Management and microbial monitoring of final rinse water for flexible endoscopes in 290 hospitals in Jiangsu Province, China: a multicenter cross-sectional study

Abstract Background There is a lack of a universally accepted standard or guideline for the frequency of disinfection in purified water pipelines. Furthermore, there is no standardized method for detecting microorganisms in the final rinse water utilized for endoscope cleaning.This study aims to exa...

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Main Authors: Zhanjie Li, Bo Liu, Qingtang Zhu, Zijun Ge, Feng Zang, Wensen Chen, Yongxiang Zhang, Xiafen Ding, Jing Ding, Weihong Zhang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Antimicrobial Resistance and Infection Control
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Online Access:https://doi.org/10.1186/s13756-025-01560-3
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author Zhanjie Li
Bo Liu
Qingtang Zhu
Zijun Ge
Feng Zang
Wensen Chen
Yongxiang Zhang
Xiafen Ding
Jing Ding
Weihong Zhang
author_facet Zhanjie Li
Bo Liu
Qingtang Zhu
Zijun Ge
Feng Zang
Wensen Chen
Yongxiang Zhang
Xiafen Ding
Jing Ding
Weihong Zhang
author_sort Zhanjie Li
collection DOAJ
description Abstract Background There is a lack of a universally accepted standard or guideline for the frequency of disinfection in purified water pipelines. Furthermore, there is no standardized method for detecting microorganisms in the final rinse water utilized for endoscope cleaning.This study aims to examine the current management and microbial monitoring practices concerning the final rinse water used for flexible endoscope cleaning in medical institutions. Methods A questionnaire was designed using a convenience sampling method to gather data on the maintenance and microbial monitoring of final rinse water for flexible endoscopes in 290 medical institutions across Jiangsu Province, China. Results Purified water is used for endoscope rinsing by 93.45% of institutions, with 78.62% employing centralized water supply. Membrane filtration devices at the terminal are installed by 82.07%, mainly with a 0.2μm pore size (76.47%), and are replaced quarterly (32.77%). Disinfection devices are present at 52.76% of terminals, with varied disinfection frequencies; chlorine-containing disinfectants (48.15%) and peracetic acid (34.92%) are predominant. Inadequate disinfection, filter membrane neglect, sampling contamination, and biofilm formation are identified as reasons for non-compliant final rinse water. Actions include filter replacement, pipeline disinfection, and flushing. Microbial mornitoring occurs quarterly (70.96%), with faucet outlets as primary sampling sites. Standards are based on 10cfu/100ml (87.58%), using membrane filtration (40.81%) and nutrient agar plates (82.72%). A cultivation period of 2 days predominated (72.43%), with a temperature range of 35-37°C (76.47%). Conclusion While purified water and terminal filters are common for final rinsing of endoscopes, there is variation in maintenance and supply line disinfection. Current microbiological methods’ reliability is considered low, necessitating further research to establish unified standards for effective endoscope final rinse water management and monitoring.
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spelling doaj-art-c80aedac1d9247b3ad2680a71778ee6f2025-08-20T02:10:54ZengBMCAntimicrobial Resistance and Infection Control2047-29942025-04-0114111110.1186/s13756-025-01560-3Management and microbial monitoring of final rinse water for flexible endoscopes in 290 hospitals in Jiangsu Province, China: a multicenter cross-sectional studyZhanjie Li0Bo Liu1Qingtang Zhu2Zijun Ge3Feng Zang4Wensen Chen5Yongxiang Zhang6Xiafen Ding7Jing Ding8Weihong Zhang9Department of Infection Control, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Infection Control, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Infection Control, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Infection Control, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Infection Control, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Infection Control, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Infection Control, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Endoscopy Center, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Endoscopy Center, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Infection Control, The First Affiliated Hospital of Nanjing Medical UniversityAbstract Background There is a lack of a universally accepted standard or guideline for the frequency of disinfection in purified water pipelines. Furthermore, there is no standardized method for detecting microorganisms in the final rinse water utilized for endoscope cleaning.This study aims to examine the current management and microbial monitoring practices concerning the final rinse water used for flexible endoscope cleaning in medical institutions. Methods A questionnaire was designed using a convenience sampling method to gather data on the maintenance and microbial monitoring of final rinse water for flexible endoscopes in 290 medical institutions across Jiangsu Province, China. Results Purified water is used for endoscope rinsing by 93.45% of institutions, with 78.62% employing centralized water supply. Membrane filtration devices at the terminal are installed by 82.07%, mainly with a 0.2μm pore size (76.47%), and are replaced quarterly (32.77%). Disinfection devices are present at 52.76% of terminals, with varied disinfection frequencies; chlorine-containing disinfectants (48.15%) and peracetic acid (34.92%) are predominant. Inadequate disinfection, filter membrane neglect, sampling contamination, and biofilm formation are identified as reasons for non-compliant final rinse water. Actions include filter replacement, pipeline disinfection, and flushing. Microbial mornitoring occurs quarterly (70.96%), with faucet outlets as primary sampling sites. Standards are based on 10cfu/100ml (87.58%), using membrane filtration (40.81%) and nutrient agar plates (82.72%). A cultivation period of 2 days predominated (72.43%), with a temperature range of 35-37°C (76.47%). Conclusion While purified water and terminal filters are common for final rinsing of endoscopes, there is variation in maintenance and supply line disinfection. Current microbiological methods’ reliability is considered low, necessitating further research to establish unified standards for effective endoscope final rinse water management and monitoring.https://doi.org/10.1186/s13756-025-01560-3Flexible endoscopyFinal rinse waterManagementMicrobial monitoring
spellingShingle Zhanjie Li
Bo Liu
Qingtang Zhu
Zijun Ge
Feng Zang
Wensen Chen
Yongxiang Zhang
Xiafen Ding
Jing Ding
Weihong Zhang
Management and microbial monitoring of final rinse water for flexible endoscopes in 290 hospitals in Jiangsu Province, China: a multicenter cross-sectional study
Antimicrobial Resistance and Infection Control
Flexible endoscopy
Final rinse water
Management
Microbial monitoring
title Management and microbial monitoring of final rinse water for flexible endoscopes in 290 hospitals in Jiangsu Province, China: a multicenter cross-sectional study
title_full Management and microbial monitoring of final rinse water for flexible endoscopes in 290 hospitals in Jiangsu Province, China: a multicenter cross-sectional study
title_fullStr Management and microbial monitoring of final rinse water for flexible endoscopes in 290 hospitals in Jiangsu Province, China: a multicenter cross-sectional study
title_full_unstemmed Management and microbial monitoring of final rinse water for flexible endoscopes in 290 hospitals in Jiangsu Province, China: a multicenter cross-sectional study
title_short Management and microbial monitoring of final rinse water for flexible endoscopes in 290 hospitals in Jiangsu Province, China: a multicenter cross-sectional study
title_sort management and microbial monitoring of final rinse water for flexible endoscopes in 290 hospitals in jiangsu province china a multicenter cross sectional study
topic Flexible endoscopy
Final rinse water
Management
Microbial monitoring
url https://doi.org/10.1186/s13756-025-01560-3
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