In this study, researchers sought to determine whether endoscopes serve as a reservoir for Helicobacter pylori. They also investigated whether the technique currently recommended for manual cleaning and disinfection of the instruments removes the risk of H. pylori transmission.
The team's findings are published in the April issue of Endoscopy.
|1 of the 128 samples was contaminated with H. pylori, even after routine manual cleaning and disinfection.|
They performed a prospective study with 400 patients who were undergoing upper gastrointestinal endoscopy for routine clinical indications.
The team determined each patient's H. pylori status using a urea detection system (HUT) and culture.
In addition, H. pylori contamination was assayed by culturing rinsing samples from the endoscopes both before and after manual cleaning and disinfection.
The team also assayed gastric biopsies using rapid urease testing of 2 antral and gastric body biopsies and cultures.
The research team found that of the 400 patients included in this study, 128 were found to be H. pylori-positive using HUT testing.
The team found that of the endoscopes used in H. pylori-positive patients, 54 of the 128 rinsing samples were contaminated before cleaning and disinfection.
Furthermore, 1 of the 128 rinsing samples was found to be contaminated with H. pylori even after routine manual cleaning and disinfection. This indicated that cleaning and disinfection procedures may be insufficient to completely eradicate H. pylori from endoscopes.
The team observed no seroconversion during serological follow-up in the patient who had been examined with an endoscope contaminated with H. pylori.
The patient was still found to be seronegative 5 months after inoculation.
Dr Nürnberg's team concluded, "Endoscopes are frequently contaminated with H. pylori immediately after gastroduodenal endoscopy in H. pylori-infected patients".
"Iatrogenic transmission is possible, as H. pylori can survive manual cleaning and disinfection…particularly when there is ineffective cleaning before disinfection".