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
{"title":"一项多中心研究，比较紫外线-C 光消毒与标准内窥镜清洗消毒对无工作通道的柔性内窥镜的细菌减少效果：随机对照试验。","authors":"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":"10.1186/s13756-024-01486-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515285/pdf/","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"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\":\"10.1186/s13756-024-01486-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>To prevent cross-contamination between patients, adequate reprocessing is necessary when using flexible endoscopes (FEs) without a working channel. 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The primary outcome was microbiological contamination, defined by Colony Forming Units (CFU).</p><p><strong>Results: </strong>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). 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引用次数: 0
摘要
背景：为了防止病人之间的交叉感染，在使用没有工作通道的柔性内窥镜（FE）时，必须进行充分的再处理。目前使用内窥镜清洗消毒器（EWD）进行的再处理过程非常耗时。C 组紫外线（UV-C）照射是一种替代性的快速消毒方法，以前的研究表明它能充分减少无工作通道 FE 上的菌落形成单位（CFU）。本研究的目的是检验与 EWD 相比，紫外线-C 是否能有效减少无工作通道的受污染纤维素上的菌落形成单位：方法： 在荷兰三个不同的耳鼻喉科收集无工作通道的 FE。咽喉内窥镜检查后，用自来水进行人工预清洁，并在琼脂平板上滚动 FE 的远端 8-10 厘米收集培养物。然后，随机分配 FE 用紫外线-C 光（D60）或 EWD（金标准）消毒。消毒后，再进行一次培养。主要结果是微生物污染，以菌落形成单位（CFU）定义：随机抽取了 600 台无工作通道的 FE。经过临床使用和人工预清洁后，紫外线-C 组和 EWD 组分别有 239/300 台（79.7%）和 262/300 台（87.3%）FE 受污染（即 > 0 CFU）。没有经过培养确认污染的 FEs 被排除在进一步分析之外。紫外线-C 光消毒后，195/239（81.6%）个 FE 显示为 0 CFU，而使用 EWD 消毒的 187/262（71.4%）个 FE 显示为 0 CFU（p 结论：紫外线-C 光消毒后，FE 的 CFU 为 0，而使用 EWD 消毒的 187/262（71.4%）个 FE 显示为 0：紫外线-C 光消毒无工作通道的 FE 比 EWD 更能有效减少 CFU，可能是一种很好的替代消毒方法：试验注册：不适用。
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.
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.
期刊介绍：
Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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