Freely accessible endoscope channels improve efficacy of cleaning

Background and Study Aims: Inadequate cleaning and disinfection of medical devices, including flexible endoscopes, can result in the transmission of micro-organisms to patients. The aim of this study was to investigate the influence of the design of medical devices on the efficacy of manual cleaning of endoscope channels. Materials and Methods: The investigation was carried out using four endoscopes (two duodenoscopes and two gastroscopes), The air/water channels of one duodenoscope and one gastroscope were freely accessible and could be brushed. The instrumentation and the air/water channels were contaminated with blood containing Enterococcus faecium as a test organism, After manual cleaning of the channels by flushing and, where possible, brushing, the recovery rates for the test organism were studied. Results: The comparable rates for recovery of the test organism after cleaning of the instrumentation channels proved that the method used was reproducible. With regard to the air/water channels, the rate of micro-organisms in the cleaning solution recovered after flushing alone was a maximum of 3% relative to the rate detected after brushing and flushing. Conclusions: The data collected in the study show that only flushing channels that are not freely accessible resulted in significantly lower (P < 0.001) recovery rates for the test organism. In practice, this means that contamination may remain in the channels, and it shows that the design of a medical device has an important influence on the reprocessing of reusable instruments such as flexible endoscopes.