- Design
- Single-centre, prospective, randomised microbiological surveillance study
- Population
- 222 GI endoscope-use episodes
- Primary outcome
- Post-reprocessing surveillance success
- Effect
- 90.5% (acidic electrolysed water), 95.9% (ozonated water), 95.9% (peracetic acid)
A single-centre study randomised 222 uses of upper and lower GI endoscopes to automated reprocessing with strongly acidic electrolysed water, ozonated water or peracetic acid, after standard pre-cleaning and manual cleaning, then cultured internal and external sites.
Surveillance success — 20 or fewer colony-forming units at every site and no indicator organisms — was 90.5% with acidic electrolysed water and 95.9% with both ozonated water and peracetic acid. Neither alternative met a strict non-inferiority margin against peracetic acid. Repeated failures clustered in individual endoscopes.
The practical lesson is less about the disinfectant than about the scope: when one instrument repeatedly fails, it needs removal and inspection rather than another cycle.
- Run routine microbiological surveillance of reprocessed endoscopes.
- Track results by individual scope; repeated failures pointed to specific instruments.
- Withdraw a scope that repeatedly fails cultures for inspection and repair.
- Meticulous manual cleaning before automated reprocessing remains essential.
Why it matters
Endoscope-transmitted infections are rare but serious, and surveillance only helps if failures are acted on.
Don't overread it
This measured microbial counts, not patient infections, in an exploratory single-centre study.
The statistics, in plain English
The risk difference of −5.4 points for electrolysed water had an interval from −14.6 to 3.2, so it could be meaningfully worse than peracetic acid or about the same.
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