5 6 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E M A Y 2 0 1 7
Flexible endoscopes are noto-
riously tough to clean. In one
recent study, 12 out of 20
(60%) reprocessed GI scopes
tested positive for microbial
growth — even though they
were disinfected in accor-
dance with current repro-
cessing guidelines
(osmag.net/C8WRex). Studies like this tend to raise a lot of alarms. So do a series
of recent carbapenem-resistant Enterobacteriaceae outbreaks at high-profile
facilities, caused by improperly cleaned duodenoscopes.
Donna Swenson, BS, CRCST, CHL, ACE, president of Sterile Processing
Quality Services in Stickney, Ill., says most low-temp sterilization methods can-
not sterilize long-lumened endoscopes. One option that works very well is ethyl
oxide (EtO). But it's an expensive and impractical way to sterilize scopes —
cycles take about 2.5 hours to complete and are followed by a mandatory 8- to
12-hour mechanical aeration.
A low-temperature sterilizer offers hydrogen peroxide and ozone sterilization in
a single cycle and is validated to sterilize multi-channel flexible endoscopes up to
3.5 meters in length. Ozone can achieve slightly more natural penetration than
vaporized hydrogen peroxide in lumened instruments, says Frank Myers, MA, CIC,
FAPIC, assistant associate director of infection prevention and clinical epidemiolo-
gy at University of California, San Diego Health. But having both methods in a sin-
gle unit packs a powerful decolonizing one-two punch.
Ms. Swenson isn't a big proponent of moving toward sterilizing endoscopes. She
believes efforts must focus instead on redesigning the devices and working with
DECONTAMINATION DEBATE
Is It Time to Sterilize Every Scope?
• TURNAROUND TROUBLE Some infection control experts believe high-level
disinfection isn't adequate to reprocess tough-to-clean flexible endoscopes.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
