TY - JOUR
T1 - Evaluation of plasma activated liquids for the elimination of mixed species biofilms within endoscopic working channels
AU - Northage, Naomi
AU - Shvalya, Vasyl
AU - Modic, Martina
AU - Juergens, Thorsten
AU - Eschborn, Sascha
AU - Horsburgh, Malcolm J.
AU - Walsh, James L.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/11/19
Y1 - 2024/11/19
N2 - The use of reusable flexible endoscopes has increased dramatically over the past decade, however despite improvements in endoscope reprocessing, the continued emergence of endoscopy-associated outbreaks as a result of multi-drug resistant bacteria has highlighted the need for a new approach to disinfection. Here, the use of plasma activated liquids (PALs) for the elimination of mixed species biofilm contamination within the working channels of endoscopes was evaluated. Cold atmospheric pressure plasma was used to chemically activate water and a commercially available pH buffered peracetic acid to create PALs. Polytetrafluoroethylene endoscope surrogate test pieces were contaminated with clinically relevant mixed species biofilms. The efficacy of PALs for the decontamination of narrow lumens was compared against the commercial disinfectant. Plasma activation was found to increase the antibiofilm capabilities of pH buffered peracetic acid by introducing reactive chemical species into the solution. Disinfection of endoscopic test pieces with plasma activated disinfectant (PAD) resulted in a 7.30 log10 reduction of biofilm contamination in 5 min, surpassing the 4.39 log10 reduction observed with the currently used endoscope disinfection method. PAD also resulted in reduced regrowth and recolonization of the surface of the endoscopic test pieces. Minimal changes to the surface morphology and composition were observed following exposure to PAD in comparison to the commercial disinfectant, suggesting the developed approach is no more aggressive than current disinfection approaches.
AB - The use of reusable flexible endoscopes has increased dramatically over the past decade, however despite improvements in endoscope reprocessing, the continued emergence of endoscopy-associated outbreaks as a result of multi-drug resistant bacteria has highlighted the need for a new approach to disinfection. Here, the use of plasma activated liquids (PALs) for the elimination of mixed species biofilm contamination within the working channels of endoscopes was evaluated. Cold atmospheric pressure plasma was used to chemically activate water and a commercially available pH buffered peracetic acid to create PALs. Polytetrafluoroethylene endoscope surrogate test pieces were contaminated with clinically relevant mixed species biofilms. The efficacy of PALs for the decontamination of narrow lumens was compared against the commercial disinfectant. Plasma activation was found to increase the antibiofilm capabilities of pH buffered peracetic acid by introducing reactive chemical species into the solution. Disinfection of endoscopic test pieces with plasma activated disinfectant (PAD) resulted in a 7.30 log10 reduction of biofilm contamination in 5 min, surpassing the 4.39 log10 reduction observed with the currently used endoscope disinfection method. PAD also resulted in reduced regrowth and recolonization of the surface of the endoscopic test pieces. Minimal changes to the surface morphology and composition were observed following exposure to PAD in comparison to the commercial disinfectant, suggesting the developed approach is no more aggressive than current disinfection approaches.
KW - Cold atmospheric plasma
KW - Endoscope reprocessing
KW - Flexible endoscopes
KW - High level disinfection
KW - Plasma activated liquids
KW - Reactive oxygen and nitrogen species
UR - http://www.scopus.com/inward/record.url?scp=85209408306&partnerID=8YFLogxK
U2 - 10.1038/s41598-024-79276-4
DO - 10.1038/s41598-024-79276-4
M3 - Article
C2 - 39562626
AN - SCOPUS:85209408306
SN - 2045-2322
VL - 14
JO - Scientific reports
JF - Scientific reports
IS - 1
M1 - 28593
ER -