Disinfection and endoscopy: Summary and recommendations

This working party was convened by the organizers of the World Congresses of Gastroenterology, Sydney 1990. Its remit was to produce a report on disinfection in endoscopy. Endoscopy plays an essential role in the management of gastrointestinal disorders; its benefits far outweigh the occasional complications which arise. Nevertheless, case reports and surveys performed over a 20-year period confirm that endoscopic procedures do occasionally cause cross-infection and the current epidemic with human immunodeficiency virus (HIV) has highlighted the potential for more serious disease transmission if suitable precautionary measures are not generally applied in endoscopy practice. Contaminated equipment may cause infection in three ways: transmission of pathogenic organisms from one patient to another, the commonest example being Salmonellosis; transmission of infection such as hepatitis B (HBV) from patient to staff by needle-stick injury; and introduction of opportunistic organisms which colonize endoscopic and ancillary equipment on storage. This may cause focal sepsis or septicaemia, particularly in the immunocompromised, or cholangitis and pancreatic sepsis following endoscopic retrograde cholangiopancreatography (ERCP). These risks can be eliminated by the use of effective cleaning and disinfection techniques, by providing suitable staff training and by paying attention to endoscopy room procedures. Both HBV and HIV are inactivated by all currently accepted disinfecting or sterilizing procedures.(ABSTRACT TRUNCATED AT 250 WORDS)