Highlights
- •Flexible endoscopes had residual fluid after reprocessing and drying.
- •Fluid resembled simethicone used to reduce foam and bubbles.
- •Photographs and laboratory analysis found that the fluid contained simethicone.
- •Residual fluid containing simethicone may impact reprocessing effectiveness.
Background
During a study designed to assess endoscope reprocessing effectiveness, a borescope
was used to examine lumens and ports. Cloudy, white, viscous fluid was observed inside
fully reprocessed gastroscopes and colonoscopes. This fluid resembled simethicone,
which is commonly administered to reduce foam and bubbles that impede visualization
during gastrointestinal endoscopy. This article describes methods used to determine
whether the observed fluid contained simethicone.
Methods
Photographs of residual fluid were taken using a borescope. Sterile cotton-tipped
swabs were used to collect samples of fluid observed in 3 endoscope ports. Samples
were evaluated using Fourier transform infrared spectroscopy (FTIR)–attenuated total
reflection analysis.
Results
Residual fluid was observed inside 19 of 20 endoscopes. Fluid photographed in 8 endoscopes
resembled simethicone solutions. FTIR analysis confirmed the presence of simethicone
in 2 endoscopes.
Conclusions
Fluid containing simethicone remained inside endoscopes despite reprocessing. Simethicone
is an inert, hydrophobic substance that may reduce reprocessing effectiveness. Simethicone
solutions commonly contain sugars and thickeners, which may contribute to microbial
growth and biofilm development. Studies are needed to assess the prevalence of residual
moisture and simethicone in endoscopes and determine the impact on reprocessing effectiveness.
We recommend minimizing the use of simethicone pending further research into its safety.
Key Words
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Article info
Publication history
Published online: August 03, 2016
Footnotes
Funding/Support: Supported by 3M Company, Medivators Incorporated, and HealthMark Industries, which provided study materials and funding for this study. The University of Minnesota Health and Ofstead & Associates, Inc, also provided additional research support.
Disclaimer: The sponsors were not present during endoscope examinations and sample collection, and they did not review this manuscript prior to submission. The physicians and staff at the University of Minnesota received no monetary compensation for participating in the research or writing of this manuscript.
Conflicts of Interest: C.L.O. is employed by Ofstead & Associates, Inc, which has received research funding and speaking honoraria related to infection prevention from STERIS Corporation, 3M Company, Medivators, HealthMark Industries, Boston Scientific, invendo medical, and Advanced Sterilization Products. H.P.W., E.A.J., and O.L.H. are employed by Ofstead & Associates, Inc, and have no other disclosures to report. M.J.S. and T.J.M. have no disclosures to report.
Identification
Copyright
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
