Freely accessible endoscope channels improve efficacy of cleaning

Background and Study Aims: Inadequate cleaning and disinfection of medical devices, including flexible endoscopes, can result in the transmission of m icro-organisms to patients. The aim of this study was to investigate the in fluence of the design of medical devices on the efficacy of manual cleaning of endoscope channels. Materials and Methods: The investigation was carried out using four endosco pes (two duodenoscopes and two gastroscopes), The air/water channels of one duodenoscope and one gastroscope were freely accessible and could be brush ed. The instrumentation and the air/water channels were contaminated with b lood containing Enterococcus faecium as a test organism, After manual clean ing of the channels by flushing and, where possible, brushing, the recovery rates for the test organism were studied. Results: The comparable rates for recovery of the test organism after clean ing of the instrumentation channels proved that the method used was reprodu cible. With regard to the air/water channels, the rate of micro-organisms i n the cleaning solution recovered after flushing alone was a maximum of 3% relative to the rate detected after brushing and flushing. Conclusions: The data collected in the study show that only flushing channe ls that are not freely accessible resulted in significantly lower (P < 0.00 1) recovery rates for the test organism. In practice, this means that conta mination may remain in the channels, and it shows that the design of a medi cal device has an important influence on the reprocessing of reusable instr uments such as flexible endoscopes.