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BACKGROUND/OBJECTIVE: Adequate cleaning plays a critical and integral part in the efficacy of endoscope reprocessing. There are always questions regarding proper cleaning and the existence of organic residues on cleaned endoscopes. Visual inspection, which is the recommended method, is difficult because the test endoscopes are solid black in color and visually inspecting tiny lumens is virtually impossible. This paper reports a study that was performed to evaluate the effectiveness of endoscope cleaning in an automated endoscope reprocessor utilizing artificial soil and ninhydrin spray reagent, a chemical that stains proteins/amino acids. METHODS: The bodies and biopsy lumens of three types of flexible endoscopes were contaminated with artificial soils. Three separate artificial soils were made using a combination of adhesive substances and proteins including glycerol, serum, hog mucin, wheat flour, and egg. The endoscopes contaminated with artificial soil were allowed to dry at ambient temperature for 2 hours and then processed through a cleaning cycle with an enzymatic detergent in an automated endoscope reprocessor (AER). After the cleaning cycle, the endoscope surfaces were wiped and the biopsy lumens were brushed with sterile absorbent-towel pieces. The towel pieces were first inspected visually for evidence of organic soil followed by treatment with ninhydrin spray reagent to detect any residual protein /amino acids, as indicated by the presence of purple color. RESULTS: Tests showed that the AER's cleaning cycle with an enzymatic detergent removed the organic load from the biopsy lumens and surfaces of the flexible endoscopes tested. CONCLUSION: Using ninhydrin spray reagent to detect organic residues in flexible endoscopes was found to be an effective method to monitor endoscope cleaning. |
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