Page updated 30 April 2007
Endoscopes - New Disinfectants
Glutaraldehyde is now no longer recommended because of the stringent precautions laid down to reduce risk of exposure. Glutaraldehyde is relatively non-damaging to endoscopes and is cheap but contact times to ensure kill of mycobacteria are long.
New agents include superoxidised water, hydrogen peroxide, chlorine dioxide, improved quaternary ammonium compounds, peroxygen and peracetic acid compounds. Most of them have potential disadvantages of insufficient spectrum of activity, corrosiveness and irritant activity and cost. Of these new agents, peracetic acid formulations appear to be the best but, if used, ventilation and health screening are advocated (as for the use of glutaraldehyde). Commercial formulations include "Steris" and "NuCidex". The former is a dedicated endoscopy system with a long cycle time, the latter can be used in any suitably modified endoscope washer/disinfector.
Various guidelines have been published. Those given by different groups are given in MDA DB 9607 Nov 96: Decontamination of endoscopes. An update to this document was issued in 2002 [Device Bulletin DB(NI)2002/05]. These tables given for different preparations and recommended minimal disinfection times are given below but do not include recommendations for newer disinfectants. Individual policies in different units should conform to these minimum requirements.
The recommended minimum exposure times (minutes) are controversial and are a balance between adequate decontamination, damage to the instrument and the required interval between procedures.
For
- Peracetic acid 0.35% "STERIS"
- Chlorine dioxide "TRISTEL"
- Electrolysed salt solution "STERILOX"
The contact time for all circumstances is 5 minutes
EXCEPT for Bronchoscopes and Cystoscopes where the contact time is 10 minutes. (note: some manufacturers may recommend 5 minutes for all types of endoscopes)
Note: Please consult Microbiology staff before purchasing or testing any new disinfectant or washer/disinfector.
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