RESUMO
Four endoscopes were cleaned by an experienced endoscopy technician using an enzyme detergent solution with brushing, rinsing with tap water, and then high-level disinfection in an automatic endoscope reprocessing machine using CIDEX orthophthalaldehyde solution (CIDEX OPA). After disinfection, the channels of these patient-ready endoscopes were flushed with sterile neutralizing medium, brushed with a sterile brush, and then flushed again with sterile medium. The effluent from each flush was collected in sterile bottles, immediately returned on ice to a laboratory, and tested for the presence of bacteria. An average of about 200 colony-forming units of bacteria were recovered from each endoscope. Upon staining and microscopic examination, 3 of these colonies were spore-forming bacteria, and 7 colonies were nonspore-forming bacteria. These results suggest that the endoscopes might have been contaminated with a biofilm. Bacterial biofilms have been speculated to commonly occur in endoscopes as a result of the many possible inadequacies of cleaning, disinfecting, rinsing, drying, storage, and other functions associated with the difficulties of reprocessing endoscopes. As one possible cause for a biofilm, three high-level disinfectants (CIDEX activated dialdehyde solution, CIDEX OPA, and Aldahol high-level disinfectant) were tested for their sporicidal activity against high-protein or low-protein cultures of spore-forming bacteria in suspension. The potential importance of killing spore-forming bacteria within a practical exposure time in order to prevent the formation of biofilms is discussed.
Assuntos
Biofilmes , Desinfetantes/normas , Endoscópios Gastrointestinais/microbiologia , Contaminação de Equipamentos/prevenção & controle , Glutaral/normas , Esporos Bacterianos , Bacillus subtilis/efeitos dos fármacos , Bacillus subtilis/crescimento & desenvolvimento , Biofilmes/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Clostridium/efeitos dos fármacos , Clostridium/crescimento & desenvolvimento , Contagem de Colônia Microbiana , Desinfecção/métodos , Desinfecção/normas , Avaliação Pré-Clínica de Medicamentos , Guias como Assunto , Humanos , Esporos Bacterianos/efeitos dos fármacos , Esporos Bacterianos/crescimento & desenvolvimento , Fatores de Tempo , o-Ftalaldeído/normasAssuntos
Cistoscópios/microbiologia , Desinfetantes/normas , Desinfecção/métodos , o-Ftalaldeído/normas , Contagem de Colônia Microbiana , Desinfetantes/toxicidade , Desinfecção/normas , Contaminação de Equipamentos/prevenção & controle , Contaminação de Equipamentos/estatística & dados numéricos , Reutilização de Equipamento , Óxido de Etileno/normas , Óxido de Etileno/toxicidade , Seguimentos , Glutaral/normas , Glutaral/toxicidade , Humanos , Soluções , Fatores de Tempo , o-Ftalaldeído/toxicidadeRESUMO
The microbiocidal efficacy of 0.55% ortho-pthalaldehyde (OPA) was evaluated in a rough carrier test, using more than 200 strains of bacteria and yeasts from patients and reference ATCC strains. This test was then compared with the European carrier test (prEN14561) using Pseudomonas aeruginosa. We also sought to determine whether recently isolated P. aeruginosa had the same susceptibility to OPA, after laboratory adaptation. It was shown that P. aeruginosa was less susceptible to OPA (being reduced by a factor of 10(3.8)) than the other strains (reduced by a factor of 10(4)). The surface test used, produced a lesser reduction of P. aeruginosa than the European test. For recently isolated strains (N = 66), the rough model demonstrated that the number of survivors increased both quantitatively and qualitatively from day one to day seven. It was concluded that disinfectant efficacy should be confirmed with recently isolated organisms.
Assuntos
Desinfetantes/normas , Desinfecção/métodos , Avaliação Pré-Clínica de Medicamentos/métodos , Contaminação de Equipamentos/prevenção & controle , Pseudomonas aeruginosa/efeitos dos fármacos , Preparo de Canal Radicular/instrumentação , o-Ftalaldeído/normas , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Reservatórios de Doenças , Desinfecção/normas , Avaliação Pré-Clínica de Medicamentos/normas , Farmacorresistência Bacteriana , Farmacorresistência Bacteriana Múltipla , Reutilização de Equipamento , Humanos , Unidades de Terapia Intensiva , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas/microbiologia , Infecções por Pseudomonas/prevenção & controle , Pseudomonas aeruginosa/isolamento & purificação , Pseudomonas aeruginosa/fisiologia , Propriedades de SuperfícieRESUMO
One hundred endoscopes used for bronchoscopy (30), gastroscopy (35) or colonoscopy (35) were studied to determine the efficiency of a new high level disinfectant, orthophthalaldehyde (OPA). Manual cleaning was the method studied since this would be the least effective and thereby provide the greatest challenge to the 0.5% (w/v) OPA solution. The OPA was convenient and easy to use since it did not have irritating vapours and as it is used directly, does not require dilution. Our study demonstrated that the OPA was stable for up to 14 days despite repeated re-use. The cleaning/disinfection procedure could achieve a > or = 5 LOG10 reduction in bacterial load. This in-hospital evaluation supports the conclusion that OPA is an effective choice as a high level disinfectant for flexible endoscopes.