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DOI: 10.1055/s-2001-17330
Cleaning and Disinfection Practices in Digestive Endoscopy in Spain: Results of a National Survey
Publication History
Submitted: 06 March 2001
Accepted after Revision: 31 May 2001
Publication Date:
20 September 2001 (online)

Background and Study Aims:
Disinfection and surveil- lance of it are important for ensuring safety in gastrointestinal endoscopy. The aim of this survey was to assess the current status of disinfection in gastrointestinal endoscopy units in Spain.
Materials and Methods:
An anonymous questionnaire on cleaning and disinfection methods was sent to gastrointestinal endoscopy units at 244 public hospitals in Spain. A minimum standard of disinfection (MSD) was defined to evaluate the appropriateness of disinfection practices.
Results:
A total of 144 centers responded (58 %). All units perform manual washing of endoscopes before disinfection. Automatic washers are available in only 23 % of the centers. Selective cleaning of internal channels is systematically performed in 85 % of the centers. Glutar aldehyde-based disinfectants are the most commonly employed (84 % of units). The time of exposure to the disinfectant is at least 10 min in 97 % of units, but 20 min or more in only 36 % of them. Endoscopic accessories are sterilized in 57 % of centers. The MSD was complied with by 79 % of the units evaluated. Compliance with the MSD was significantly lower in small units (P = 0.0005) performing small numbers of examinations per month. Quality control tests on the efficacy of disinfection methods are conducted at 66 % of the centers. Specialized personnel record disinfection procedures in 85 % of the centers and supervise them in 55 % of the centers. Half of the units have inadequate equipment and facilities.
Conclusions:
This survey suggests that cleaning and disinfection practices in gastrointestinal endoscopy units in Spain have improved in recent years, and that there is a good compliance with standard guidelines. Most units should improve their equipment and facilities in order to provide better comfort and safety for patients and staff.
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References
- 1 Spach DH, Silverstein FE, Stamm WE. Transmission of infection by gastrointestinal
endoscopy and bronchoscopy. Ann Intern Med 1993; 118: 117-128
MissingFormLabel
- 2 Rutala WA, Clontz EP, Weber DJ, Hoffmann KK. Disinfection practices for endoscopes
and other semicritical items. Infect Control Hosp Epidemiol 1991; 12: 282-288
MissingFormLabel
- 3 Pascual Torres D, Condom Mundó MJ, Bordas JM, Prats Alonso E. Risk in digestive endoscopy:
disinfection methods and management of equipment. Gastroenterol Hepatol 1990; 13:
499-506
MissingFormLabel
- 4 Alvarado CJ, Stolz SM, Maki DG et al. Nosocomial infection and pseudoinfection from
contaminated endoscopes and bronchoscopes: Wisconsin and Missouri. JAMA 1991; 266:
2917-2918
MissingFormLabel
- 5
American Society for Gastrointestinal Endoscopy
. Infection control during gastrointestinal endoscopy: guidelines for clinical application
Gastrointest. Endosc 1988; 34 (Suppl) 37-40
MissingFormLabel
- 6
British Society of Gastroenterology
. Cleaning and disinfection of equipment for gastrointestinal flexible endoscopy:
interim recommendations of a working party. Gut 1988; 29: 1134-1151
MissingFormLabel
- 7 Axon AT. Working party report to the World Congresses: disinfection and endoscopy
- summary and recommendations. J Gastroenterol Hepatology 1991; 6: 23-24
MissingFormLabel
- 8 Axon A, Kruse A, Urgell R et al. European Society of Gastro intestinal Endoscopy
(ESGE): guidelines for the reprocessing of accessories in digestive endoscopy. Endoscopy
1996; 28: 534-535
MissingFormLabel
- 9
American Society for Gastrointestinal Endoscopy
. Ad Hoc Committee on Disinfection. Reprocessing of flexible gastrointestinal endoscopes.
Gastrointest Endosc 1996; 43: 540-546
MissingFormLabel
- 10 Bordas JM, Pou Fernandez JM, Nieto M et al. Disinfection in digestive endoscopy:
current status and recommendations. Gastroenterol Hepatol 1999; 22: 157-159
MissingFormLabel
- 11 Spaulding EH. Chemical disinfection and antisepsis in the hospital. J Hosp Res 1972;
9: 5-31
MissingFormLabel
- 12 Tennenbaum R, Colardelle P, Chonchon M et al. Hepatitis C virus after endoscopic
retrograde cholangiopancreatography. Gastroenterol Clin Biol 1993; 338: 572-573
MissingFormLabel
- 13 Andrieu J, Barny S, Colardelle P et al. Prevalence and risk factors of hepatitis
C virus infection in a hospitalized population in a gastroenterology unit: role of
endoscopic biopsies. Gastroenterol Clin Biol 1995; 19: 340-345
MissingFormLabel
- 14 Rene E, Lucet JC, Bouvet E et al. Digestive endoscopy and risk of transmission of
hepatitis C virus: hygiene and discussion. Gastroenterol Clin Biol 1996; 20: 109-111
MissingFormLabel
- 15 Bronowicki JP, Venard V, Botte C et al. Patient to patient transmission of hepatitis
C virus during colonoscopy. N Engl J Med 1997; 337: 237-240
MissingFormLabel
- 16 Ponchon T. Risk of hepatitis C and prion diseases through digestive endoscopy: evaluation
of risk and recommended practices. Endoscopy 1997; 29: 199-202
MissingFormLabel
- 17 Urayama S, Kozarek RA, Sumida S et al. Mycobacteria and glutaraldehyde: is high-level
disinfection of endoscopes possible?. Gastrointest Endosc 1996; 43: 451-456
MissingFormLabel
- 18 Kaneko H, Mitsuma T, Kotera H et al. Are routine cleaning methods sufficient to remove
Helicobacter pylori from endoscopic equipment?. Endoscopy 1993; 25: 435
MissingFormLabel
- 19 Akamatsu T, Tabata K, Hironga M et al. Transmission of Helicobacter pylori infection
via flexible fiberoptic endoscopy. Am J Infect Control 1996; 24: 396-401
MissingFormLabel
- 20 Van Gossum A, Loriers M, Serruys E, Cremer M. Methods of disinfecting endoscopic
material: results of an international survey. Endoscopy 1989; 21: 247-250
MissingFormLabel
- 21 Collignon P, Graham E. How well are the endoscopes cleaned and disinfected between
patients?. Med J Aust 1989; 151: 269-272
MissingFormLabel
- 22 Collignon P, Graham E. Cleaning and disinfected of endoscopes: have there been recent
improvements?. Med J Aust 1991; 154: 391-394
MissingFormLabel
- 23 Gorse GJ, Messner RL. Infection control practices in gastrointestinal endoscopy in
the United States: a national survey. Infect Control Hosp Epidemiol 1991; 12: 289-296
MissingFormLabel
- 24 Favero MS. Strategies for disinfection and sterilization of endo- scopes: the gap
between basic principles and actual practice. Infect Control Hosp Epidemiol 1991;
12: 279-281
MissingFormLabel
- 25 Axon ATR, Banks J, Cockel R et al. Disinfection in upper digestive tract endoscopy
in Britain. Lancet 1981; i: 1093-1094
MissingFormLabel
- 26 Kaczmarek RG, Moore Jr RM, McCrohan J et al. Multi-state investigation of the actual
disinfection/sterilization of endoscopes in health care facilities. Am J Med 1992;
92: 257-261
MissingFormLabel
- 27 Reynolds CD, Rhinehart E, Dreyer P, Goldmann DA. Variability in reprocessing policies
and procedures for flexible fiberoptic endoscopes in Massachusetts hospitals. Am J
Infect Control 1992; 20: 283-290
MissingFormLabel
- 28 Katner HP, Buckley RL, Smith MU, Henderson AM. Endoscopic cleaning and disinfection
procedures for preventing iatrogenic spread of human immunodeficiency virus. J Fam
Pract 1988; 27: 271-276
MissingFormLabel
- 29 Orsi GB, Filocamo A, Di Stefabo L, Tittobello A. Italian national survey of digestive
endoscopy disinfection procedures. Endoscopy 1997; 29: 732-740
MissingFormLabel
- 30 Brullet E, Campo R, Puig M et al. National questionnaire on cleaning and disinfection
habits in digestive endoscopy. Gastroenterol Hepatol 1994; 17: 455-459
MissingFormLabel
- 31 Vesley D. Significant factors in the disinfection and sterilization of flexible endoscopes.
Am J Infect Control 1992; 20: 291-300
MissingFormLabel
- 32
British Society of Gastroenterology Endoscopy Committee
. Cleaning and disinfection of equipment for gastrointestinal endoscopy: report of
a working party. Gut 1998; 42: 585-593
MissingFormLabel
- 33 Barragan Casas JM, Hernandez Hernandez JM, Gonzalo Molina MA et al. Decontamination
of gastroscopes with glutaraldehyde. Enf Infec Microbiol Clin 1998; 16: 487-488
MissingFormLabel
- 34 Muscarella LF. High-level disinfection or "sterilization" of endoscopes. Infect Control
Hosp Epidemiol 1996; 17: 183-187
MissingFormLabel
- 35 Deva AK, Vickery K, Zou J et al. Detection of persistent vegetative bacteria and
amplified viral nucleic acid from in-use testing of gastrointestinal endoscopes?.
J Hosp Infect 1998; 39: 149-157
MissingFormLabel
- 36 Speer T, Cowen A. Endoscopy in Australia. Gastrointest Endosc 1998; 47: 431-433
MissingFormLabel