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Randomized Controlled Trial
. 2024 Oct 26;13(1):128.
doi: 10.1186/s13756-024-01486-2.

A multicenter study comparing the bacterial reduction on flexible endoscopes without a working channel between UV-C light disinfection versus standard endoscope Washer Disinfection: a randomized controlled trial

Yana Halmans  1   2 , D J Wellenstein  3 , M Romijn  3 , A J M van Bemmel  4 , H van den Berge  5 , R A Scheeren  6 , J S Kalpoe  7 , R Klont  8 , J H van Zeijl  9 , H Sikkema  10 , S M Euser  11 , J Hopman  12 , R P Takes  3 , G B van den Broek  3
Affiliations
Randomized Controlled Trial

A multicenter study comparing the bacterial reduction on flexible endoscopes without a working channel between UV-C light disinfection versus standard endoscope Washer Disinfection: a randomized controlled trial

Yana Halmans et al. Antimicrob Resist Infect Control. .

Abstract

Background: To prevent cross-contamination between patients, adequate reprocessing is necessary when using flexible endoscopes (FEs) without a working channel. The current reprocessing process using an Endoscope Washer Disinfector (EWD) is time-consuming. Ultraviolet light group C (UV-C) exposition is an alternative and fast disinfection method and has previously been shown to adequately reduce Colony Forming Units (CFUs) on FEs without a working channel. The objective of this study was to examine whether UV-C light is as effective in reducing CFUs on contaminated FEs without a working channel compared to the EWD.

Methods: FEs without a working channel were collected in three different Otorhinolaryngology Departments in the Netherlands. After pharyngolaryngoscopy, a manual pre-cleaning with tap water was performed and a culture was collected by rolling the distal 8-10 cm of the FE over an agar plate. Next, the FE was randomly assigned to be disinfected with UV-C light (D60) or the EWD (gold standard). After disinfection, another culture was taken. The primary outcome was microbiological contamination, defined by Colony Forming Units (CFU).

Results: 600 FEs without a working channel were randomized. After clinical use and manual pre-cleaning, 239/300 (79.7%) FEs in the UV-C group and 262/300 (87.3%) FEs in the EWD group were contaminated (i.e., > 0 CFU). FEs without culture confirmed contamination were excluded from further analysis. After UV-C light disinfection, 195/239 (81.6%) FEs showed 0 CFUs, compared to 187/262 (71.4%) FEs disinfected with the EWD (p < 0.01). A multivariate logistics regression analysis showed an increased odds of 0 CFUs when using UV-C light (OR 1.83, 95% CI 1.19-2.79; p < 0.01), conditional on participating hospitals and types of FE.

Conclusions: UV-C light disinfection of FEs without a working channel appears more effective in reducing CFUs compared to the EWD and might be a good alternative disinfection method.

Trial registration: Not applicable.

Keywords: Colony forming units; Disinfection; Endoscope Washer Disinfector; Flexible endoscope without a working channel; UV-C; Ultraviolet light C.

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Conflict of interest statement

The authors declare no competing interests.

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