Bacterial contamination of endoscopes used in ambulatory ENT consultation

Introduction: The duration of the official disinfection procedure of a Hopk ins rhinoscope agreed by the hospital hygiene authorities may be a handicap in a busy ENT consultation. A shortened procedure is sometimes used, but w ithout risk assessment. Objective: To determine the risk of contamination of the endoscope used for rhinoscopy after simple manual cleaning with a pad impregnated with a disi nfectant solution (Neosabenyl(R)). Patients and method: In 60 patients undergoing rhinoscopy at our ENT policl inic, a nasal swab as well as the endoscope were examined bacteriologically . The nasal physiological flora and specifically Staphylococcus aureus were semiquantitatively analysed on each specimen. In 50 patients, the rhinosco pes were simply cleaned with an impregnated pad, whereas in 10 patients the official disinfection procedure with glutaraldehyde was applied. Results: 25 out of the 50 endoscopes (50%) which were manually cleaned with the impregnated pad, were still contaminated with bacteria. Among the 12 ( 20%) identified healthy carriers of S. aureus, 7 (58%) showed a rhinoscope still contaminated with S. aureus after cleaning with the pad. The overall risk of contaminating the following patient with S. aureus 14%. None of the 10 endoscopes cleaned and disinfected with glutaraldehyde were contaminate d. Conclusions: Simple manual cleaning and disinfection with an impregnated pa d is insufficient and carries the risk of contaminating the following patie nt. This emphasises the need to follow the recommended cleaning and disinfe ction procedures even in a small or busy practice.