耳鼻咽喉科用内視鏡の洗浄法別の清浄度

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  • ATP Hygiene Monitoring of Flexible Laryngeal Endoscopes with Deferent Cleaning Protocol
  • 耳鼻咽喉科用内視鏡の洗浄法別の清浄度 : ATP法による評価
  • ジビ インコウカヨウ ナイシキョウ ノ センジョウホウ ベツ ノ セイジョウド : ATPホウ ニ ヨル ヒョウカ
  • ―ATP法による評価―

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<p>Background: Flexible laryngeal endoscopes are important tools in the everyday practice of Ear-Nose-Throat (ENT) departments. However, reprocessing procedures for endoscopes without suction or instrument channels (i.e., observation-only scopes) have not yet been standardized in Japan. The reprocessing process of endoscope consists of cleaning, disinfection, rinse, and storage. As for cleaning, the guideline of United Kingdom recommends the scopes to be cleaned using running water and neutral enzymatic detergents. However in Japan, recent questionnaire surveys show that the majority of ENT departments clean the scopes without detergents.</p><p>Therefore, we performed an ATP bioluminescence test for hygiene monitoring of the scopes to confirm the necessity of detergents.</p><p>Materials and methods: In two ENT clinics, 30 laryngoscopes were cleaned using each different protocols as follows.</p><p>Clinic A:</p><p>i.Wipe the insertion parts with alcohol gauze.</p><p>ii.Scrub the insertion parts with a sponge soaked with a neutral detergent for kitchen use.</p><p>iii.Scrub the insertion parts with a sponge soaked with an enzymatic detergent for endoscopes.</p><p>Clinic B:</p><p>i.Soak insertion parts in running water for a few seconds.</p><p>ii.Scrub the insertion parts with a sponge soaked with a neutral detergent for kitchen use.</p><p>iii.Scrub the insertion parts with a sponge soaked with an enzymatic detergent for endoscopes.</p><p>After soaking these scopes in the disinfectant and rinsing them with water, the ATP test was performed using a 3M™ Clean-Trace™ Luminometer. The measured ATP was expressed in relative light units (RLU). The result is defined as “pass” when the measured RLU was 20 and below, “fail” when the RLU was 21 and above. The ratio of pass/fail was compared between the different cleaning protocols.</p><p>Results: The ratio of pass/fail was as follows.</p><p>Clinic A: alcohol gauze, 14/18 (pass: 43.8%), neutral detergent for kitchen use, 24/6 (80%), enzymatic detergent for endoscopes, 29/1 (96.6%).</p><p>Clinic B: Running water, 21/9 (70%), neutral detergent for kitchen use: 25/5 (83%), enzymatic detergent for endoscopes, less soaking time 19/11 (63.3%), enough soaking time 30/0 (100%).</p><p>Conclusion: ATP hygiene monitoring shows, that for cleaning of laryngeal endoscopes, it is necessary to use enzymatic detergents with sufficient soaking time. The detergent for kitchen use is inadequate for cleaning endoscopes.</p>

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