Abstract
Storage of flexible endoscopes under germicidal ultraviolet (UVC) light has been associated with degradation of device material leading to failure and increased risk to patients. 405 nm germicidal light presents a possible alternative, potentially providing effective bacterial inactivation without material damage. Samples of endoscope material were exposed to UVC and 405 nm germicidal light sources and a broad spectrum light source control. Material properties were monitored using FTIR, AFM, contact angle and confocal microscopy. Significant changes were observed with samples exposed to the UVC source, with variations in FTIR spectra indicative of side chain scission, a decrease in contact angle from 82.6° to 61.4°, an increase in average surface roughness from 2.34 nm to 68.7 nm and visible cracking of the surface. In contrast samples exposed to the 405 nm light source showed little to no changes, with any variations being comparable to those seen on samples exposed to the broad spectrum control. Bacterial adhesion tests on samples showed an 86.8% increase in Pseudomonas aeruginosa adhesion on UVC exposed samples and no significant increase in adhesion with samples exposed to the other light sources. 405 nm germicidal light therefore potentially represents a safer alternative to UVC light for use in flexible endoscope storage.
Highlights
With the ever present issue of hospital acquired infections, decontamination and sterilisation technologies are of great interest in modern healthcare
The average Fourier Transform Infrared Spectroscopy (FTIR) spectra obtained from unexposed samples was used to better identify the composition of the material samples, an exact identification of the sample material is challenging as it is likely a proprietary composition unique to the manufacturer
Japan USA LLC.) indicated that the material was likely poly(methyl methacrylate) (PMMA) based (93.8% similarity) with strong similarities to copolymers including poly(methyl methacrylate: butadiene) (95.1%), poly(methyl methacrylate-co-ethyl methacrylate) (93.7%) and Average spectra for unexposed samples and samples exposed to the 405 nm, broadspectrum and UVC light sources, between 4000 cmÀ1 and 500 cmÀ1. (B) Average spectra for unexposed samples and samples exposed to the UVC light source, between 4000 cmÀ1 and 2500 cmÀ1
Summary
With the ever present issue of hospital acquired infections, decontamination and sterilisation technologies are of great interest in modern healthcare. A wide range of technologies play a role in sterilisation and infection control; in some cases, these methods can result in the degradation of underlying material [1e4]. As part of the infection control measures for flexible endoscopes, germicidal ultraviolet (UVC) light has been incorporated into some specialised drying and storage cabinets. These light sources have been implicated in the degradation of endoscope material, prompting warnings from manufacturers and regulatory bodies [5,6]. UVC light provides air and surface decontamination, promoting aseptic storage conditions; any degradation of the endoscope material could be detrimental to device performance and patient safety
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