Artigo Produção Nacional Revisado por pares

Effectiveness of current disinfection procedures against biofilm on contaminated GI endoscopes

2015; Elsevier BV; Volume: 83; Issue: 5 Linguagem: Inglês

10.1016/j.gie.2015.09.016

ISSN

1097-6779

Autores

Marcelo Soares Neves, Marlei Gomes da Silva, Grasiella M. Ventura, Patrícia Barbur Côrtes, Rafael Silva Duarte, Heitor Siffert Pereira de Souza,

Tópico(s)

Healthcare and Environmental Waste Management

Resumo

Background and Aims Attention to patient safety has increased recently due to outbreaks of nosocomial infections associated with GI endoscopy. The aim of this study was to evaluate current cleaning and disinfection procedures of endoscope channels with high bioburden and biofilm analysis, including the use of resistant mycobacteria associated with postsurgical infections in Brazil. Methods Twenty-seven original endoscope channels were contaminated with organic soil containing 10 8 colony-forming units/mL of Pseudomonas aeruginosa , Staphylococcus aureus , or Mycobacterium abscessus subsp bolletii. Biofilms with the same microorganisms were developed on the inner surface of channels with the initial inoculum of 10 5 colony-forming units/mL. Channels were reprocessed following current protocol, and samples from cleaning and disinfection steps were analyzed by bioluminescence for adenosine triphosphate, cultures for viable microorganisms, and confocal microscopy. Results After contamination, adenosine triphosphate levels increased dramatically, and high bacterial growth was observed in all cultures. After cleaning, adenosine triphosphate levels decreased to values comparable to precontamination levels, and bacterial growth was demonstrated in 5 of 27 catheters, 2 with P aeruginosa and 3 with M abscessus . With regard to induced biofilm, a remarkable reduction occurred after cleaning, but significant microbial growth inhibition occurred only after disinfection. Nevertheless, viable microorganisms within the biofilm were still detected by confocal microscopy, more so with glutaraldehyde than with peracetic acid or O -phataladehyde. Conclusion After the complete disinfection procedure, viable microorganisms could still be detected within the biofilm on endoscope channels. Prevention of biofilm development within endoscope channels should be a priority in disinfection procedures, particularly for ERCP and EUS.

Referência(s)