Abstract:
OBJECTIVE To investigate the quality and management of cleaning and disinfection of soft endoscopes in Wuxi hospitals, to analyze the existing problems and put forward suggestions for improvement, and to provide references for endoscope-related infection in hospitals.
METHODS From Sep. to Nov. 2024, the cleaning and disinfection status and managements of soft endoscopes were investigated. Endoscopes were sampling for adenosine triphosphate (ATP) biofluorescence and bacteriological testing; final rinsing water, hands of disinfection personnels, disinfectants and environmental surfaces were collected for bacteriological testing.
RESULTS Totally 68.18% of hospitals performed daily leaks test before cleaning, and 81.82% used o-Phthalaldehyde; 81.25% of hospitals used peracetic acid in endoscopy sterilization, with only 1 hospital using glutaraldehyde. Totally 86.36% of hospitals monitored the concentration of disinfectants before daily works. There were statistically significant differences in full-time, education levels, age and working experience of personnels among different levels of hospitals (P < 0.05). The pass rate of the 60 endoscope ATP specimens was 88.33%, and there were statistically significant differences in the pass rate of gastroscopic ATP testing among different levels of hospitals (P= 0.032). The qualification status differed significantly in the types of endoscopes and the time length of enzyme washing (P < 0.05). All 60 endoscopic bacteriological samples were qualified, while 141 environmental bacteriological samples were with a pass rate of 94.33%. Unqualified samples were mainly for disinfection personnel′s hands, rinse tank faucets, final rinse water. Rolestonella piercei and Staphylococcus wolffii were detected in one failed final rinse water by mass spectrometry.
CONCLUSIONS The overall equipment and staffing of the surveyed endoscope centers (rooms) basically meet operational needs and generally follow endoscope cleaning and disinfection guidelines. However, there are still deficiencies in cleaning and disinfection management, equipment maintenance, disinfectant concentration monitoring and personnel training. Further efforts are needed to strengthen the disinfection quality monitoring of endoscope and related factors.