy channel into the stomach, combined with the routine cleaning and disinf ection, were done immediately after biopsy and bleeding in the stomach or the esophagus. These procedures decreased a positive rate for occult blood in biopsy channel down to 2/42 (4.8%) as illustrated in Table 7.