Subscribe to RSS
DOI: 10.1055/s-1999-55
Endoscope Disinfection Using Acidic Electrolytic Water
Publication History
Publication Date:
31 December 1999 (online)
Background and Study Aims: The aim of the present study was to evaluate a new endoscope disinfector (WM-1) that uses acidic electrolytic water (AEW).
Materials and Methods: AEW was produced by electrolysis of a 0.05 % NaCl-water mixture, with a redox potential greater than 1000 mV and a pH lower than 2.7. In the first study, an endoscope artificially contaminated with 15 species of bacteria and four strains of viruses was treated using the WM-1. In the second study, endoscopic contamination after clinical use was examined by culture for Helicobacter pylori and other bacteria, and by polymerase chain reaction for the H. pylori urease gene and hepatitis C virus. The extent of contamination was then examined after exposing the WM-1 to AEW. The safety of AEW was examined using both in vivo and in vitro studies.
Results: All of the bacteria and viruses were destroyed or inactivated after the instrument had been exposed to AEW. Clinical contamination was detected from the instrument in 19 of 30 endoscopic procedures, whereas no bacteria or viruses were detected after five minutes' exposure to AEW. AEW was found to be nonirritant, nontoxic to cells, and nonmutagenic.
Conclusion: The WM-1 successfully and safely disinfected the endoscopes. With running costs of ¥24 per day ($0.21 per day), the WM-1 provides an effective and inexpensive alternative to conventional disinfection equipment.
References
- 1 Spach DH, Silverstein FE, Stamm WE. Transmission of infection by gastrointestinal endoscopy and bronchoscopy. Ann Intern Med. 1993; 118 117-128
- 2 O'Connor HJ, Axon ATR. Gastrointestinal endoscopy: infection and disinfection. Gut. 1983; 24 1067-1077
- 3 LeFrock JL, Ellis CA, Turchik JB, et al. Transient bacteremia associated with sigmoidoscopy. N Engl J Med. 1973; 289 467-469
- 4 Shull HJ, Green BM, Allen SD, et al. Bacteremia with upper gastrointestinal endoscopy. Ann Intern Med. 1975; 83 212-214
- 5 Katner HP, Buckley RL, Smith MU, et al. Endoscopic cleaning and disinfection procedure for preventing iatrogenic spread of human immunodeficiency virus. J Fam Pract. 1988; 27 271-276
- 6 Axon AT, Phillips I, Cotton PB, et al. Disinfection of gastrointestinal fiber endoscopes. Lancet. 1974; i 656-668
- 7 Carr-Locke DL, Clayton P. Disinfection of upper gastrointestinal fibreoptic endoscopy equipment: an evaluation of a cetrimide chlorhexidine solution and glutaraldehyde. Gut. 1978; 19 916-922
- 8 O'Connor HJ, Rothwell J, Maxwell S, et al. New disinfecting apparatus for gastrointestinal fiberendoscopes. Gut. 1982; 23 706-709
- 9 Gerding DN, Peterson LR, Vennes JA. Cleaning and disinfection of fiberoptic endoscopes: evaluation of glutaraldehyde exposure time and forced-air drying. Gastroenterology. 1982; 83 613-618
- 10 Hughes CE, Gebhard RL, Peterson LR, et al. Efficacy of routine fiberoptic endoscopic cleaning and disinfection for killing Clostridium difficile. . Gastrointest Endosc. 1986; 32 7-9
- 11 Yoshii Y, Kasugai T, Nakamura T. Disinfectious effect of endoscopes using new washer model EW-10 [in Japanese]. Gastroenterol Endosc. 1985; 27 354-361
- 12 Kawaguchi K, Yamaki H, Okuwaki J. Cleaning and disinfection of fiberoptic endoscope [in Japanese]. Gastroenterol Endosc. 1995; 37 24-31
- 13 American Society for Gastrointestinal Endoscopy. Infection control during gastrointestinal endoscopy: guidelines for clinical application. Gastrointest Endosc. 1988; 34 (Suppl 3) 37-40S
- 14 Van Gossum A, Loriers M, Serruys E, et al. Methods of disinfecting endoscopic material: result of an international survey. Endoscopy. 1989; 21 247-250
- 15 British Society of Gastroenterology Working Party. Cleaning and disinfection of equipment for gastrointestinal flexible endoscopy. Gut. 1988; 29 1134-1151
- 16 Tolon M, Thofern E, Miederer SE. Disinfection procedures of fiberscopes in endoscopy departments. Endoscopy. 1979; 8 24-29
- 17 Fantry GT, Zheng QX, James SP. Conventional cleaning and disinfection techniques eliminate the risk of endoscopic transmission of Helicobacter pylori. . Am J Gastroenterol. 1995; 90 227-232
- 18 Graham DY, Alpert LC, Smith JL, et al. Iatrogenic Campylobacter pylori infection is a cause of epidemic achlorhydria. Am J Gastroenterol. 1988; 83 974-980
- 19 Langenberg W, Rauws EAJ, Widjojokusumo A, et al. Patient-to-patient transmission of Campylobacter pylori infection by fiberoptic gastroduodenoscopy and biopsy. J Infect Dis. 1990; 161 507-511
- 20 Katoh M, Saito D, Noda T, et al. Helicobacter pylori may be transmitted through gastrofiberscope even after manual hyamine washing. Jpn J Cancer Res. 1993; 84 117-119
- 21 Sugiyama T, Naka H, Yabana T, et al. Is Helicobacter pylori infection responsible for postendoscopic acute gastric mucosal lesions?. Eur J Gastroenterol Hepatol. 1992; 4 S93-S96
- 22 Iwasaki A, Nakamura R, Nakamura K, et al. Bactericidal effect of aqua oxidation water [in Japanese]. Clin Pharmacol Ther. 1993; 3 1555-1562
- 23 Okubo K, Arata T, Kobayashi H, et al. Report on electrolytic acidic water [in Japanese]. Nippon Shujutsu Igaku Zasshi. 1994; 15 508-520
- 24 Masuda T, Oikawa K, Oikawa H, et al. Endoscopic disinfection with acid electrolyzed water. Dig Endosc. 1995; 7 61-64
- 25 Davis EM, Moore JD, Casserly D, et al. Disinfection. J Water Pollut Control Fed. 1975; 47 1323-1334
- 26 Clayton CL, Kleanthous H, Coates PJ, et al. Sensitive detection of Helicobacter pylori by using polymerase chain reaction. J Clin Microbiol. 1992; 30 192-200
- 27 Okamoto H, Sugiyama Y, Okada S, et al. Typing hepatitis C virus by polymerase chain reaction with type-specific primers: application to clinical surveys and tracing infectious sources. J Gen Virol. 1992; 73 673-679
- 28 Draize JH, Woodard G, Calvery HO. Methods for the study of irritation and toxicity of substances applied topically to the skin and mucous membranes. J Pharmacol Exp Ther. 1944; 82 377-390
- 29 Birnie GG, Quigley EM, Clements GB, et al. Endoscopic transmission of hepatitis B virus. Gut. 1983; 24 171-174
- 30 Chiaramonte M, Farini R, Truscia D, et al. Risk of hepatitis B virus infection following upper gastrointestinal endoscopy: a prospective study in an endemic area. Hepatogastroenterology. 1983; 30 189-191
- 31 Hoofnagle JH, Blake J, Buskell-Bales Z, et al. Lack of transmission of type B hepatitis by fiberoptic upper endoscopy. J Clin Gastroenterol. 1980; 2 65-69
S. TsujiM.D.
First Department of Medicine
Osaka University School of Medicine
Suita, 565
Japan
Phone: + 81-6-6879-3639
Email: tsuji@medone.med.osaka-u.ac.jp