February 25, 2020

Challenges in achieving high-level endoscope disinfection

By: Judy Mathias
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Editor's Note

In this review article, Cori L. Ofstead, MSPH, and associates highlight the reasons endoscope reprocessing is often ineffective and microbes frequently remain on endoscopes after high-level disinfection.

Among the reasons:


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  • non-adherence to guidelines
  • use of damaged endoscopes
  • use of insoluble products during endoscopy
  • insufficient cleaning
  • contaminated rinse water
  • inadequate drying before storage.

After analyzing the literature, interviews with frontline personnel, and evidence from their previous studies, the research team found that reusable high-level disinfectants commonly failed tests for minimum effective concentration before their maximum use periods. Minimum effective concentration tests also found failures linked to single-use high-level disinfectants that did not fully deploy.

Recognizing the need for quality improvement in association with high-level disinfectants is growing, and infection preventionists should build on this momentum and collaborate with manufacturers, endoscopists, and reprocessing personnel to improve high-level disinfection effectiveness, the researchers say.

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