Enhanced disinfection makes no difference for duodenoscope contamination — 3 insights

A study, published in Gastroenterology, examined three different disinfection methods to determine which one best sterilized a duodenoscope.

Mandeep Sawhney, MD, of Boston-based Beth Israel Deaconess Medical Center, and colleagues performed a single-center prospective, randomized study. Researchers reprocessed duodenoscopes through:

  • Standard high-level disinfection
  • Double high-level disinfection
  • Standard high-level disinfection followed by ethylene oxide gas sterilization

Researchers measured the proportion of duodenoscopes with an elevator mechanism or working channel showing one or more multidrug-resistant organisms.

Here's what they found:

1. After only three months, researchers closed the study because of a lack of sufficient events to evaluate the primary outcomes.

2. Researchers tested 541 culture events and included 516 in the final analysis. Out of those included, no culture was positive for multidrug-resistant organisms.

3. However, researchers found bacteria growth with a score higher than zero colony-forming units in 16.1 percent of duodenoscopes in the standard disinfection group, 16 percent in the double disinfection group and 22.5 percent in the standard followed by gas disinfection group. Bacteria growth with a score higher than 10 was found in 2.3 percent, 4.1 percent and 4.2 percent of the respective disinfection groups.

Researchers concluded, "We found no significant differences between groups for multidrug-resistant organisms or bacteria contamination. Enhanced disinfection methods did not provide additional protection against contamination. However, insufficient events occurred to assess our primary study end-point."

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