Clin Endosc.  2021 Jul;54(4):526-533. 10.5946/ce.2020.238.

Does the Reprocessing of Endoscopes Have to Take Place Immediately after Pre-Cleaning? A First Evaluation

• Eichel VM
• Jabs JM
• Unser S
• Mutters NT
• Scherrer M

• KMID: 2518855
• DOI: http://doi.org/10.5946/ce.2020.238

Abstract

Background/Aims
The recommendations on the time interval between pre-cleaning and reprocessing of endoscopes differ in international guidelines, with a low level of evidence. The aim of this study was to investigate the influence of postponing reprocessing on the reprocessing quality after pre-cleaning the flexible endoscopes.
Methods
We reprocessed 124 standardized test tubes simulating endoscope channels after soiling and contamination and determined the reprocessing performance. In addition, we examined contaminated gastroscopes, colonoscopes, and bronchoscopes. The duration of interim storage after pre-cleaning was 16 h for 100 test tubes and up to 24 h for 18 endoscopes. We determined the residual protein content and germ load as markers for cleaning and disinfection performance. In addition, we determined biofilm formation by photometry of crystal violet staining.
Results
All test tubes and flexible endoscopes showed residual protein content and germ load significantly below legally prescribed threshold values, independent of the interval between pre-cleaning and reprocessing.
Conclusions
Our findings indicate that flexible endoscopes could be stored overnight after pre-cleaning without any influence on the quality of reprocessing. While ensuring patient safety, this could simplify logistical processes and enable cost savings.

Keyword

Biofilm; Endoscope; Pre-cleaning; Reprocessing; Validation

Figure

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  Fig. 1. Test tube after standardized contamination.

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  Fig. 2. Disinfection performance of the test tubes as a function of storage duration after pre-cleaning. Reduction factor of E. faecium CFU/ml after processing. Bars indicate standard deviation. CFU, colony-forming unit.

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  Fig. 3. Disinfection performance of endoscopes as a function of storage duration after pre-cleaning. CFU/10 ml after reprocessing. Bars indicate standard deviation. CFU, colony-forming unit.

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  Fig. 4. Photometric investigation of biofilm formation in the treatment process. Three test tubes were soiled and contaminated with Enterococcus faecium. During the preparation according to protocol 1, they were stored for 24 h after pre-cleaning. One test tube that was not soiled served as negative control. As a marker for biofilms, an optical density (OD) of 570 nm after staining with crystal violet was determined 6 x per test tube. Bars indicate standard deviation.

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