Microbial bioburden in endoscope reprocessing and an in-use evaluation of the high-level disinfection capabilities of Cidex PA.

Most endoscopy clinics use 2% glutaraldehyde as a high-level disinfectant for reprocessing flexible endoscopes. However, even with contact times greater than 30 minutes, survival of organisms has been documented. We compared the high-level disinfection capabilities of glutaraldehyde (45-minute immersion) with a new peracetic acid germicide (20- to 25-minute immersion). Channels, valve housings, and outer sheaths were sampled to quantify bioburden levels after a patient procedure, after manual cleaning, and after disinfection. Total mean bioburden after clinical use was greater than 6 log10 colony-forming units (CFU). Manual cleaning reduced the bioburden by means of 4.7 log10 CFU (gastroscopes) and 6.2 log10 CFU (colonoscopes). High-level disinfection with the new product was achieved in five of six (product stressed by EPA Reuse Test) and 7 of 10 (product stressed by dilution and organic load) successfully disinfected endoscopes, whereas glutaraldehyde achieved it in 4 of 10 (product stressed by dilution and organic load). We conclude that the new peracetic acid product (20- and 25-minute contact time) is at least as effective as glutaraldehyde (45-minute contact time) for reducing the bioburden of vegetative aerobic organisms in endoscopes.     

Quality of life in adolescents with chronic pain in the head or at other locations

The differences in quality of life and school absence were studied in one hundred adolescents from the open population who had reported chronic headache or chronic, physically unexplained, pain at other locations. The adolescents kept a 3-week diary about their pain and completed a quality of life questionnaire. Of all chronic pain sufferers in this study, it was the adolescents with headache who showed the least frequent pain, but they reported the poorest quality of life and the largest school absence due to their pain. Adolescents with headache or adolescents with back pain showed the highest negative correlations between pain parameters and quality of life. Headache sufferers showed highly negative relationships between pain parameters and most quality of life domains (median r = -0.46), and only in headache sufferers did this involve both intensity and frequency of pain. Qualitative studies are needed to reveal the background to these differences.