Endoscope decontamination: automated vs. manual.

Automated endoscope washer disinfectors are widely used for the decontamination of flexible endoscopes. They are more effective than manual techniques and reduce the likelihood of skin contact with irritant disinfectants. Suitable machines are those which effectively clean, disinfect and rinse all channels and external surfaces without damaging the instrument. If glutaraldehyde is used, fumes should be removed or contained to protect endoscopy and processing staff. Machines should also be equipped with a self-disinfect facility and the rinse water should be of a suitable microbiological quality for the instruments processed, i.e. bacteria-free (sterile or filtered) water should be used for bronchoscopes and all invasive endoscopes. The choice of machine and cycle will depend on the following: whether a mobile or fixed unit is required; the type of disinfectant used; instrument throughput; and whether or not it is necessary to process more than one endoscope at a time. Purchasers are advised to request independent test reports which substantiate manufacturers' claims.