Cm. Wilcox et al., USE OF STERILE COMPARED WITH TAP WATER IN GASTROINTESTINAL ENDOSCOPICPROCEDURES, American journal of infection control, 24(5), 1996, pp. 407-410
Background: Because of the concern for infection risk, use of sterile
water has been recommended in the water bottle for endoscopic equipmen
t, although studies evaluating prevalence of contamination of the wate
r bottle with clinical outcomes have not been performed. Methods: Over
a 12-week period in three endoscopy rooms at a university leaching ho
spital, the water bottles were filled on a weekly schedule with either
sterile (one room) or tap water. The water bottles were sterilized on
a weekly basis with an automated endoscope washer. At the end of each
week, an aliquot of the remaining water was transferred to a sterile
container, and quantitative cultures for aerobic and facultative anaer
obic bacteria were performed by use of a 0.01 ml calibrated loop accor
ding to standard protocols. Cultures were performed in a blinded fashi
on without knowledge of the water source. Follow-up was performed on a
ll patients within 2 weeks of the procedure to determine any potential
infectious complications. Results: During the study period, 437 proce
dures were performed (203 endoscopy, 68 colonoscopy, 38 sigmoidoscopy,
128 endoscopic retrograde cholangiopancreatography). Of a total of 36
cultures (12 sterile), the results of nine (25%) were positive, inclu
ding three bottles where sterile water was used. Bacterial isolates in
cluded five Flavobacterium sp., four Acinetobacter sp., two Pseudomona
s sp., and one Stenotrophomonas maltophilia. Colony counts ranged from
900 to more than 10,000 per ml. On follow-up no patient had developme
nt of a clinical infection from any of these organisms. Conclusions: B
acterial growth in the water bottle was infrequent, consisted predomin
antly of nonpathogenic organisms, and was not associated with clinical
complications. Our pilot study suggests that the use of lap water as
compared with sterile water may be practical, as well as provide cost
savings.