Antimicrobial Resistance and Infection Control (Oct 2024)

A multicenter study comparing the bacterial reduction on flexible endoscopes without a working channel between UV-C light disinfection versus standard endoscope Washer Disinfection: a randomized controlled trial

  • Yana Halmans,
  • D. J. Wellenstein,
  • M. Romijn,
  • A. J. M. van Bemmel,
  • H. van den Berge,
  • R. A. Scheeren,
  • J. S. Kalpoe,
  • R. Klont,
  • J. H. van Zeijl,
  • H. Sikkema,
  • S. M. Euser,
  • J. Hopman,
  • R. P. Takes,
  • G. B. van den Broek

DOI
https://doi.org/10.1186/s13756-024-01486-2
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 8

Abstract

Read online

Abstract Background To prevent cross-contamination between patients, adequate reprocessing is necessary when using flexible endoscopes (FEs) without a working channel. The current reprocessing process using an Endoscope Washer Disinfector (EWD) is time-consuming. Ultraviolet light group C (UV-C) exposition is an alternative and fast disinfection method and has previously been shown to adequately reduce Colony Forming Units (CFUs) on FEs without a working channel. The objective of this study was to examine whether UV-C light is as effective in reducing CFUs on contaminated FEs without a working channel compared to the EWD. Methods FEs without a working channel were collected in three different Otorhinolaryngology Departments in the Netherlands. After pharyngolaryngoscopy, a manual pre-cleaning with tap water was performed and a culture was collected by rolling the distal 8–10 cm of the FE over an agar plate. Next, the FE was randomly assigned to be disinfected with UV-C light (D60) or the EWD (gold standard). After disinfection, another culture was taken. The primary outcome was microbiological contamination, defined by Colony Forming Units (CFU). Results 600 FEs without a working channel were randomized. After clinical use and manual pre-cleaning, 239/300 (79.7%) FEs in the UV-C group and 262/300 (87.3%) FEs in the EWD group were contaminated (i.e., > 0 CFU). FEs without culture confirmed contamination were excluded from further analysis. After UV-C light disinfection, 195/239 (81.6%) FEs showed 0 CFUs, compared to 187/262 (71.4%) FEs disinfected with the EWD (p < 0.01). A multivariate logistics regression analysis showed an increased odds of 0 CFUs when using UV-C light (OR 1.83, 95% CI 1.19–2.79; p < 0.01), conditional on participating hospitals and types of FE. Conclusions UV-C light disinfection of FEs without a working channel appears more effective in reducing CFUs compared to the EWD and might be a good alternative disinfection method. Trial registration Not applicable.

Keywords