Mycobacteria and glutaraldehyde: is high-level disinfection of endoscopes possible?

Shiro Urayama, Richard A. Kozarek, Stanford Sumida, Shirley Raltz, Linda Merriam, P. Pethigal

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Background: High-level disinfection of endoscopes has traditionally been undertaken by manual or automatic scope cleaning plus a 10 to 20 minute soak in 2% alkaline glutaraldehyde. Mycobacteria species are less sensitive to glutaraldehyde, and a 45-minute instrument soak has recently been recommended by the manufacturer. Because of concerns over endoscope damage, need for more endoscopes, and perception that the current cleaning method is adequate, we prospectively studied mycobacteria-contaminated endoscopes at various stages of the cleaning process. Methods: All work was done under a laminar flow hood in a microbiology laboratory. Five gastrointestinal scopes were contaminated with 108 colony forming units per milliter (CFU/mL) of Mycobacterium chelonei, an atypical mycobacterium similar in chemical resistance to Mycobacterium tuberculosis but with less infectious potential. Cultures of the sheath, biopsy channel, and elevator channel were taken at baseline, after manual cleaning, and after 10, 20, and 45 minutes of glutaraldehyde soak both before and after alcohol rinse. Results: Manual cleaning resulted in a mean of 4.7 log10 reduction in viable mycobacterial colonies. Qualitative studies of the external endoscope surface as well as the air-water valve showed no detectable organisms after a 10-minute exposure to alkaline glutaraldehyde. Conventional quantitative culture techniques of the channels demonstrated one endoscope out of five with consistent growth after a 10-minute exposure to glutaraldehyde. Following alcohol treatment, there was no significant colony growth. In contrast, a quantitative membrane filter system showed the presence of at least one mycobacterial colony in four out of five scopes after a 45-minute glutaraldehyde exposure. Conclusions: Additional studies utilizing a standardized mycobacterial species, inoculum size, and suspension characteristics are recommended to delineate adequate duration of disinfectant exposure time.

Original languageEnglish (US)
Pages (from-to)451-456
Number of pages6
JournalGastrointestinal Endoscopy
Volume43
Issue number2 PART 2
StatePublished - 1996
Externally publishedYes

ASJC Scopus subject areas

  • Gastroenterology

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    Urayama, S., Kozarek, R. A., Sumida, S., Raltz, S., Merriam, L., & Pethigal, P. (1996). Mycobacteria and glutaraldehyde: is high-level disinfection of endoscopes possible? Gastrointestinal Endoscopy, 43(2 PART 2), 451-456.