Can Whipple's disease be transmitted by gastroscopes?

Infect Control Hosp Epidemiol. 2003 Mar;24(3):191-4. doi: 10.1086/502188.

Abstract

Objective: To determine whether disinfection protocols currently used for gastroscopes are effective against cultures of Tropheryma whipplei.

Design: The bactericidal activity of 2% glutaraldehyde and two peracetic acids on the Twist-Marseille strain of T. whipplei grown in cell monolayers was determined.

Patients: Two patients who were diagnosed as having Whipple's disease 3 years after they had had intestinal biopsies.

Results: The disinfectants reduced bacteria by approximately 2 log to 3 log10 after 5 to 60 minutes of contact.

Conclusion: The bactericidal activity of a disinfectant is usually considered significant if it causes a 5 log10 or greater reduction in viable bacterial titers. Disinfecting gastroscopes with 2% glutaraldehyde or peracetic acids for 20 minutes may be insufficient to prevent transmission of T. whipplei on the instruments or stop false-positive results on polymerase chain reaction.

Publication types

  • Case Reports

MeSH terms

  • Actinomycetales / isolation & purification
  • Actinomycetales / pathogenicity*
  • Adult
  • Aged
  • Disease Transmission, Infectious
  • Disinfectants / pharmacology*
  • Equipment Contamination*
  • Equipment Reuse
  • Female
  • Gastroscopes / microbiology*
  • Glutaral / pharmacology*
  • Humans
  • Male
  • Peracetic Acid / pharmacology*
  • Whipple Disease / etiology*

Substances

  • Disinfectants
  • Peracetic Acid
  • Glutaral