The risk of disease transmission associated with inadequate disinfection of gastrointestinal endoscopes

Abstract

Reports of nosocomial infection associated with improper cleaning, inadequate disinfection or insufficient drying of gastrointestinal (GI) endoscopes, although rare, have been published. One recent report documents the potential for disease transmission due to failure by healthcare workers to monitor the concentration of the disinfectant throughout the day as instructions require. 1 Mackeen D. Unclean record of disinfecting. Newsday. 27 June 2004; Google Scholar A disinfectant used at a concentration below its minimum effective concentration (MEC) may fail to achieve high-level disinfection, posing a significant risk of nosocomial infection. Manual cleaning of GI endoscopes is crucial to prevent disease transmission. It reduces the initial level of bioburden, or contamination, on the endoscope's surfaces after clinical use. Endoscope drying is also an important reprocessing step that complements cleaning and high-level disinfection and prevents the transmission of waterborne bacteria and mycobacteria that may have grown and colonized in the GI endoscope's moist internal channels during storage. 2 Muscarella L.F. The importance of bronchoscope reprocessing guidelines: raising the standard of care. Chest. 2004; 126 (author reply 1002–1003): 1001-1002 Crossref PubMed Scopus (1) Google Scholar , 3 Muscarella L.F. Contribution of tap water and environmental surfaces to nosocomial transmission of antibiotic-resistant Pseudomonas aeruginosa. Infect Control Hosp Epidemiol. 2004; 25: 342-345 Crossref PubMed Scopus (48) Google Scholar GI endoscopes that are cleaned, high-level disinfected and dried in accordance with published guidelines pose virtually no risk of nosocomial infection.