Biofilms develop inside
endoscope channels even when valid
endoscope reprocessing protocols are applied. The use of an efficient
biocide is not sufficient if the channels are not cleaned thoroughly prior to disinfection. This study compared new anti-biofilm combinations of detachment promoting agents with a cleaning product in current use. Tests were performed using
Teflon tubing and a contamination device that reproduces conditions that are prevalent during endoscopy. Products were subjected to static+brushing or dynamic treatments, and their ability to remove a preformed biofilm was assessed. The residual biofilm
after treatment was assessed and compared with untreated controls. The percentage of surface covered by biofilm was measured after staining with
crystal violet. Culturable bacteria levels were determined by plating the bacteria scraped from the tubing surface and counting the colony-forming units (CFU). Further tests were performed on actual
endoscopes that had been contaminated artificially. Biofilm removal was confirmed by scanning electron microscopy. This study showed that the new anti-biofilm products prevented the build-up of biofilm and removed a mature biofilm (approximately 10(8)CFU/cm(2)), whereas protocols based on
detergent-
disinfectants containing
quaternary ammonium compounds showed low efficacy as these protocols and products fixed the biofilm on the
endoscope surfaces. The new procedure and agents represent a new approach to biofilm control that may improve the efficacy of
endoscope reprocessing, and reduce the risk of transmitting
infections.