Investigation of the efficacy of an innovative endoscope drying and storage method in a simulated ERCP setting.

Abstract

Background and study aims Drying after cleaning and disinfection is essential in the reprocessing of endoscopes since microorganisms can grow and form biofilms on wet surfaces. In this experimental non-clinical study, we investigated the efficacy of a novel, fast-drying method when reprocessing duodenoscopes. Methods During a series of 40 tests, three duodenoscopes were exposed to an artificial test soil containing supraphysiological loads of four types of gut microorganisms in a non-clinical ERCP simulation, followed by reprocessing and drying with the PlasmaTYPHOON. Cultures of the distal tip and working channel were acquired immediately after automated decontamination and after drying with the PlasmaTYPHOON. Cobalt chloride paper tests and borescope inspections were used to evaluate drying efficacy. Results Contamination of the working channels dropped from 86.4 % post-decontamination to 33.6 % post-drying, with 94 % of the positive post-drying samples belonging to one duodenoscope. This duodenoscope showed persistent contamination with P. aeruginosa in the working channel. The other two duodenoscopes only showed low levels of P. aeruginosa in post-decontamination channel samples, but not after drying. Cobalt chloride paper tests and borescope inspections revealed good drying efficacy. Conclusions Positive cultures for gut microorganisms were often found in wet endoscopes post-decontamination. The PlasmaTYPHOON is an effective fast-drying method capable of abolishing nearly all remaining microorganisms after decontamination provided no biofilm has developed, even when using a supraphysiological concentration of bacterial load. The clinical use of the PlasmaTYPHOON has the potential to reduce endoscope contamination, the use of wet contaminated endoscopes and therefore the risk of patient infection.