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Question

Most breaches of endoscope disinfection result from inadequate manual cleaning or improper use of disinfectants. This is a description of how a quality assurance program identified rinse water as a source of bacterial contamination and how it facilitated the introduction of a novel means of delivering rinse water of high purity. Methods: Between 1996 and 2001, weekly samples were obtained from accessory and suction channels of endoscopes as well as the internal chambers of automated washing machines. Samples were processed for routine bacterial and mycobacterial culture. Results: Bacteria were isolated in 8.7% of samples collected between 1996 and 1998. Of 36 positive samples, 20 (54%) were Pseudomonas sp. Analysis of rinse water from pipework downstream from filters demonstrated high growth of Pseudomonas sp, suggesting biofilm within piping was contaminating rinse water. A system of hot water flushing of pipework was developed that maintains a temperature above 60°C for 60 minutes on a daily basis. This resulted in a consistently low level of bacterial contamination. Conclusion: This report demonstrates the value of a quality assurance program for endoscope disinfection and shows how rinse water may contaminate disinfected endoscopes. A system of hot water purging of the rinse water delivery system markedly reduces this contamination. (Gastrointest Endosc 2002;56:402-6.)

Answer 1

Most breaches of endoscope disinfection result from inadequate manual cleaning or improper use of disinfectants.

大多数违规内窥镜消毒是由于手工清洗不充分或者不恰当使用消毒剂造成的。

This is a description of how a quality assurance program identified rinse water as a source of bacterial contamination and how it facilitated the introduction of a novel means of delivering rinse water of high purity.

本文将讲述质量保证程序是如何确认冲洗水为细菌污染源以及它如何促进了一种关于传送高纯度冲洗水新方法的引入。

Methods: Between 1996 and 2001, weekly samples were obtained from accessory and suction channels of endoscopes as well as the internal chambers of automated washing machines. Samples were processed for routine bacterial and mycobacterial culture.

研究方法：从1996到2001年，每周从内窥镜附件和抽吸通道以及自动冲洗机械内腔获取样本。样本进行常规细菌及分枝杆菌培养。

Results: Bacteria were isolated in 8.7% of samples collected between 1996 and 1998. Of 36 positive samples, 20 (54%) were Pseudomonas sp. Analysis of rinse water from pipework downstream from filters demonstrated high growth of Pseudomonas sp, suggesting biofilm within piping was contaminating rinse water. A system of hot water flushing of pipework was developed that maintains a temperature above 60°C for 60 minutes on a daily basis. This resulted in a consistently low level of bacterial contamination.

结果：从1996至1998采集的样品中，8.7%分离出细菌。36个阳性样品中，20（54%）个样品是假单胞菌。对过滤器管道下游冲洗水的分析表明了假单胞菌的高生长，其暗示着管道中的生物膜正污染冲洗水。一个每日维持60分钟60摄氏度以上温度的热水管道冲洗系统被开发出来。这将维持一个低水平细菌污染。

Conclusion: This report demonstrates the value of a quality assurance program for endoscope disinfection and shows how rinse water may contaminate disinfected endoscopes. A system of hot water purging of the rinse water delivery system markedly reduces this contamination. (Gastrointest Endosc 2002;56:402-6.)

结论：报告论证了内窥镜质量保证程序的价值并且显示冲洗水如何污染已消毒的内窥镜。对冲洗水传送系统进行热水净化的系统显著地减少这种污染。

Answer 2

最违反内镜消毒导致不足或不当使用手工清洗消毒剂。这是怎样的质量保证程序确定冲洗水细菌污染源的描述以及如何促进提供高纯度的冲洗水的一种新的手段的介绍。方法：在1996和2001，分别从附件和内窥镜抽吸通道获得以及内部室自动洗衣机每周样本。样本进行常规细菌和分枝杆菌培养。结果：在1996和1998之间的样本8.7%细菌分离。36阳性，20（54%），假单胞菌分析冲洗水从管道下游的过滤器表现出假单胞菌高增长，表明生物膜内的管道被污染的水。一个系统的热水冲洗管道工程的开发，保持温度高于60°C 60分钟，每天的基础上。这导致了一贯的低污染水平。结论：该报告显示，内镜消毒质量保证程序的价值和如何冲洗水可能污染消毒内窥镜。一个热水系统冲洗水的输送系统吹扫明显减少这种污染。（胃肠外科杂志2002；56:402-6。）

Answer 3

大多数违反不足的手工清洗或不当使用消毒剂的内窥镜消毒结果从。这是一个描述的质量保证程序是如何确定的冲洗水细菌污染的来源和如何促进引进一种新的手段，提供高纯度的冲洗水。方法：1996年至2001年间，每周样本取自配件和吸气通道的内窥镜室以及内部自动清洗机。样品处理常规细菌和细菌培养。结果：细菌被隔离在1996年和1998年之间收集的样本的8.7％。36个阳性样品中，有20个（54％）分别为假单胞菌。分析冲洗水过滤器的管道下游的假单孢菌表现出高增长，这表明生物膜内管道被污染的冲洗水。热水冲洗管道工程的系统的开发，维护的温度高于60℃下进行60分钟，每天。这导致在一个持续低电平的细菌污染。结论：这份报告显示的质量保证计划的内窥镜消毒和冲洗水可能会污染消毒内窥镜。显着降低系统的冲洗水输送系统中的热水清洗污染（2002年内镜;56:402-6。）

Answer 4

大多数违反内窥镜消毒效果不足或不当使用手工清洗的消毒剂。这是一个描述一个质量保证程序确定冲洗水的一个来源的细菌污染,以及它如何促进引进的一种新的手段提供冲洗水的纯度高。方法:在1996年和2001年之间,每周样本,获得了从附件和抽吸通道的内视镜以及内部钱伯斯的自动洗衣机。样本处理常规细菌和分枝杆菌培养。结果:细菌被隔离在8.7%的样本收集了在1996年和1998年之间。36个阳性样品的,20(54%)。分析的假单胞菌sp冲洗水从管道工程下游过滤器演示了高增长的假单胞菌生物膜内sp,表明管道被污染冲洗水。一个系统的热水冲洗管道工程的开发,维护一个温度高于60°C为每天60分钟。这导致了一个持续低水平的细菌污染。结论:本报告演示了一个质量保证程序的价值为内窥镜消毒,并展示了如何冲洗水会污染内窥镜消毒。一个系统的热水清洗的冲洗水输送系统明显降低这种污染。(Gastrointest .中国内镜杂志2002;56:402-6。)