ESGE–ESGENA guideline: Cleaning and disinfection in gastrointestinal endoscopy

U. Beilenhoff; C. S. Neumann; J. F. Rey; H. Biering; R. Blum; M. Cimbro; B. Kampf; M. Rogers; V. Schmidt; null

doi:10.1055/s-2008-1077722

Endoscopy 2008; 40(11): 939-957
DOI: 10.1055/s-2008-1077722

Guidelines

ESGE–ESGENA guideline: Cleaning and disinfection in gastrointestinal endoscopy

Update 2008U. Beilenhoff¹ , C. S. Neumann² , J. F. Rey³ , H. Biering⁴ , R. Blum⁵ , M. Cimbro⁶ , B. Kampf⁷ , M. Rogers⁸ , V. Schmidt⁹ , and the ESGE Guidelines Committee

¹ESGENA President, Ulm, Germany
²ESGENA Past President, Birmingham, UK
³ESGE Guidelines Commitee Chairman, Institute A. Tzanck, Saint Laurent du Var, France
⁴R,D&E Health Care EMEA, Ecolab GmbH & Co OHG, Düsseldorf, Germany
⁵BU Endoscopy Reprocessing Systems, Olympus Medical Systems Europa GmbH, Hamburg, Germany
⁶CBC (Europe) Ltd., MILAN Branch, Nova Milanese (MI), Italy
⁷PENTAX Europe GmbH, Service Division, Hamburg, Germany
⁸Sterilox Endoscopy, PuriCore International Limited, Stafford, UK
⁹Microbiology and Hygiene Department, Chemische Fabrik Dr. Weigert GmbH & Co. KG, Hamburg, Germany

Abstract

1. Introduction
2. Definition of terms
3. Endoscopy-related infections
4. Principles of infection control
5. Chain of infection
6. Health and safety of endoscopy personnel
7. General requirements
7.1. Classification of endoscopic equipment
7.2. Aims of the reprocessing procedure
7.3. Staff requirements
7.4. Reprocessing room
7.5. The reprocessing procedure
7.6. Manual versus automated reprocessing
8. Process chemicals
8.1. Detergents
8.1.1. Detergents with enzymatic boosters
8.1.2. Detergents with alkaline boosters
8.1.3. Detergents with enzymatic and alkaline boosters
8.1.4. Detergents containing antimicrobial active substances
8.2. Disinfectants
8.2.1. Glutaraldehyde
8.2.2. Orthophthalaldehyde (OPA)
8.2.3. Peracetic acid (PAA)
8.2.4. Chlorine dioxide
8.2.5. Electrolytically generated disinfectants
8.3. Rinse aid
8.4. Combination of products from different manufacturers
8.5. Change of products
9. Reprocessing of endoscopes
9.1. Manual cleaning
9.1.1. Pre-cleaning in the endoscopy room
9.1.2. Manual cleaning in the reprocessing room
9.2. Reprocessing in washer-disinfectors
9.2.1. Definition and process basics for washer-disinfectors
9.2.2. Process specifications for washer-disinfectors
9.2.3. Specific recommendations for washer-disinfectors
9.2.4. Advantages and disadvantages of washer-disinfectors
9.3. Reprocessing in automated disinfection devices
9.3.1. Definition and process basics for automated disinfection devices
9.3.2. Process specifications for automated disinfection devices
9.3.3. Specific recommendations for automated disinfection devices
9.3.4. Advantages and disadvantages of automated disinfection devices
9.4. Manual reprocessing of endoscopes
9.4.1. Definition and process basics for manual reprocessing
9.4.2. Process specifications for manual reprocessing
9.4.3. Advantages and disadvantages of manual reprocessing
9.5. Drying, storage and reuse of endoscope
10. Quality assurance
10.1. Documentation
10.2. Maintenance of washer-disinfectors and automated disinfection devices
10.3. Process validation and microbiological surveillance
10.4. Outbreak management
11. Reprocessing of endoscopic accessories
11.1. General recommendations
11.2. Process specifications
11.2.1. Manual cleaning
11.2.2. Reprocessing in washer-disinfectors
11.2.3. Manual reprocessing
11.2.4. Sterilization
11.2.5. Storage
11.3. Specific recommendations
11.3.1. Biliary and pancreatic procedures
11.3.2. Injection needles
11.3.3. Biopsy forceps
11.3.4. Water bottle and its connectors
12. Appendices
Appendix 1: Manual cleaning of flexible endoscopes
Appendix 2: Reprocessing of flexible endoscopes in washer-disinfectors and automated disinfection devices
Appendix 3: Manual reprocessing of flexible endoscopes
Appendix 4: Manual reprocessing of reusable endoscopy accessories
Appendix 5: Reprocessing of endoscopic accessories in washer-disinfectors and automated disinfection devices
13. References

Full Text

References

13. References and guidelines

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