Study On The Efficacy Of Peracetic Acid Disinfectant (Type ?) On Gastrointestinal Endoscopy Disinfection

BackgroundWith the development of medicine,the essential role of gastrointestinal endoscopy in the diagnosis and treatment of digestive diseases has been widely recognized.It is reported that more than 10 million cases of endoscopic examinations and treatments each year have been carried out in the United States.However,gastrointestinal endoscopes are invasive instruments with sophisticated structure,which are at increased risks of developing nosocomial infections and virus transmission due to non-standard operations during cleaning and disinfection procedures and improper use of disinfectants.A number of studies have shown that during the diagnostic and therapeutic interventions,the incidence rate of bacterial cross-infection and transmission of virus like hepatitis B virus(HBV)or hepatitis C virus(HCV)increase due to non-standard reprocessing procedures.It is particularly important to perform endoscopic disinfection and avoid cross-infection in hospitals due to the association between unqualified disinfection of endoscopes and nosocomial infection.2%glutaraldehyde disinfectant is the most widely used disinfectant at present,however,with the long-term clinical application and research,many non-negligible negative effects have been recognized.The 2016 version of "Regulation for cleaning and disinfection technique of flexible endoscope"and several research reports indicated that the glutaraldehyde disinfectant was irritant and sensitive,especially on skin,eyes,otolaryngology and respiratory mucosa,causing dermatitis,conjunctivitis,occupational asthma,even systemic toxicity.In addition,residual glutaraldehyde after disinfection can lead to chemical colitis,abdominal cramps,and even hemorrhagic diarrhea.Glutaraldehyde disinfectant is easy to form induration on the endoscope and disinfection equipment,which is difficult to be removed,affecting the lifetime of endoscopic instruments.Therefore,in recent years,more and more experts have suggested to find safer disinfectants and replace it.Peracetic acid is a strong oxidant with the ability to kill microorganisms such as bacteria,fungi,and viruses by reacting with enzymes,amino acids,nucleic acids and cleavaging DNA bases and double chains,widely used in surgical instrument sterilization,pharmaceutical and food manufacturing.In order to find a more efficient and safe disinfectant and to ensure the disinfection and safety of the digestive endoscope,this experimental study was carried out.ObjectiveIn this experiment,peracetic acid disinfectant(Type ?)was compared with 2%glutaraldehyde through measuring bacteria and virus before and after disinfection,as well as residual bacteria on the surface of endoscopic biopsy channels after the disinfection of peracetic acid,providing a theoretical basis for clinical practice.MethodEndoscopes were disinfected respectively by 2%glutaraldehyde and peracetic acid disinfectant(Type ?)according to the procedures stipulated by the 2016 version of "Regulation for cleaning and disinfection technique of flexible endoscope",then samples were collected through biopsy channel at the specified steps.The bacterial count and pathogenic bacteria of these samples were detected,and hepatitis B virus surface antigen(HBsAg),HCV antibody and Treponemiapallidum antibody(TP-Ab)were detected by chemiluminesent microparticle immunoassay(CMIA)in peracetic acid disinfectant(Type ?)group.The samples from peracetic acid disinfectant(Type?)group were collected for 5 days continuously,and then only the bacterial count and pathogenic bacteria of these samples were detected.Statistical analysis was carried out by ?2 test or Fisher's exact test,paired t-test and two-factor repeat analysis of variance using SPSS version 22.0.Whether the p value was statistically significant difference was determined by 95%CI range.ResultAfter disinfection,the bacterial count was significantly reduced by both 2%glutaraldehyde and peracetic acid disinfectant(Type ?)(p<0.05).In terms of the qualified rate and total qualified rate,the peracetic acid group(97.83%,98.36%)was higher than the glutaraldehyde group(92.86%and 94.44%respectively).After disinfecting by peracetic acid disinfectant(Type ?)HBsAg,anti-HCV and TP-Ab were negative.In term of colonies number detected for 5 days continuously,there was no significant difference at different collection steps and sampling days(p>0.05).ConclusionPeracetic acid disinfectant(Type ?)can be well applied to clinical with meeting the standard of high-level disinfection for gastrointestinal endoscopy,and after the disinfection of peracetic acid disinfectant(Type ?),there was no obvious bacterial residue in the biopsy channel.