1722. Evaluation of the Cleaning and Disinfection Process of Endoscopes by ATP (Adenosine Triphosphate) Method at a University Hospital
Session: Poster Abstract Session: Infection Prevention: Infection Prevention in Resource Limited Environments
Saturday, October 10, 2015
Room: Poster Hall
  • Banner Endoscopia FINAL.pdf (3.0 MB)
  • Background: To evaluate the cleaning practices, ATP bioluminescence method which is an enzyme present in all organic matter, when present on surfaces or material indicates the presence of micro-organism. This study will assess the cleaning and disinfection process with the use of ATP on digestive endoscopes.

    Methods: It was an  observational, prospective study where the prior cleaning of the device, mechanical cleaning and disinfection with ortho-phthalaldehyde (OPA) of the digestive endoscopes was observed. Data collection occurred in two phases, through a checklist based on the Standard Operating Procedure for the cleaning and disinfection of the devices and ATP was collected from inside and outside of the devices.

    Results: A total of 119 devices were evaluated with the use of the checklist and ATP collection. One hundred and seven devices were evaluated in the first phase, of these an average of 20% presented an increase in RLU numbers after the completion of the three stages. An average of 23% of the devices showed that the RLU numbers decreased gradually until they reached the indicated limit of 45 RLU. Twelve devices were evaluated in the second phase which four were after the completion of the three stages, the number of RLU decreased gradually, but it remained above the ideal 45 RLU.The checklist showed that the following adjustments were not met: the enzymatic detergent was not changed when it became turbid; the brush used in the device’s lumen was not cleaned before it was tractioned, returning with dirt; OPA redilution due to the improper drying of the device; the device was not rinsed with 70% alcohol after the disinfection and the OPA saturated on the 7thday of use as well, verified by metering tape, indicating replacement of the product which did not occur. Non adjustments reported in the second phase are the same as the first phase.

    Conclusion: The cases observed show weaknesses that indicate the need for a rigorous rehabilitation program in the reprocessing of the devices. Due to the large number of tests performed daily by the endoscopy service, the OPA used for high-level disinfection saturates prematurely, and must be changed according to what the metering tape presents, and the test should be performed for each cycle. The use of ATP may be an option for assess the efficacy of cleaning of endoscopes and could be incorporated routinely.

    Janaina Lacerda, nurse, Hospital Infection Control Commission, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, Brazil, Fernanda Spadao, nurse master, Hospital Infection Control, Hospital das Clinicas de Sao Paulo, Sao Paulo, Brazil, Isabel Oshiro, nurse master, Hospital Infection Control, Hospital das Clinicas, Sao Paulo, Brazil, Eduardo Moura, MD, PhD, Endoscope Service, Hospital das Clinicas da Universidade de São Paulo, Sao Paulo, Brazil and Thais Guimaraes, MD, PhD, Hospital Infection Control, Hospital das Clinicas de Sao Paulo, Sao paulo, Brazil


    J. Lacerda, None

    F. Spadao, None

    I. Oshiro, None

    E. Moura, None

    T. Guimaraes, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.