JZUS - Journal of Zhejiang University SCIENCE

Journal of Zhejiang University SCIENCE B 2016 Vol.17 No.7 P.526-536

A pilot study on using chlorine dioxide gas for disinfection of gastrointestinal endoscopes

Author(s): Ying Yi, Li-mei Hao, Shu-ren Ma, Jin-hui Wu, Tao Wang, Song Lin, Zong-xing Zhang, Jian-cheng Qi
Affiliation(s): Institute of Medical Equipment, Academy of Military Medical Sciences, Tianjin 300161, China; more
Corresponding email(s): qijch@npec.org.cn
Key Words: Bacillus atrophaeus, Chlorine dioxide, Gaseous disinfectant, Gastrointestinal endoscope, Long and narrow channel

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Abstract: Objectives: This pilot study of employing chlorine dioxide (CD) gas to disinfect gastrointestinal endoscopes was conducted to meet the expectations of many endoscopy units in China for a high-efficiency and low-cost disinfectant. Methods: An experimental prototype with an active circulation mode was designed to use CD gas to disinfect gastrointestinal endoscopes. One type of testing device composed of polytetrafluoroethylene (PTFE) tubes (2 m long, inner diameter 1 mm) and bacterial carrier containers was used to simulate the channel of the endoscope. PTFE bacterial carriers inoculated with Bacillus atrophaeus with or without organic burden were used to evaluate the sporicidal activity of CD gas. Factors including exposure dosage, relative humidity (RH), and flow rate (FR) influencing the disinfection effect of CD gas were investigated. Moreover, an autoptic disinfecting test on eight real gastrointestinal endoscopes after clinical use was performed using the experimental prototype. Results: RH, exposure dosage, organic burden, and the FR through the channel significantly (P<0.05) affected the disinfection efficacy of CD gas for a long and narrow lumen. The log reduction increased as FR decreased. Treatment with 4 mg/L CD gas for 30 min at 0.8 L/min FR and 75% RH, resulted in complete inactivation of spores. Furthermore, all eight endoscopes with a maximum colony-forming unit of 915 were completely disinfected. The cost was only 3 CNY (0.46 USD) for each endoscope. Conclusions: The methods and results reported in this study could provide a basis for further studies on using CD gas for the disinfection of endoscopes.

应用二氧化氯气体消毒消化内镜的初步研究

目的：以大型消化内镜中心控制消化内镜消毒成本的需求为牵引，评价二氧化氯气体应用于消化内镜消毒的可行性。
创新点：首次研究了二氧化氯气体对细长管腔内部的消毒效果及其影响因素，并以此为基础研究了采用主动灌流方法的二氧化氯气体消毒消化内镜的原型机。
方法：设计了一种聚四氟乙烯（PTFE）细长管腔实验装置（长2 m，内径1 mm），在其进气端、中部和出气端分别设置PTFE菌片容器。将含有PTFE菌片和细长管腔和置于平皿内的PTFE菌片装载于一种消毒实验原型机中，通过主动灌流使二氧化氯气体流过细长管腔，平皿内的PTFE菌片直接曝露于二氧化氯气体中，分别评价二氧化氯气体对PTFE细长管腔内壁和外壁的消毒效果。以萎缩芽孢杆菌为指示微生物，评价二氧化氯剂量（浓度与时间的乘积）、相对湿度、流过细长管腔的流量及有机干扰物对消毒效果的影响。同时使用实验原型机对8条消化内镜进行了实效验证实验。
结论：实验结果表明，除了相对湿度、二氧化氯剂量和有机干扰物都显著影响二氧化氯气体的消毒效果外（图3、5和6），随着经过细长管腔流量的增大，二氧化氯气体对细长管腔内部的芽孢杀灭对数值有减小的趋势（图4）。按照本文设计的流程，应用实验原型机对8条消化内镜消毒后，未检出存活的微生物。应用二氧化氯气体消毒消化内镜时，其每条内镜的消毒剂成本小于3元人民币。

关键词：二氧化氯；气体消毒剂；消化内镜；细长管腔；萎缩芽孢杆菌

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