Gilby, J.; Mulcahy, M.; Allison, M.C.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA77
Academic Journal
Introduction: Until recently most endoscopy units in Europe and the USA have employed glutaraldehyde based disinfectants. Occupational exposure to glutaraldehyde is associated with hypersensitivity reactions prompting one manufacturer (Johnson & Johnson) to withdraw one of its widely used products (Cidex®). The Medical Devices Agency has recently revised its recommendations for endoscope decontamination. There have also been concerns about possible transmission of prion proteins by endoscopes, prompting the recommendation that enzymatic detergents are used during mechanical precleaning. Methods: We undertook a telephone survey of 107 hospitals in the UK to gather information on decontamination practice and the range of disinfectants and detergents in current use. A range of size of hospital was chosen, including seven private hospitals. Of the NHS hospitals there were 60 from England, and 20 each from Scotland and Wales. Results: All units surveyed perform manual cleaning before automatic endoscope disinfection. Manual cleaning is done using an enzymatic detergent by 63 (59%) of units and using ordinary detergent or soap solutions such as washing-up liquid by 28 (26%). The type of detergent used was unknown for 16 units. Aldehyde based disinfectants are used by 69 (64%); within this group 48 continue to use glutaraldehyde based solutions, 2 use dialdehydes and 19 use ortho-phthalaldehyde (an aldehyde with greater mycobactericidal activity and lower sensitisation risk than glutaraldehyde). Of the remainder 20 units use peracetic acid disinfectants, 11 use superoxidised saline, and 8 use chlorine dioxide. We identified 20 different brands of automatic endoscope reprocessor. Conclusions: Mechanical cleaning followed by automatic endoscope reprocessing is now standard practice. Recommendations for the use of enzymatic detergents are only partly being adhered to. While most centres use aldehyde based disinfectants, a wide variety of other agents are in...


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